OvuSense logo

Fertility Apps and Monitors – Can they really help you conceive?

Fertility Apps and Monitors – Can they really help you conceive?

With advancing technology, we have come to rely on apps for many things in our lives, be it shopping, music or social media and now even apps for your fertility! Over the last 12 months there has been a great deal of media attention surrounding the benefits of apps and monitors for fertility, but can they really help you get pregnant?

My patients tell me that they feel really confused as to which is the best fertility app and monitor to use. Previous research studies have found that fertility apps used alone without a monitor are generally ineffective and do not accurately determine a woman’s readiness to conceive (Setton et al. 2016, Duane et al. 2016), resulting in even greater confusion among women.

In this blog I review the most commonly used fertility apps and monitors, explain what they are, how they work and whom they would be useful for. Most importantly I review their accuracy, including their ability to identify fertile days and ovulation, as well as considering the customer support they offer and the all-important cost. However, before I start, it’s really important to explain one crucial difference between fertility apps and monitors.

The difference between fertility apps and fertility monitors

There are many fertility apps that you can purchase to use on your smart phone and some are even free. Used alone these fertility apps calculate your fertile time using a calendar method. These apps rely on a traditional 28-day cycle to tell you when you may be fertile. However very few women have a 28-day cycle and can ovulate at differing times of the month. Therefore, the calendar method is notoriously ineffective and is, in essence, merely an electronic diary.

Some fertility apps go a step further by taking into consideration your previous cycle length, however, to predict individual fertility reliably, it’s not enough to just extrapolate data from previous cycles. While there is no doubt that tracking your fertility enables you to take control and leads to a greater awareness of your cycle, to increase reliability and to be beneficial for your fertility you need to observe the physiological signs of fertility as well. This is where the fertility monitor steps in.

Fertility monitors used in conjunction with apps offer greater reliability. As well as tracking your cycle, the monitor gives you the ability to monitor your body temperature. For accuracy body temperature should be measured orally, rectal or vaginally (rectally and vaginally being the most accurate as this measures core body temperature and is free from potential disturbances).  Following ovulation, your progesterone levels rise and stay elevated for the rest of your cycle. Progesterone causes your body temperature to rise, indicative of ovulation, and can be easily and accurately observed. Detecting when you ovulate is vital to increase your chances of conception. Another recognised fertility indicator is cervical mucous. Observed throughout the cycle, cervical mucous changes in appearance and consistency and stretchy, egg white secretions indicate peak fertility.

Your fertility can also be monitored by testing the levels of luteinising hormone (LH) present in your urine using ovulation prediction kits or monitors. The LH surge occurs approximately 24-48 hours prior to ovulation. However, ovulation predictor kits and monitors have been widely documented to produce ‘false negative’ results meaning that you get no indication of ovulation (Lloyd et al. 1989, Irons et al. 1994 and Arici et al. 1992)

 

The Most Commonly Used Fertility Apps and Monitors

1.  Ava

Ava is a wearable wristband worn at night, which is used in conjunction with an App. The monitor observes physiological data to identify 5.3 fertile days per cycle, with 89% efficacy but is not able to detect ovulation.

Ava monitors skin temperature to monitor progesterone levels, however as research demonstrates, this is not an accurate method (Wark et al 2015) as it is subject to temperature disturbances due to environment and illness. Ava also gives you the opportunity to measure other aspects such as pulse rate and sleep, which whilst useful for general health and lifestyle, have very little bearing on when you are fertile each cycle.

You can use Ava if your cycles range between 24-35 days, however, if you have irregular cycles the performance diminishes. For PCOS for example, this App and monitor would not be effective for you, in fact, Ava has not been tested on women with PCOS. Ava’s customer support is in the form of FAQ’s and email support but whether the email support is clinical or technological is not defined.

Cost - £249  + Shipping.

Delivery time – 3-5 business days.

My opinion – Ava is a combination of a lifestyle and fertility monitor. If monitoring your general health is the most important aspect for you then you might like this but due to it’s low efficacy and inability to detect ovulation, I wouldn’t recommend it for fertility.

 

2.  Clearblue Fertility Monitor

 

The Clearblue Fertility Monitor detects changes in two key fertility hormones luteinizing hormone and estrogen present in the urine. It is able to identify 6 fertile days and states it is 99% accurate in detecting the LH surge.

