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Mobile app that replaces the pill approved as contraceptive - can you trust it?

The Telegraph logo The Telegraph 09/02/2017 By Cara McGoogan
Mobile app that replaces the pill approved as contraceptive - can you trust it?

A mobile app has been granted medical approval to be used as a contraceptive in the European Union in a breakthrough that could spell the end for hormonal and intrusive birth control measures.

Natural Cycles is a fertility tracking app that tells users whether they're fertile or not by monitoring their temperature. Used by 150,000 around the world, it has received approval from Tuv Sud, a certification body, to be marketed as a medical device for contraception. The stamp by a body within the European Economic Area approves it for use in the UK.

It is the first time that such technology has been classified as being effective in preventing pregnancy. Similar to the natural planning or "rhythm" method, the app tells users how fertile they are on a given day and says whether they can or cannot have sex without being at risk of pregnancy. 

Natural planning

The Natural Cycles app  works in conjunction with a thermometer and algorithm to determine whether users are fertile on any given day. For it to work accurately, women must take their temperature every morning and enter it into the app. Because of minor temperature fluctuations after ovulation, which increase by up to 0.45C, the app can tell the days users will be fertile. 

It was created by Nobel Prize winning physicist Dr Berglund and her husband Dr Raoul Scherwitzl who used their mathematical backgrounds to design an algorithm that can learn individual women's temperature fluctuations over time.  

Women using Natural Cycles log their temperature into the app every morningCredit: Natural Cycles

Natural Cycles, which launched in the UK in 2016, gives users red and green days that indicate whether they're safe to have unprotected sex - if using it as a contraceptive. For women with a regular 28 day cycle the app will on average advise against sex on days six to 16. 

Fertility experts warned that medical approval doesn't guarantee that the app will prevent pregnancy, and called for further testing. 

"Women who wish to use fertility awareness-based contraception are advised to receive guidance from a qualified teacher to learn how to effectively monitor the different indicators," said Diana Mansour, vice president of clinical quality at the Faculty of Sexual and Reproductive Health of the Royal College of Obstetricians and Gynaecologists.

"As well as requiring regular, consistent monitoring of fertility indicators, all fertility awareness-based contraceptive methods rely on women abstaining from sex or using condoms correctly during the fertile window. If women don’t follow these instructions perfectly, their risk of pregnancy greatly increases."

Dr Richard Anderson, a specialist in reproductive health at the University of Edinburgh, said: "The issue will be how confident users can be. The pregnancy rate is seven per 100 women in a year, so certainly not as good as the best current methods.

"But many women will like not taking hormones, as well as being in control and more aware of their bodies."

By comparison, one in 100 women get pregnant a year when using other popular methods of contraception such as the pill, implant, IUD and patch. According to the NHS, one in 100 women using natural family planning will get pregnant a year. 

Dr Adam Balen, the chair of the British Fertility Society, warned that there is always a risk with contraceptives that don't prevent eggs from being released and coming into contact with sperm.

"Any device that monitors the menstrual cycle is fallible as women don’t always ovulate predictably every month and even those with very regular cycles can sometimes have occasional months where ovulation doesn’t occur when expected," he said. 

"For those who wish to take control of their lives, do not wish to use conventional contraception and for whom it wouldn’t be a disaster if an accidental pregnancy occurred this device may help avoid unwanted pregnancy."

Dr Berglund, co-founder of Natural Cycles, said: "Women around the world are interested in exploring effective non-hormonal and non-invasive forms of contraception, and now they have a new, clinically verified and regulatory approved option.

"Natural Cycles allows women to better understand their bodies so they can make choices that are right for them."

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