February 15, 2021

Spotlight on Research: A Physician’s Vision Advances Women’s Health


By Amaryllis Sánchez Wohlever, MD


As senior writer and editor for FACTS, today I have a heartwarming opportunity to brag a little and share a meaningful story. Regardless of the various reasons why women choose to use fertility awareness-based methods (FABMs), FACTS exists to educate medical professionals about the science behind FABMs. Since the inception of FACTS, our goal has been to share the evidence behind these versatile methods with practical applications not only in family planning but also in women’s health. This foundation and purpose are built into our very name: FACTS is the Fertility Appreciation Collaborative to Teach the Science.

An Exciting Opportunity

Ten years into this pioneering work, Dr. Marguerite Duane, cofounder and executive director of FACTS, had an ‘Aha!’ moment. In a fresh and stirring way, she realized that research remains the highest need in the field of fertility awareness. Never one to sit on her laurels, she pursued a prestigious research opportunity that will launch FACTS to a new level of impact. Twenty years into her practice as a physician, Dr. Duane applied and was selected for a research fellowship in women’s health at the University of Utah working directly with Dr. Joseph Stanford, one of the pre-eminent leaders and researchers in fertility awareness worldwide. A practicing family physician, Dr. Stanford has authored or co-authored over a hundred scholarly articles in fertility awareness and women’s health over more than twenty years.

For this compelling reason — in the middle of a lingering pandemic — Dr. Duane moved her family across the country from Washington D.C. to Salt Lake City, Utah to complete a research fellowship in women’s health and a Master of Science in Public Health. As she settled into a new community in the fall of 2020 while continuing to lead our organization, the dedicated FACTS team accepted the challenge of this time as well.*

The Acute Need for Research

The paucity of research in these modern methods has many causes, with a lack of funding perhaps the most frustrating obstacle keeping women and couples from experiencing the benefits of FABMs. “And just because research isn’t published, that doesn’t mean the research doesn’t exist,” explains Dr. Duane while reflecting on this hindrance to bridge knowledge gaps among medical professionals and patients alike. “It may be that no one has asked the question, or they asked and found the answer but don’t have the funding. Or perhaps they looked and found answers but have trouble getting it published.”

Aware of the need for more people doing this research, Dr. Duane decided to pursue this unique fellowship with Dr. Stanford. As a fellow family physician, she appreciates Dr. Stanford’s wholistic approach in patient care and his commitment to addressing male factors that contribute to a couple’s inability to conceive. Beyond the strong emphasis of this fellowship on research methods and analysis, Dr. Duane is thrilled the clinical experience with Dr. Stanford includes learning and refining her skills in bedside ultrasound interpretation.

Does a Short Luteal Phase Increase a Woman’s Risk for Miscarriage?

For her research project, Dr. Duane decided to consider factors that may help prevent miscarriages, which occur in 10-20% of clinically recognized pregnancies.[i] She wanted to study something related to charting of the female cycle that is not specific to any one fertility awareness-based method. Since miscarriage has both physical and psychological consequences, it is important to identify women at risk for miscarriage and seek ways to prevent it.

Aware of the research showing that progesterone supplementation may help prevent recurrent miscarriage, Dr. Duane wondered why this may be. Might progesterone help prevent recurrent miscarriages by correcting or lengthening a short luteal phase? Does a short luteal phase increase their chance of miscarriage? She finds it tragic that a thorough evaluation to search for root causes of miscarriage is often not pursued until after a woman has at least three miscarriages, an approach that leaves women and couples in a tornado of emotions and grief without answers or understanding.

Dr. Duane hopes for a different approach in which, rather than sit and wait, we do all we can to understand and prevent future losses, and charting the female cycle offers hope in this regard. She explains, “If we can identify women at risk for miscarriage by using the female chart to detect luteal phase issues, we can diagnose earlier.” Part of her study involves assessing how FABM charting of the female cycle can enhance the identification of women at risk for miscarriage, thus potentially helping prevent at least some of them.

It is Time to Integrate Fertility Awareness in Women’s Health

With a decade of sharing the FACTS behind us, our mission to educate the next generation of medical professionals about FABMs and their medical applications includes a commitment to not only share the research available but also expand it. Stay tuned for Dr. Duane’s study findings to publish in the near future! Such research will be one more contribution to the much-needed literature in fertility awareness that holds promise to revolutionize women’s health care.


[i] Hogue CJ. Invited Commentary: Preventable Pregnancy Loss Is a Public Health Problem. Am J Epidemiol. 2016;183(8):709-712. doi:10.1093/aje/kww004.


* The FACTS Team Meets the Challenge

In the last year, we expanded the FACTS elective to meet the growing demand for high quality online learning in medical education. We launched a database for physicians, practitioners, and educators to list their practices so patients can access FABM-trained professionals throughout the country. We offered our first-ever virtual CME conference in the fall of 2020 and are preparing to launch a virtual CME course for physicians this spring. Mark your calendars and plan to join us for our next virtual CME conference on May 14-15, 2021.

We could not do this important work without the generous support of all our donors, especially our monthly benefactors. Together we can achieve better healthcare for women. Thank you for partnering with us by making a gift today!


About the Author

Amaryllis Sánchez Wohlever, MD

Amaryllis Sánchez Wohlever, MD is senior writer and editor for FACTS. She is also associate course director for the cutting-edge fertility awareness FACTS elective offered through Georgetown University School of Medicine. She is a Board-certified family physician, a national expert in clinician wellness and burnout prevention, and a certified wellness and leadership coach for physicians. She speaks throughout the country to empower medical professionals with the message of hope from her latest book, Recapturing Joy in Medicine.

Did You Know?

As a FACTS member, you are able to view and download more than 160 research articles. The searchable database groups articles into 12 categories including Charting and the Science of the Cycle, FABM Effectiveness for Preventing Pregnancy, FABMs for Infertility and Achieving Pregnancy, Fertility Awareness Apps and FemTech, Psychosocial Aspects of FABMs, and more!

Memberships start at only $20/year!

Medical professionals, residents, and students – Become a FACTS member today and take advantage of this, and many more great resources and benefits!

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