You can contact Clearblue via Live Chat and email or by the telephone careline where women can get both technical support and advice on their journey to parenthood.

Cost – Clearblue Fertility Monitor £87.67 subsequent ovulation tests from £27.99-42.59

My opinion – The Clearblue monitor offers women a practical and clear way of identifying the fertile. The monitor, however, is not suitable for women with PCOS due to elevated levels of LH or women who are using fertility treatment medication such as Chorionic Gonadotrophin (HCG) or Clomid as this can cause elevated estrogen levels. For those reasons, this monitor would not be accurate for a large percentage of women who are trying to conceive.

To achieve accurate results, you need to test on multiple days leading up to ovulation. This can be inconvenient but also requires purchasing subsequent ovulation tests.

 

3.  Clue

Clue is a cycle tracking app that uses the calendar method to predict your cycle. You are also able to input any symptoms you experience such as bleeding, pain, emotions and energy and also events such as appointments, exercise when you have sex and your contraceptive method

Clue offers app technical support only.

Cost – Free app but you can upgrade your plan to access more information

My opinion – If you want to get more knowledgeable on your cycle and understand more about your body then you may like using this app. It is user-friendly but doesn’t identify ovulation. Is it likely to help you conceive? No more than your own diary or wall calendar would!

 

4.  Daysy

Daysy is a fertility monitor and app that monitors basal body temperature with one quick reading on waking, using an oral thermometer. The monitor identifies fertile days with 99.3% accuracy and learns your individual cycle pattern, which it then uses to forecast your next cycle. Daysy does not appear to confirm ovulation.

The Daysy app offers you some fun features such as a gender prediction tool, however, research does not support gender prediction based on the timing of sexual intercourse in a given cycle (Wilcox et al 1995). The app also allows you to share information with your partner to let him know when it is ‘time to get down to business’! Unfortunately, you can’t use Daysy if you have irregular cycles, which would mean that it’s not suitable for many women.

Daysy offers telephone customer support, video tutorials and downloads and the method can be used to avoid pregnancy as well as to achieve pregnancy.

Cost - $330/£256 for the thermometer, free app + shipping

Delivery time – 2-5 days

My Opinion – Daysy offers an 21st century alternative to manual temperature charting but it is debatable as to whether it does any more than your average ‘under the tongue thermometer’. Oral (basal) temperature recordings are subject to disturbances and therefore are not the most accurate method. This, combined with the inflated price, would be a non-starter for many women.

 

5.  Fertility Friend

Fertility Friend is a widely used cycle tracking app that incorporates oral temperature readings and other physiological data into its system. Temperature readings are taken using a basic oral thermometer and users are encouraged to input cervical secretions, sexual intercourse, and other physiological data.

The app can confirm ovulation based on your recorded temperature rise and offers an indication of fertile days but is unable to predict ovulation.

Fertility Friend offers support via access to a community and helpful videos.

Cost – Free. There is a cost to upgrade to access other features

My opinion – Fertility Friend offers women an easy and convenient way of charting her cycle and fertility indicators. However, having looked at many Fertility Friend charts, unfortunately, it is common for me to see inaccuracies with the confirmed date of ovulation and fertile days. You could do it more accurately with a little teaching and by using a pen and a paper chart!

 

6.  Flo

 

Flo is another period tracking app and an ovulation calendar. It uses AI to increase its prediction accuracy to help women understand their cycle.

The app offers daily health insights and analytical reports on your period and lifestyle. The App provides support via email and community groups to engage with on topics from healthy eating to anxiety and depression. However, at the time of writing these groups do not seem active

Cost – Free App but £7.49 / $10.00 per month to unlock unlimited access for further support

My Opinion – The Flo app offers you a great deal of advice at your finger tips via their many informative articles. It is disappointing to see that the Flo community is not active; this could be because it’s a recent initiative, as it is a great idea. However, there is no getting away from the fact that, like Clue, this is yet another calendar tracking device and as such is not reliable at identifying ovulation.

 

7. FitBit

With the FitBit Versa watch, Charge 3 or Ionic devices, you are able to track your female health via the in-app experience. It is designed to help you learn more about your menstrual cycle and your body.

The app allows you to log your period, record symptoms and receive notifications of when your period is due. The app is also able to give you an average estimated ovulation day.

Fitbit has a Female Health Forum Community but it appears that this is for technical help rather than female health support and advice.

