Expert comments

Comments on this technology were invited from clinical and academic specialists working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

All 4 experts were familiar with or had used this technology before.

Level of innovation

Three experts agreed that Natural Cycles was novel compared with services currently offered by the NHS, such as fertility-awareness counselling. One expert stated that it was a minor variation to existing fertility-awareness methods. There are several fertility awareness apps that are similar to Natural Cycles, but none are CE‑marked or available on the NHS.

Potential patient impact

The experts stated that the potential benefits of Natural Cycles include:

  • people not having to access a health service for fertility advice

  • that it is non-hormonal and has no side effects

  • that it supports users to develop an increased awareness of natural body rhythm, and

  • that it is easy to use and private.

The experts also noted that Natural Cycles provides another contraceptive option and that this may be preferred by people who are unable to, or do not wish to, use other methods of contraception. One expert noted that Natural Cycles may benefit people who are already using fertility‑awareness methods in terms of its usability. Three experts noted that Natural Cycles can also be used by people who want to get pregnant.

One expert noted that Natural Cycles might be more suitable to monitor the menstrual cycle rather than as a contraceptive in some users. This is because there are a number of factors that can affect basal body temperature, such as medications, stress, alcohol, and disturbed or irregular sleep.

Potential system impact

All experts stated that Natural Cycles would be used as well as current service provision in the NHS. Two experts noted that there could be reduced health service visits for people trying to conceive and fewer referrals to assisted reproduction clinics if the app is proven to help conception. Two experts agreed that Natural Cycles is likely to be cheaper than a contraception or fertility counselling session. One felt that there could be an increase in the rate of termination of pregnancy, whereas another thought there could be a decrease. One expert noted that there could be reduced costs for unwanted pregnancies for people who currently use fertility awareness methods. One expert noted that the annual cost of Natural Cycles was less than the annual cost of an oral contraceptive prescription. Three experts advised that using Natural Cycles would not need any change in service provision. One highlighted the need for training for GPs providing advice on contraception and fertility.

General comments

Three of the experts highlighted the need for further evidence before Natural Cycles can be adopted in the NHS.