Contraception最新文献

{"title":"Transcutaneous electrical nerve stimulation (TENS) for pain control during first-trimester procedural abortion: A blinded randomized controlled trial.","authors":"Andrea Henkel, Erica P Cahill, Sonia Chavez, Jade M Shorter, Serena M Liu, Stephanie I Amaya, Simranvir Kaur, Kate A Shaw","doi":"10.1016/j.contraception.2025.110955","DOIUrl":"10.1016/j.contraception.2025.110955","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) to manage pain during first-trimester procedural abortion for those not eligible for or otherwise forgoing sedation.</p><p><strong>Study design: </strong>This is a double-blinded, block-randomized superiority trial (IRB approved, NCT05320432) comparing TENS (placed posteriorly, T10-L1 and S2-S4) to sham for pain management during first-trimester procedural abortion. We enrolled pregnant people less than 12 weeks gestation, English- or Spanish-speaking at two outpatient clinics not receiving sedation. The primary outcome was self-reported pain by visual analog scale (VAS, 100 mm) with passage of largest cervical dilator. We planned to enroll 70 patients to detect a 15 mm difference in median pain score (80% power, α = 0.05).</p><p><strong>Results: </strong>Between January 2023 and March 2024, we enrolled 70 participants. Baseline demographics were balanced between groups: median (range) gestational duration 6 (5-11) weeks, 35.7% nulliparous. Median (range) reported pain with passage of largest dilator was 44 mm (0-88) and 50 mm (0-96) in the TENS and sham groups, respectively (p = 0.56). We did not find a difference in median pain at any collected time point including placement of tenaculum, paracervical block, aspiration, or recovery. The active TENS group was more likely to say they would recommend this method of pain control to others (94 mm vs 73 mm, p = 0.01). More participants receiving TENS unit correctly identified their group allocation (91.4% vs 63.6%, p < 0.001).</p><p><strong>Conclusion: </strong>While we did not demonstrate a difference in pain scores during the procedure, TENS is a non-pharmacologic alternative that may improve patient experience during uterine aspiration.</p><p><strong>Implications: </strong>In a blinded randomized trial, the median pain scores during first-trimester procedure abortion did not differ between those receiving TENS or sham. However, those randomized to TENS were more likely to recommend the method. For those with contraindications to IV sedation, improved experience may justify offering TENS during first-trimester abortion care.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110955"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First trimester suction aspiration without septum resection for transverse vaginal septum: A case report.","authors":"Abraham Fessehaye Sium, Gebresilassie Andualem Asmare","doi":"10.1016/j.contraception.2025.110954","DOIUrl":"10.1016/j.contraception.2025.110954","url":null,"abstract":"<p><p>A 27 years-old G2 Para 1 patient with a known uterine didelphys presented at 11 weeks of gestation with 3 days of vaginal bleeding. Evaluation demonstrated a fetal demise and a thin transverse vaginal septum with a central dimple. We successfully performed a mannual vacuum aspiration without septoplasty by dilating the dimple with vacuum cannulas.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110954"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating emergency contraception efficacy with levonorgestrel and copper intrauterine devices.","authors":"Susan E Nourse, Alexandra L Woodcock, Kathryn S Brown, Alexandra Gero, Lori M Gawron, David K Turok","doi":"10.1016/j.contraception.2025.110946","DOIUrl":"10.1016/j.contraception.2025.110946","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine observed vs expected pregnancy risk among levonorgestrel 52 mg and copper T380A intrauterine device (IUD) emergency contraception (EC) users.</p><p><strong>Study design: </strong>This is a secondary analysis of participants seeking EC randomly assigned to a levonorgestrel 52 mg or copper T380A IUD. Participants had at least one episode of unprotected intercourse (UPI) in the 5 days preceding enrollment and reported all episodes in the preceding 5 days. We report the proportion of pregnancies prevented of those expected at 1 month following IUD insertion using an established approach that assigns pregnancy risk by menstrual cycle day of intercourse. We calculated proportion of pregnancies prevented using both the day of most recent UPI and all reported UPIs within 5 days of presentation.</p><p><strong>Results: </strong>One pregnancy occurred among the 312 participants who received the levonorgestrel 52 mg IUD, with 137 (43.9%) reporting multiple episodes of UPI. No pregnancies occurred among the 318 participants who received the copper IUD, of whom 142 (44.6%) reported multiple episodes. In the levonorgestrel 52 mg IUD group, 14.8 pregnancies were expected using the most recent episode of UPI, and 22.0 pregnancies were expected using all episodes within 5 days of presentation. In the copper IUD group, we calculated 15.0 and 23.1 expected pregnancies, respectively. Levonorgestrel 52 mg IUDs prevented 93.2% to 95.7% of expected pregnancies, and copper IUDs prevented 100% of expected pregnancies.</p><p><strong>Conclusions: </strong>The results of this analysis provide additional data quantifying the pregnancy risk reduction for both the levonorgestrel 52 mg IUD and copper IUD in a realistic population of EC users.