Cost – Prices vary depending on the device from $170.75- 328.00/£129.99-249.99

 

My Opinion – FitBit offers you the ability to get to know your menstrual cycle and symptoms so you can better understand how your menstrual cycle effects your energy levels, mood and general wellbeing. It also helps you to plan around your cycle, such when you’ll have better energy and when a duvet day is best! However, FitBit does not use any physiological data such as temperature and is therefore a calendar tracking advice, and as such is not able to reliably predict ovulation or when your next period will occur.

 

8. Glow

Glow is a cycle tracking and lifestyle app that allows you to input physiological data such as temperature, cervical mucus and moods. Using a calendar method Glow is able to grade your chance of pregnancy at a given day and notify you when your period is due.

Glow has a thriving online community and offers support through FAQ’S. The app also includes an add on Glow Fertility Program which offers discounted fertility treatments and egg freezing with featured US based clinics and showcases top US fertility doctors.

Cost – Free App but £7.99 / $10.00 per month to unlock advanced charting and more tools.

My opinion - Glow has been heavily criticised in the recent Fertility app study as one of the worst fertility apps. It may provide you with some lifestyle data and if a lifestyle app is your thing, then it might just be for you but don’t even consider it to help you get pregnant. Whilst it is available in the UK it does appear to be more US audience based.

 

9. Kindara and Wink

Kindara is a cycle tracking app that is used with Wink – an oral thermometer. Wink monitors basal body temperature, which then syncs this information with the Kindara app on your smartphone.

Kindara is able to identify your fertile time and confirm ovulation but offers no ovulation prediction in real time. Kindara states that Wink is the most accurate body temperature thermometer on the market but offers no efficacy rating for it’s ability to accurately identify the fertile time or confirm ovulation. It is unclear whether Kindara works for women with irregular cycles.

Kindara offers access to 1:1 practitioner teaching for an extra $154. Charts can also be shared with your clinician via the Practitioner Portal.

Cost – Free App but £4.99 per month to track unlimited data.

Wink Thermometer $129 plus shipping

Delivery time – Not stated

My opinion -  The Kindara app and Wink thermometer are certainly appealing to the eye. The thermometer is easy to use and read however like Daysy, you are paying for a glorified oral thermometer with all the inaccuracies this mode of temperature recording has.

 

10. Leaf (Bellabeat)

Leaf, made by Bellabeat is a reproductive and fitness health tracker in the form of wearable jewellery. Leaf syncs with your smartphone to give you information about your cycle and period as well as tracking your activity, stress levels and sleep.

Leaf uses the calendar method to predict ovulation, based on your previous cycle and the date of your last period.

Leaf offers support via FAQ’s, a telephone call back service and pictorial tutorial to help with the technical side.

Cost – Free App. Leaf jewellery £77 plus shipping.

Delivery time – Not stated

My opinion - If you are looking for a nice piece of jewellery and a lifestyle tracker then Leaf might be just what you need. However, if you really want to get knowledgeable about your cycles and accurately predict ovulation then I strongly recommend looking elsewhere!

 

11. MyLotus

My Lotus is a personalised fertility testing device and App that allows you to monitor your luteinising Hormone (LH) levels and how this links to ovulation and the identification of your fertile days.

MyLotus measures how much LH is present in your urine. LH levels increase as you prepare to ovulate. All women have a different baseline LH level and MyLotus is able to provide a measured (quantitative) result that differs from traditional (qualitative) ovulation tests. MyLotus state that therefore the device is suitable for women with irregular cycles and women with PCOS.

MyLotus offers technical support via FAQ’s and the ability to report a technical problem within the App. However, it does not appear that MyLotus offers any clinical support

Cost – MyLotus Starter pack £349.00 thereafter £54.00 for 20 ovulation tests. MyLotus App is free and can be used as a stand-alone calendar tracker.

My opinion – MyLotus is certainly the next generation of ovulation prediction using LH in the urine. The ability to identify LH increase from a woman’s normal baseline is likely to improve the efficacy of the traditional LH testing. However, it is evident that MyLotus was tested on a very small sample size of 111 women over a 12-week period (Note there is a further reference on the website to a sample size of 64 women and therefore exact sample size is unclear).

MyLotus claim that the device is suitable for women with irregular cycles and PCOS however there is no reference to the device having been tested by women with these cycle characteristics and therefore it is difficult to substantiate this claim.

