Time to pregnancy recognition among users of an FDA-cleared fertility application

Abstract

Background: Previous investigations of time-to-pregnancy recognition have analysed data from national surveys and clinics, but this has not been investigated in the context of digital fertility applications. Timely pregnancy recognition can help individuals in health and pregnancy management, reducing maternal and foetal risk and costs, whilst increasing treatment options, availability, and cost. Methods: This dataset contained 23,728 pregnancies (conceived between June 2018 and December 2022) from 20,429 participants using a Food and Drug Administration (FDA) cleared fertility app in the United States. Most participants (with non-missing information) identified as Non-Hispanic White, and one-third reported obtaining a university degree. We used two-tailed Welch’s t-test, Mann–Whitney U-test, and two-tailed Z-tests to compare time to pregnancy recognition between those using the app to conceive or contracept. Results: Participants using an app to conceive recognised pregnancy on average at 31.3 days from last menstrual period (LMP) compared to 35.9 days among those using the app to prevent pregnancy. Conclusion: Generalisability is limited, as all participants were using a fertility app and had relatively homogenous sociodemographic characteristics.

PLAIN LANGUAGE SUMMARY

People who recognise pregnancy early may benefit, as earlier recognition can reduce costs and risks, and make more treatment options available. In the past, researchers have studied the time it takes for an individual to recognise that they are pregnant by asking them in national surveys or when they attend a clinic. However, with the advent of digital fertility tracking apps, we investigated the time it takes to recognise pregnancy when using such an app. We analysed data from 23,728 pregnancies from 20,429 users of the Natural Cycles app between June 2018 and December 2022. We found that participants using the app to try to get pregnant recognised pregnancy an average of 4.6 days earlier than those using the app to prevent pregnancy.

Keywords:

• Contraception
• pregnancy
• pregnancy recognition
• fertility application
• conception

Acknowledgements

We would like to express our sincere gratitude to the participants, who generously consented to sharing their anonymized menstrual and fertility data on the Natural Cycles application for research. A special thank you to Chelsea Polis who provided substantial input into prior versions of this manuscript; she has not received any financial support from Natural Cycles.

Author contributions

AvL and EB designed, performed and interpreted the analysis and wrote the manuscript, JTP, RU, KGD, HKK, CF, AN, EB and RS interpreted the analysis, wrote and reviewed the manuscript.

Disclosure statement

AvL, JP, EB, and CF are employees of Natural Cycles with shares or stock warrants in the company. EBS and RS are the CEO’s and Co-founders of Natural Cycles and have shares in the company. KGD received honorarium for the support of manuscript writing and as a speaker at meetings for Natural Cycles. HKK received a past honorarium from Natural Cycles. AN had previously attended an advisory board for Natural Cycles. CBP and RU did not receive any financial support from Natural Cycles.

Data availability statement

Data is available upon reasonable request to the corresponding author.

Additional information

Funding

Natural Cycles provided access to anonymized data collected on their digital fertility application as well as salaries for AvL, JTP, CF, EB, EBS, and RS as full-time employees.