</p><p><strong>Implications: </strong>The levonorgestrel 52 mg IUD for emergency contraception prevented 93% to 96% of expected pregnancies using an established pregnancy risk method, while copper IUD users experienced 100% pregnancy prevention.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110946"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombosis risk with the use of hormonal contraception among women with thrombophilia: An updated systematic review.","authors":"Naomi K Tepper, Antoinette T Nguyen, Kathryn M Curtis, Caitlin Baumhart, Laura Schieve, Maura K Whiteman","doi":"10.1016/j.contraception.2025.110943","DOIUrl":"10.1016/j.contraception.2025.110943","url":null,"abstract":"<p><strong>Objectives: </strong>Thrombophilia is associated with an elevated risk of thrombosis, which may be further elevated with the use of hormonal contraception. Our objective was to update a previously published systematic review on thrombosis risk with the use of hormonal contraception among women with thrombophilia.</p><p><strong>Study design: </strong>We conducted a systematic review of five databases from database inception through December 8, 2022. We searched for articles that examined risk of venous thromboembolism (VTE) or arterial thromboembolism (ATE) in women with thrombophilia using hormonal contraception compared with women using nonhormonal or no contraception. We assessed the risk of bias for each study and certainty of evidence for all outcomes.</p><p><strong>Results: </strong>Eighteen articles met inclusion criteria; four had moderate risk of bias and 14 had high risk of bias. Odds of VTE in women with factor V Leiden (FVL) mutation or prothrombin (PT) gene mutation were elevated in combined oral contraception (COC) users vs nonusers. Odds of VTE were elevated in COC users with FVL mutation, PT gene mutation, both FVL and PT mutations, antithrombin deficiency, or protein C deficiency compared with nonusers without the mutation. Odds of stroke were elevated in COC users with FVL mutation compared with nonusers without the mutation. Evidence was mixed on whether risk was elevated in women with protein S deficiency using COC compared with nonuse. One study found elevated odds of VTE in women with FVL mutation but not women with PT gene mutation using progestin-only contraception (POC), compared with nonusers without the mutation.</p><p><strong>Conclusions: </strong>Overall, studies found elevated odds of VTE and ATE in women with thrombophilia using COC compared with nonusers without thrombophilia. The certainty of evidence for all outcomes is low. Evidence is also limited by small numbers of women and minimal evidence on the use of patch, ring, or progestin-only contraception and is insufficient to assess differential risk by all thrombophilia types.</p><p><strong>Implications: </strong>Use of estrogen-containing hormonal contraception might further elevate the risk of thrombosis among women with thrombophilia. Further study is needed on safety of POC use in women with thrombophilia.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110943"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not here, not now: a mystery caller study of availability of mifepristone in community pharmacies in Alberta, Canada.","authors":"Erin A Brennand, Natalie V Scime, Beili Huang, Alam Randhawa, Shunaha Kim-Fine, Orly Aziza, Jadine Paw, Erin L Nelson","doi":"10.1016/j.contraception.2025.110945","DOIUrl":"10.1016/j.contraception.2025.110945","url":null,"abstract":"<p><strong>Objectives: </strong>This study assessed same-day availability, dispensing practices, and information provision for mifepristone in Alberta pharmacies.</p><p><strong>Study design: </strong>Cross-sectional data from 1620 pharmacies (>99% response) were collected from pharmacy respondents using a mystery caller approach (January to October 2024). Using a standardized script, team members inquired about mifepristone availability, Alberta's coverage plan, and dispensing. Outcomes included (1) same-day stock availability, (2) willingness to order, (3) refusal to order, and (4) conscientious objection. Accuracy of cost information and adherence to regulatory standards were assessed. Geographic patterns and associations with the deprivation index of pharmacy location were explored.</p><p><strong>Results: </strong>Same-day dispensing was available at 12.9% pharmacies, and 76.2% offered to order it, with delivery times estimated from the next day to 10 days. A small number of pharmacies (n = 86, 5.3%) did not offer to order with no reason given; conscientious objection was reported by 90 pharmacies (5.6%), of which only 10.0% (n = 9) provided onward referrals. Awareness of Alberta's universal coverage for mifepristone was low; 71.1% of respondents incorrectly stated that uninsured patients must pay out of pocket. Mifepristone was less often in stock in Alberta's two major cities; pharmacies in high-deprivation areas were less likely to have mifepristone in stock and more often expressed conscientious objection.</p><p><strong>Conclusion: </strong>Same-day mifepristone availability in Alberta pharmacies is limited, and adherence to referral standards among objectors is poor. Awareness of universal coverage is suboptimal, raising concern about overcharging. Enhancing access may require collaboration between abortion providers and pharmacies, increased communication about coverage policies, and innovative solutions related to dispensing.</p><p><strong>Implications: </strong>Limited same-day access to mifepristone, compounded by poor adherence to regulatory standards and low awareness of public coverage, highlights equity gaps in abortion care across Alberta, Canada. Targeted policy reforms and pharmacist education are needed to improve timely, reliable access, particularly for socioeconomically disadvantaged communities.