Costs can escalate, as subsequent ovulation tests are needed. Some women may find it inconvenient to test multiple times.

 

12.  Ovacue

Ovacue is a fertility monitor that monitors both saliva and vaginal mucous via 2 different sensors, requiring one measurement per day. Ovacue monitors electrolyte changes in both saliva and vaginal secretions to predict and confirm ovulation with 98% efficacy and giving 5-7 days notice of ovulation can be used for both irregular cycles and PCOS.

Ovacue’s customer support consists of FAQ’s and live chat technical support only.

Cost - $269 including shipping

Delivery – Not stated

My opinion - Ovacue offers an alternative to body temperature monitoring, however, the efficacy of monitoring saliva ferning to predict ovulation is not supported by clinical research (Guida et al 1999, Fehring and Gaska 1998). On the other hand, observing vaginal secretions does provide an accurate interpretation of fertility, however, the effective monitoring of cervical secretions can be done manually, avoiding the need for expensive monitoring equipment.

 

13. OvuSense

OvuSense is a vaginal sensor that syncs to a smartphone app. Unlike other temperature recording fertility monitors, OvuSense observes the more accurate core body temperature whilst you are asleep, taking multiple readings throughout the night. OvuSense is able to predict ovulation up to 24 hours in advance with 96% accuracy and detect ovulation with 99% accuracy (Papaioannou et al 2012).

OvuSense is a class 2 medical device and is suitable for any woman wishing to conceive and can be used for irregular cycles, PCOS and diminished ovarian reserve.

The OvuSense individual customer support is extensive with 24 hour, 7 days a week technical support, Fertility Nurse 1:1 consultations via online video, email support and a thriving online community with regular online fertility clinics. OvuSense also offers 100% money back guarantee if ovulation is not detected after 6 months of use (terms and conditions apply).

Cost – $99/£79 Starter pack with 30-day app subscription free delivery

$299/£199Starter Pack with 12 -month app subscription free delivery

Delivery – Next Day

My opinionOvuSense is the only fertility monitor that has the ability predict ovulation in real time. This gives women timely and accurate cycle and ovulation information, empowering them to plan and take back control. The monthly plan offers true flexibility, especially if you want to take time out of trying for a month or two. The OvuSense support package is unrivalled and all together OvuSense offers clinically proven accuracy and value for money. Compatible with both iPhone and Android.

You can find more information here:  www.ovusense.com

 

14. Tempdrop

Tempdrop is a sensor that uses skin temperature measurements to determine your personal nightly temperature and use this information to track ovulation and determine the most fertile days in a cycle.

Tempdrop is worn under your arm during sleep using the Tempdrop armband. Each night, Tempdrop collects thousands of data points on your body temperature and sleep motion and then in the morning syncs with the Tempdrop app.

Tempdrops support is limited and consists of FAQ’s on their website and App and an in App chat service.

Cost –  $149-249. Free App

Delivery – 4-6 weeks

My opinion – It is unclear from the website if Tempdrop has been tested to accurately identify ovulation or the fertile time. Tempdrop quote a study by Rubia-Rubia et al. (2011) where the efficacy of skin temperature recording was compared to other methods. Skin temperature recordings were not found to be as accurate in measuring body temperature than other methods but it was found to be convenient, easy to use and comfortable. Due to the inaccuracies of skin temperature monitoring, this is not a method I would recommend.

 

15.  Yono

Yono is an in-ear fertility monitor and app. Yono monitors your basal body temperature overnight whilst you sleep using a small ear bud. There is little clinical research in to the efficacy of the tympanic (in-ear) route of temperature measurement for fertility. A recent study by Niven et al. (2015) concluded that peripheral thermometers ‘do not have clinically acceptable accuracy’ and should not be used when accuracy is important.

The website states that Yono can be used for ovulation prediction and that it identify the fertile days each cycle. There is no reference to the accuracy or if the monitor can be used for women with irregular cycles or PCOS. Yono’s support is via email, phone or from the FAQ page.

Cost –$149 Free shipping

Delivery – not stated

My opinion – With dubious accuracy given the in-ear route, this is not a monitor I would recommend. The device is not compatible with android devices.

