The Good, the Bad and the Ugly of Fertility Apps and Devices - www.clarabailey.com

The Good, the Bad and the Ugly of Fertility Apps and Devices

Writers note: This article was originally published in August 2019 and has been updated in July 2021.

 

Navigating the complex world of FemTech can be a mind spin. There’s a lot of fertility and menstrual cycle tracking products, devices and apps out there these days.

When it comes to using a tool to help you discern when you can and cannot get pregnant, you need to have your eyes wide open. You also need to do your research and understand the limitations of the method you’ve chosen.

The FemTech market is very crowded, and often doctors will find it challenging to keep up. What is left is a vacuum of good advice, leaving women reliant on word-of-mouth, social media influencers, reviews, and ease of use.

 

What I Use and Recommend as a Fertility Awareness Educator

I recommend the free app, Kindara (I have no financial allegiances with them). You can do a paid upgrade, but I’ll show you a little trick I use so that I don’t have to pay anything. The fertility awareness method should be free.

The Fertility Awareness Method (FAM) is about your knowledge of your fertile signs and knowing how to interpret them.

The reason I like Kindara is that it is a data recording app. They do have some predictive options; but, I recommend you turn all those off.

There is no algorithm, it visualises your data, and you interpret your fertility yourself.

If you don’t know how to use FAM, it will be confusing. If you’ve been taught by a trained teacher, it will be seamless and intuitive.

Setting Kindara Up

  1. Download the app
  2. Go into the settings > Turn ON “Start New Cycle Manually” + “Chart has Fertile Valley” + “Add Times to Temps”> Turn OFF “Period Prediction.”
  3. [Optional] Reminders > Turn ON “Cervical Fluid Reminder” and make this in the afternoon and “Conduct Breast Exam.”

Note: As a healthcare professional, I LOVE that Kindara will remind you to do a monthly breast exam after your bleed. This is the most accurate time in the cycle to determine that all is well with your breasts. It can be too difficult in the second half of the cycle.

My Kindara Hack

The way that I teach FAM is based on vaginal sensation, which most women find so much easier than looking and feeling the cervical mucus itself.

You ask yourself each day, do I feel dry, moist, wet or slippery?

To take advantage of Kindara’s wonderful visualisation tool, I’ve created my own internal code of how I record cervical fluid:

Dry = none

Moist = egg white x1

Wet = Watery x1-2

Slippery = Watery x3

I always recommend getting familiar with the method and then come up with your own code. Internal consistency is key.

This is what it looks like charting this way. As the bars go down (increasing wetness) the closer to ovulation you’re getting.

How I use Kindara

It doesn’t always look textbook!

This was one of my charts from two years ago over a year ago when I was using temperature as well.  I recommend recording your temperature during the first couple of years of practising the method, and anytime you’re going through a change.

As you can see, some of these temperatures are a little all over the place. This is where the coverline feature is excellent! When you look at the temperatures, you can see that the majority went under and the majority over the coverline in the two haves of the cycle.

You can also record your Peak Day within Kindara. It will count the 4 days of the mucus plug re-securing itself, and it will count the luteal phase days. It’s these little features that give Kindara an elegance the other apps don’t have.

You can buy Kindara’s companion Bluetooth basal body thermometer, Wink. I love that this thermometer vibrates instead of beeps and it will sync with the app. And they’ve made it a very discreet design: it so it looks like a lipstick or some other mysterious cosmetic, which may be important for some people.

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The Bad

Natural Cycles & Daysy

I can see how these devices and apps can be appealing as a good entry point into hormone-free birth control if you haven’t undertaken a FAM course.

BUT

I do not recommend them.

Why?

They are produced, marketed and developed by developers, not people who are trained in the fertility awareness method.

The devices/app use basal body temperature only – which has zero predictive values whatsoever (it can only confirm ovulation has occurred).

Both use an algorithm to determine your fertility for you.

Furthermore, there are some very sticky ethical issues. Both companies use irresponsible language that inflates consumer confidence.

The clinical studies that these devices claim their efficacy from have been funded by the app creators themselves. In Natural Cycles case, the research is both conducted and funded by the founders.

Natural Cycles App

Natural Cycles markets itself as an EU approved medical device.

In Europe, the Natural Cycles app “is a Class IIb medical device (CE0123) for use as a contraceptive.”

What they fail to mention is that this category holds “medium to high risk” to users.

Medical device classification based on risk

Following the European Medical Device Directive 93/42/EEC:

  • Class I = Low risk
  • Class Im (measuring device) = Low risk
  • Class Is (sterile device) = Low risk
  • Class IIa = Medium risk
  • Class IIb = Medium to high risk
  • Class III = High risk

(Eurofins Scientific, 2019)

Daysy

Valley Electronics (the manufacturers of Daysy) recently had their key study that claims a 99.4% efficacy rate retracted due to:

fundamental flaws in the methodology, which means that the conclusions are unreliable due to selection bias and the retrospective self-reporting of whether pregnancies were intentional.” (Koch et al., 2019)

In other words: poor study design, cherry-picked data and overinflation consumer confidence (Polis, 2019).