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110945"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning from medication abortion: Repeat doses of misoprostol after mifepristone for early pregnancy loss management.","authors":"Fatoumata Bah, Robin Wallace, Angel M Foster, Libby Wetterer, Melissa Grant, Cari Sietstra","doi":"10.1016/j.contraception.2025.110934","DOIUrl":"10.1016/j.contraception.2025.110934","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110934"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal contraception after use of ulipristal acetate as emergency contraception: A systematic review.","authors":"Emily M Snyder, Kathryn M Curtis, Antoinette T Nguyen, Ananya Tadikonda, Katherine Kortsmit, Lauren B Zapata, Maura K Whiteman","doi":"10.1016/j.contraception.2025.110898","DOIUrl":"10.1016/j.contraception.2025.110898","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review literature on whether hormonal contraception following ulipristal acetate (UPA) for emergency contraception decreases the effectiveness of either drug.</p><p><strong>Study design: </strong>We searched multiple databases through December 2022 for studies assessing the interaction between UPA and hormonal contraception. The primary outcome was contraceptive effectiveness, measured by pregnancy rates or proxy measures (e.g., ovarian activity). We extracted and summarized findings from identified studies, assessed risk of bias for each study, and determined certainty of evidence for all outcomes.</p><p><strong>Results: </strong>Four studies met inclusion criteria; all had low risk of bias. Two studies assessed whether UPA use affected the ability of oral contraceptives (OCs) to inhibit ovulation; no differences were observed in ovarian activity when starting OCs 1 day after UPA compared with starting OCs 1 day after placebo. Two studies assessed whether OC use affected the ability of UPA to delay ovulation; both studies observed higher proportions of ovulation when UPA was followed by OC use versus delayed or no OC use. One study assessed ovulation risk when UPA was taken after missed OCs, followed by immediate versus delayed OC resumption; no ovulations occurred within the first 5 days after UPA administration in either group, but there was greater risk of ovulation beyond 5 days with delayed versus immediate OC resumption.</p><p><strong>Conclusions: </strong>While there is no evidence that UPA affects the ability of hormonal contraception to inhibit ovulation, hormonal contraception use immediately or soon after UPA may decrease UPA's ability to delay ovulation. The certainty of evidence ranged from moderate to very low.</p><p><strong>Implications: </strong>If a patient desires hormonal contraception after UPA, an interaction can be avoided by delaying initiation or resumption of hormonal contraception. The risk of pregnancy due to decreased UPA effectiveness with immediate hormonal contraception should be balanced against the risk of subsequent pregnancy due to delay or non-start of hormonal contraception.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110898"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Clinical Recommendation: Management of undesired pregnancy of unknown location and abortion at less than 42 days of gestation.","authors":"Siripanth Nippita, Catherine Cansino, Alisa B Goldberg, Neena Qasba, Katharine White, Vinita Goyal, Angeline Ti, Christy Boraas","doi":"10.1016/j.contraception.2025.110865","DOIUrl":"10.1016/j.contraception.2025.110865","url":null,"abstract":"<p><p>Pregnancy of unknown location is a condition in which a pregnancy test is positive, but no intrauterine or extrauterine pregnancy is visualized using transvaginal ultrasonography. We recommend using standardized nomenclature and definitions to describe intrauterine pregnancy (IUP), probable IUP, pregnancy of unknown location (PUL), probable ectopic pregnancy (probable EP), and ectopic pregnancy (EP) (Best Practice). Among abortion-seeking patients found to have a PUL, the incidence of EP is 4% to 8%. We recommend clinical judgment in assessing the risk for EP in the setting of PUL; the absence of an intrauterine gestational sac (GS) or yolk sac should not delay care (GRADE 1B). In asymptomatic individuals with an undesired PUL who prefer to proceed with immediate treatment (medication or procedural management without delay) and have a low risk of EP, as determined by the clinician based on history, symptoms, and all other available data, we recommend medication management with mifepristone and misoprostol or procedural management via uterine aspiration and clear plans for ensuring pregnancy resolution in a timely fashion (GRADE 1B). While both medication and procedural management of undesired PUL are associated with earlier pregnancy resolution and identification of EP, the two main risks of inadequate follow-up include ongoing pregnancy and missing or delaying a subsequent diagnosis of EP. For individuals with PUL choosing immediate treatment with medication management, we recommend clinicians obtain a baseline serum quantitative human chorionic gonadotropin (hCG) at the time of medication provision to aid in diagnosis and follow-up (GRADE 1A). Following medication management of PUL with mifepristone and misoprostol, we suggest a repeat serum quantitative hCG level, with pregnancy resolution defined as either a 50% decline or greater at 48 