Archives of Gynecology and Obstetrics

, Volume 295, Issue 4, pp 1015–1024 | Cite as

Natural conception rates in subfertile couples following fertility awareness training

  • P. Frank-HerrmannEmail author
  • C. Jacobs
  • E. Jenetzky
  • C. Gnoth
  • C. Pyper
  • S. Baur
  • G. Freundl
  • M. Goeckenjan
  • T. Strowitzki
Gynecologic Endocrinology and Reproductive Medicine



To analyze cumulative pregnancy rates of subfertile couples after fertility awareness training.


A prospective observational cohort study followed 187 subfertile women, who had received training in self-observation of the fertile phase of the menstrual cycle with the Sensiplan method, for 8 months. The women, aged 21–47 years, had attempted to become pregnant for 3.5 years on average (range 1–8 years) before study entry. Amenorrhea, known tubal occlusion and severe male factor had been excluded. An additional seven women, who had initially been recruited, became pregnant during the cycle immediately prior to Sensiplan training: this is taken to be the spontaneous pregnancy rate per cycle in the cohort in the absence of fertility awareness training.


The cumulative pregnancy rate of subfertile couples after fertility awareness training was 38% (95% CI 27–49%; 58 pregnancies) after eight observation months, which is significantly higher than the estimated basic pregnancy rate of 21.6% in untrained couples in the same cohort. For couples who had been seeking to become pregnant for 1–2 years, the pregnancy rate increased to 56% after 8 months. A female age above 35 (cumulative pregnancy rate 25%, p = 0.06), couples who had attempted to become pregnant for more than 2 years (cumulative pregnancy rate 17%, p < 0.01), all significantly reduce the chances of conceiving naturally at some point.


Training women to identify their fertile window in the menstrual cycle seems to be a reasonable first-line therapy in the management of subfertility.


Subfertility Pregnancy rate Natural family planning Fertility awareness method Sensiplan 



The authors cordially thank Sylvia Heil-Schlehuber for her dedicated assistance and her valuable comments. The study was funded by the Jung-Stiftung für Wissenschaft und Forschung.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest. They do not have any financial relationship with the organization that sponsored the research. They have had full control of all primary data and they agree to allow the Journal to review the data if requested.

Ethical approval

Ethical approval was given by the Section of Natural Fertility of the German Society of Gynecological Endocrinology and Fertility Medicine at the University of Heidelberg. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki of 1964 and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study. They were free to withdraw at any time.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Gynecological Endocrinology and Fertility DisordersUniversity of HeidelbergHeidelbergGermany
  2. 2.Department for Child and Adolescent Psychiatry and PsychotherapyUniversity Medical CenterMainzGermany
  3. 3.Section Natural Fertility, German Society of Gynecological Endocrinology and Fertility MedicineUniversity of HeidelbergHeidelbergGermany
  4. 4.National Perinatal Epidemiology Unit, Nuffield Department of Public HealthUniversity of OxfordOxfordUK
  5. 5.Department of Gynecology and ObstetricsUniversity of DresdenDresdenGermany

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