Natural Cycles and Daysy both use social media influencers to promote their apps – which, from a public health perspective, is concerning.

They’re marketed as safe and effective alternatives to the oral contraceptive pill, which is misleading women.

These devices are particularly inaccurate for women who:

  • have irregular cycles
  • have polycystic ovarian syndrome or anovulatory -androgen excess
  • any kind of condition or circumstance that causes erratic patterns of ovulation (such as stress, anxiety, moving, thyroid conditions etc.)

The Ugly

Clue App (to be honest, the majority of the period tracking apps are very like this – based on the rhythm method).

First of all: Clue developers have made a trendy and fun app. It’s got a smart, intuitive symbol system that makes charting things like exercise, energy and mood easy. Visualising the cycle as a circle is neat. But I recommend it for that reason only.

Because I chart my cycle, I know how inaccurate Clue’s fertility prediction settings are. They also do things like this…

Your fertile window is coming up…but don’t forget to take your birth control pill?!

I do know that Clue recommends that women do not use it for fertility awareness. But if you haven’t read that fine print, and you’re seeing this fertile window stated in the app, I don’t blame you for being confused. It’s ambiguous at best and misleading at worst.

In sum, by all means, use Clue to record your changing moods, energy levels, etc., but not your fertility.

“So what should I do?”

Get confident using the method with paper first and chart for 3 cycles. Use barrier methods (condoms or a diaphragm) throughout the entire learning process.

And then, if you want to, if you do want to transition to a data recording app like Kindara.

If you learn the method with the guidance of a teacher, all those other apps and those expensive devices become redundant. This is true sovereignty over your reproductive health.

 

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The Good, the Bad and the Ugly of Fertility Apps and Devices by Clara Bailey, Naturopath and Herbalist


References

Eurofins Scientific. (2019). Medical Device Classification, MDD 93/42/EEC, IVDD. Retrieved August 13, 2019, from Eurofins Scientific website: https://www.eurofins.com/industrial/industries/medical-devices/medical-device-classification/

Koch, M. C., Lermann, J., van de Roemer, N., Renner, S. K., Burghaus, S., Hackl, J., … Thiel, F. C. (2018). RETRACTED ARTICLE: Improving usability and pregnancy rates of a fertility monitor by an additional mobile application: results of a retrospective efficacy study of Daysy and DaysyView app. Reproductive Health, 15(1), 37. https://doi.org/10.1186/s12978-018-0479-6

Koch, M. C., Lermann, J., van de Roemer, N., Renner, S. K., Burghaus, S., Hackl, J., … Thiel, F. C. (2019). Retraction Note: Improving usability and pregnancy rates of a fertility monitor by an additional mobile application: results of a retrospective efficacy study of Daysy and DaysyView app. Reproductive Health, 16(1), 54. https://doi.org/10.1186/s12978-019-0728-3

Lee, S. M. (2019). A Company Claims Its $330 Thermometer Can Predict Fertility. But A Key Study Supporting It Was Just Retracted. Retrieved August 13, 2019, from BuzzFeed News website: https://www.buzzfeednews.com/article/stephaniemlee/daysy-fertility-tracker-science-retraction

Natural Cycles. (2019). Natural Cycles’ Backgrounder | Press & Media | Natural Cycles. Retrieved August 13, 2019, from Natural Cycles Website website: https://www.naturalcycles.com/en/news/backgrounder,

Polis, C. B. (2018). Published analysis of contraceptive effectiveness of Daysy and DaysyView app is fatally flawed. Reproductive Health, 15(1), 113. https://doi.org/10.1186/s12978-018-0560-1

Polis, C. B. (2019a). How an unethical company (Daysy) responded to retraction of their study. Retrieved August 13, 2019, from Chelsea B.

Polis, PhD website: http://chelseapolis.com/1/post/2019/06/how-an-unethical-company-daysy-responded-to-retraction-of-their-study.html

Polis, C. B. (2019b). Pushing Daysy’s: How people could be misled into buying an unproven device for contraception. Retrieved August 13, 2019, from Chelsea B. Polis, PhD website: http://chelseapolis.com/1/post/2018/06/pushing-daysys-how-people-could-be-misled-into-buying-an-unproven-device-for-contraception.html

The Good, the Bad and the Ugly of Fertility Apps and Devices by Clara Bailey, Naturopath and Herbalist

Women's Health Issues & Conditions

June 30, 2021

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