to 72 hours after misoprostol or an 80% decline or greater at 7 days after mifepristone or 5 to 10 days after misoprostol (GRADE 2B). We recommend against direct extrapolation of follow-up recommendations from no-test abortion clinical protocols to individuals with a documented PUL treated with mifepristone and misoprostol, given the higher risk of EP among individuals with a known PUL (GRADE 1C). When uterine aspiration is performed at less than 42 days of gestation, including for individuals with PUL or probable IUP, and both chorionic villi and GS are not visualized, we recommend repeat ultrasonography (if an IUP or probable IUP was seen initially), serum quantitative hCG follow-up, or both (GRADE 1B). When both chorionic villi and GS are not visualized after uterine aspiration and serial serum hCG follow-up is warranted, we recommend testing on the day of the procedure and 24 to 72 hours later, with pregnancy resolution defined as greater than 50% decline 24 hours after aspiration, greater than 70% by 48 hours, or greater than 80% by approximately 72 hours (GRADE 1B).</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110865"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 2 - Abortion.","authors":"Rajita Patil, Divya Dethier, Montida Fleming, Emily Godfrey, Julia E Kohn","doi":"10.1016/j.contraception.2025.110864","DOIUrl":"https://doi.org/10.1016/j.contraception.2025.110864","url":null,"abstract":"<p><p>This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven guidance to optimize medication abortion management via telemedicine in the US. Key recommendations include: We recommend telemedicine medication abortion with or without pre- or posttreatment testing as a safe option before 12 0/7 weeks of gestation. No-test telemedicine medication abortion (NTMA) and hybrid models are shown to be safe and effective (GRADE 1B). We recommend over-the-counter nonsteroidal anti-inflammatory agents as the first line for pain management for telemedicine medication abortion with consideration of opioids as needed when providing telemedicine medication abortion care (GRADE 1C). We recommend principles of noncoercive person-centered communication be applied to meet the abortion counseling needs of the person receiving care (GRADE 1B). We suggest assessing the person's desire for contraceptive counseling at the time of telemedicine medication abortion and, depending on the preference of the person receiving care, either defer it to a later time to allow for deliberation and increased autonomy or provide contraceptive counseling if desired (GRADE 2C). We recommend assessing telemedicine medication abortion completion using a standardized patient symptom checklist (such as the sample validated checklist in Table 2) two weeks after mifepristone ingestion in conjunction with a home pregnancy test (GRADE 1C). This document builds upon the Society of Family Planning Committee Statement: Telemedicine in family planning care part 1 - Background and overarching principles and parallels recommendations outlined in the Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 3 - Contraception. Readers are encouraged to review parts 1 and 3 for this additional context.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110864"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping ethical concerns in algorithm-driven period and fertility tracking technologies.","authors":"Maria Carmen Punzi, Tamara Thuis","doi":"10.1016/j.contraception.2025.110837","DOIUrl":"10.1016/j.contraception.2025.110837","url":null,"abstract":"<p><strong>Objective: </strong>The proliferation of algorithms in period and fertility tracking technologies has increased reliance on data and analytics to interpret menstrual cycle symptoms and guide health and fertility-related action. We set out to map the ethical concerns of the (often invisible) algorithmic influence on users' experience of, and behavior related to their menstrual cycle and fertility.</p><p><strong>Study design: </strong>Reviewing literature and media, we map six ethical concerns of algorithms in period and fertility tracking technologies - inconclusive evidence, inscrutable evidence, misguided evidence, unfair outcomes, transformative effects, traceability - and highlight their potential implications, particularly for vulnerable groups.</p><p><strong>Results: </strong>Based on this mapping, we identify three overarching themes for further analysis: self-knowledge, power and control, representation and inclusion. We find that organizational activity, individual user activity and societal dynamics interact with each other and influence how we can prevent and address the mapped ethical concerns of algorithms.</p><p><strong>Conclusion: </strong>Algorithm-driven period and fertility tracking technologies carry more (and more nuanced) ethical concerns than those currently discussed in the literature and in media. We call for future research to integrate the ethics of (AI) algorithms into the field of sexual and reproductive health, recognizing the complex connections between individual, organizational, and societal levels.</p><p><strong>Implications: </strong>When taking the mapped ethical concerns seriously, we see a potential for algorithm-driven period and fertility tracking technologies to empower - and not discriminate - its users; for users to learn about their bodies and use the technologies responsibly; and for society to actively scrutinize its biases and achieve health equity.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"110837"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}