Elsevier

Fertility and Sterility

Volume 83, Issue 6, June 2005, Pages 1764-1770
Fertility and Sterility

Reproductive endocrinology
A new method for estimating the effectiveness of emergency contraception that accounts for variation in timing of ovulation and previous cycle length

Presented at the Joint Meeting of the German Region of the International Biometric Society and the German Association of Epidemiology Heidelberg, Germany, March 16–19, 2004.
https://doi.org/10.1016/j.fertnstert.2005.01.097Get rights and content
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Objective: To develop a new method for estimating the effectiveness of emergency contraception (EC) by using information about previous menstrual cycle length, accounting for the variation in the day of ovulation within the menstrual cycle, and comparing the validity of the new and previous methods.

Method(s)

Secondary analysis of a data set with a biological marker of ovulation and its distribution in the cycle. Based on a sample of cycles with known length and a known biological marker of ovulation, we simulated trials of predetermined EC effectiveness and then calculated estimates of EC effectiveness based on old and new methods.

Result(s)

Under some conditions, all methods produced biased estimates of effectiveness with simulated trials, especially when the actual effectiveness was low. The systematic bias was minimized with the new method. The new method was robust with regard to the distribution of the day of intercourse in women presenting for EC.

Conclusion(s)

Future studies of EC effectiveness should consider both the uncertainty in predicting the day of ovulation and previous cycle length. Our estimates of daily fecundity should be replicated with other data sets.

Key Words

Emergency contraception
effectiveness
cycle length
ovulation detection

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