Should home-based ovulation predictor kits be offered as an additional approach for fertility management for women and couples desiring pregnancy? a systematic review and meta-analysis
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
ENGLISH ABSTRACT: Introduction to inform the WHO Guideline on self-care
interventions, we conducted a systematic review of the
impact of ovulation predictor kits (OPKs) on time-topregnancy,
pregnancy, live birth, stress/anxiety, social
harms/adverse events and values/preferences.
Methods Included studies had to compare women
desiring pregnancy who managed their fertility with and
without OPKs, measure an outcome of interest and be
published in a peer-reviewed journal. We searched for
studies on PubMed, CINAHL, LILACS and EMBASE through
November 2018. We assessed risk of bias assessed using
the Cochrane tool for randomised controlled trials (RCTs)
and the Evidence Project tool for observational studies, and
conducted meta-analysis using random effects models to
generate pooled estimates of relative risk (RR).
Results Four studies (three RCTs and one observational
study) including 1487 participants, all in high-income
countries, were included. Quality of evidence was low.
Two RCTs found no difference in time-to-pregnancy. All
studies reported pregnancy rate, with mixed results: one
RCT from the 1990s among couples with unexplained
or male-factor infertility found no difference in clinical
pregnancy rate (RR: 1.09, 95% CI 0.51 to 2.32); two more
recent RCTs found higher self-reported pregnancy rates
among OPK users (pooled RR: 1.40, 95% CI 1.08 to 1.80). A
small observational study found higher rates of pregnancy
with lab testing versus OPKs among women using donor
insemination services. One RCT found no increase in
stress/anxiety after two menstrual cycles using OPKs,
besides a decline in positive affect. No studies measured
live birth or social harms/adverse events. Six studies
presented end-users’ values/preferences, with almost
all women reporting feeling satisfied, comfortable and
confident using OPKs.
Conclusion A small evidence base, from high-income
countries and with high risk of bias, suggests that homebased
use of OPKs may improve fertility management
when attempting to become pregnant with no meaningful
increase in stress/anxiety and with high user acceptability.
Description
CITATION: Yeh, P. T., et al. 2019. Should home-based ovulation predictor kits be offered as an additional approach for fertility management for women and couples desiring pregnancy? a systematic review and meta-analysis. BMJ Global Health, 4(2):4:e001403, doi:10.1136/bmjgh-2019-001403.
The original publication is available at https://gh.bmj.com
The original publication is available at https://gh.bmj.com
Keywords
Pregnancy, Detection of ovulation, Time determination of ovulation, Meta-analysis, Fertility -- Management
Citation
Yeh, P. T., et al. 2019. Should home-based ovulation predictor kits be offered as an additional approach for fertility management for women and couples desiring pregnancy? a systematic review and meta-analysis. BMJ Global Health, 4(2):4:e001403, doi:10.1136/
bmjgh-2019-001403