This blog has highlighted the differences between fertility Apps used alone and fertility Apps used with monitors, as well as explaining how each one works, who can use them and what they offer you. Hopefully, this takes the confusion out of fertility Apps and monitors a little and helps you to decide which would be best for you.

By Kate Davies, registered fertility nurse

About the author: Kate Davies is a fertility practitioner in the UK, fertility coach and columnist. Kate works with women wishing to optimise their ability to conceive naturally and, also, coaches women going through a difficult fertility journey. Kate is a registered nurse specialist and worked for over 20 years in the UK’s National Health Service as a specialist nurse in Gynaecology, Sexual and Contraceptive health and fertility. Kate has a special interest in PCOS and over the years has worked with 100’s of women who suffer with this debilitating condition. To enhance her practice, Kate has also undertaken specialist training to enable her to offer women both the specialist advice and emotional support they desperately need. www.yourfertilityjourney.com

 

References:

Arici A, Carr BR (1992) Comparison of two LH monitoring methods in women undergoing intrauterine insemination. Proceedings of the 48th Annual Meeting of the American Fertility Society.

Duane, M., Contreras, A., Jensen, E.T. and White, A. (2016) ‘The performance of fertility awareness-based method Apps marketed to avoid pregnancy’, The Journal of the American Board of Family Medicine, 29(4), pp. 508–511. doi: 10.3122/jabfm.2016.04.160022.

Fehring, R.J. and Gaska, N. (1998) ‘Evaluation of the Lady Free Biotester® in determining the fertile period’, Contraception, 57(5), pp. 325–328. doi: 10.1016/s0010-7824(98)00039-0.

Guida, M., Tommaselli, G.A., Palomba, S., Pellicano, M., Moccia, G., Di Carlo, C. and Nappi, C. (1999) ‘Efficacy of methods for determining ovulation in a natural family planning program’, Fertility and Sterility, 72(5), pp. 900–904. doi: 10.1016/s0015-0282(99)00365-9.

Irons DW, Singh M (1994) Evaluation of transvaginal sonography combined with a urinary luteinizing hormone monitor in timing donor insemination. Hum Rep 9:1859-62.

Lloyd R, Coulman CB (1989) The accuracy of urinary luteinising hormone testing in predicting ovulation. Am J Obstet Gynecol, 60:1370-2.

Niven, D.J., Gaudet, J.E., Laupland, K.B., Mrklas, K.J., Roberts, D.J. and Stelfox, H.T. (2015) ‘Accuracy of peripheral thermometers for estimating temperature’, Annals of Internal Medicine, 163(10), p. 768. doi: 10.7326/m15-1150.

Papaioannou, S., Aslam, M., Al Wattar, B.H., Milnes, R.C. and Knowles, T.G. (2012) ‘Ovulation assessment by vaginal temperature analysis (the ovusense advanced fertility monitoring system) in comparison to oral temperature measurement’, Fertility and Sterility, 98(3), p. S160. doi: 10.1016/j.fertnstert.2012.07.590.

Rollason, J., Outtrim, J. and Mathur, R. (2014) ‘A pilot study comparing the DuoFertility® monitor with ultrasound in infertile women’, International Journal of Women’s Health, , p. 657. doi: 10.2147/ijwh.s59080.

Rubia-Rubia, J., Arias, A., Sierra, A. and Aguirre-Jaime, A. (2011). Measurement of body temperature in adult patients: Comparative study of accuracy, reliability and validity of different devices. International Journal of Nursing Studies, 48(7), pp.872-880.

Setton, R., Tierney, C. and Tsai, T. (2016) ‘The accuracy of web sites and cellular phone applications in predicting the fertile window’, Obstetrics & Gynecology, 128(1), pp. 58–63. doi: 10.1097/aog.0000000000001341.

Wark, J.D., Henningham, L., Gorelik, A., Jayasinghe, Y., Hartley, S. and Garland, S.M. (2015) ‘Basal temperature measurement using a multi-sensor Armband in Australian Young Women: A comparative observational study’, JMIR mHealth and uHealth, 3(4), p. e94. doi: 10.2196/mhealth.4263.

Wilcox, A.J., Weinberg, C.R. and Baird, D.D. (1995) ‘Timing of sexual intercourse in relation to ovulation — effects on the probability of conception, survival of the pregnancy, and sex of the baby’, New England Journal of Medicine, 333(23), pp. 1517–1521. doi: 10.1056/nejm199512073332301.