Fertility Info 2017-10-23T20:13:08+00:00

Fertility Info

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For more than 30 years, Toni Weschler has devoted herself to empowering women to take charge of their reproductive health and fertility. During this time, she has received thousands of inquiries from women as they learn to incorporate her teachings on the Fertility Awareness Method into their daily lives. Below is a collection of the most frequently asked questions, along with Toni’s answers! If you have a question that doesn’t appear here, please Contact Us.
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Is it worth checking my cervical position? 2015-11-19T23:08:15+00:00

Although it is not necessary to check your cervix in order to practice FAM effectively, I urge you to learn how to do so. At a minimum, I think you should practice checking in the days leading up to and just past ovulation, for the first few cycles that you’re learning the method. Once you recognize how your cervical position reflects your fertility, you will always be able to use it as a cross check whenever you find the slightest ambiguity in your other two fertility signs.

The bottom line is that complete familiarity with the changes in your cervix will greatly increase the confidence with which you observe your fertility and overall gynecological health. And since it only takes seconds a day to check, my attitude is that for those few relevant days per cycle, you should just do it!

A distinct but closely related question is whether those women using FAM for contracption should ever check their cervical fluid at the cervical tip. The short answer is that it isn’t necessary to do so, although if you want to be even more conservative than the FAM rules require, or if you simply want to know your cervical fluid status ahead of time, it certainly couldn’t hurt (Remember that the cervical fluid you normally check at the vaginal opening might have taken several hours to trickle down from the cervical tip). Finally, checking this way may provide some couples with more time for unprotected sex.

What does it mean if I don’t see a thermal shift but I have very regular, 28-day cycles? 2015-11-19T23:07:44+00:00

It can mean one of several things: First, you may be ovulating, but you may be one of the few women whose temperatures do not reflect the heat-inducing progesterone produced following ovulation. Second, you may indeed be having a thermal shift, but are not drawing the coverline correctly in order to accurately interpret your charts Third, and finally, you may not be ovulating altogether, although this is not that likely, since women with extremely regular cycles usually do ovulate.

How can temperatures be relied upon if I sometimes get a fever? 2015-11-19T23:07:26+00:00

There may be several factors, from fever to alcohol to lack of sleep, that could affect your waking temperature. Yet this doesn’t compromise your ability to rely on them while charting, because you ultimately want to identify a pattern of low and high temperatures, rather than focusing on individual ones. Outlying temperatures can be effectively dealt with by using the Rule of Thumb, which usually allows you to ignore them in interpreting your chart. In addition, you will always be able to rely on your other two signs to cross-check your fertility in situations such as these.

Do I have to wake up every day at the same time in order to take my temperature? 2015-11-19T23:06:57+00:00

No, although you should try to be as consistent as possible. In general, waking temperatures tend to creep up about two-tenths of a degree for every extra hour you sleep in. Thus, if you take it substantially later than usual, it may result in a reading that is outside the range of your usual pattern. If you wake up earlier than usual, you should take your temperature upon awakening, so long as you have had at least 3 hours of consecutive sleep.

Regardless, an occasional aberrant temperature can easily be dealt with by following the Rule of Thumb. You should also be aware that if taking your temperature feels like a burden, you can in fact take it for only about a third of the cycle without sacrificing contraceptive efficacy, as described in Chapter 10 of Taking Charge of Your Fertility.

How many days do you have to abstain when using the Fertility Awareness Method for birth control? 2015-11-19T23:05:27+00:00

You never have to abstain when using the Fertility Awareness Method. This is different than Natural Family Planning, which does require abstinence during the fertile phase. However, if you do have intercourse when you are potentially fertile, you must use a barrier method of contraception. The fertile phase will vary, but in practice this means that the average couple would have to use barriers about 8-10 days per cycle. The average cycle is 27-31 days, and thus for the typical couple, barriers (or abstinence) would be required for about 30% of the cycle.

How effective is FAM as a method of birth control? 2015-11-19T23:04:49+00:00

If used perfectly every cycle, including abstaining during the fertile phase, the FAM rules have a failure rate of approximately 2% per year. This is considered lower than any barrier method, except the condom, which is also 2%. But unlike other methods of contraception, this method is the most unforgiving, since, if you make a mistake, by definition, it will occur during your most fertile time. So in actual use, failure rates may be higher, depending on the motivation of the couple to adhere to the rules.

What are the differences between the various methods of natural birth control? 2015-11-19T23:04:29+00:00

* Fertility Awareness Method (FAM) is the generic term used to describe all scientifically validated, natural forms of contraception. It involves the daily charting of the primary fertility signs which indicate the fertile phase surrounding ovulation. The three signs which are charted are waking temperature, cervical fluid, and cervical changes. It allows for the use of a barrier contraceptive during the woman’s fertile phase.
* Natural Family Planning (NFP) is virtually the same as the Fertility Awareness Method, but it requires abstinence during the fertile phase. It is typically practiced by those individuals who think of the method more as a way of life and tend to be more religious-oriented.
* The Rhythm Method is an antiquated, obsolete, ineffective method of contraception which is based upon a strictly mathematical computation of the average of a woman’s past cycle lengths, with absolutely no daily observations to determine impending ovulation of each individual cycle . The Rhythm Method is the greatest obstacle to the acceptance of FAM and NFP as valid, effective methods of contraception, since it is often erroneously associated with the two, even though FAM and NFP are based upon scientifically validated principles which treat each cycle uniquely.

How soon after childbirth will I start ovulating? Can I expect the same cycle as before? 2015-11-19T23:03:48+00:00

Women who don’t breastfeed find that their cycles resume very quickly – as early as 4-10 weeks after childbirth. But, if you meet the following 3 criteria, then your chances of ovulating are only about 2%:

* Your menses have not returned.
* You are fully or nearly fully breastfeeding.
* Your baby is less than six months old.

If you wanted to have a safe and natural method of contraception during these first 6 months, you could use the Lactational Amenorrhea Method (LAM), as described in TCOYF.

Why does my ovulation kit indicate that I am ovulating, but my BBT doesn’t have a rise at the same time? 2015-11-19T23:03:13+00:00

This experience is completely normal and to be expected. The ovulation kits predict impending ovulation by detecting the surge of a hormone called, LH, or luteinizing hormone. This hormone is the very catalyst that thrusts the egg out of the ovary during ovulation. The temperature shift indicates that ovulation has already occurred. Once you ovulate, the leftover follicle (the corpus luteum) that encased the egg in the ovary starts producing progesterone, a heat-inducing hormone.

It is the progesterone that causes a thermal shift, or temperature rise in your body, usually a day or two after you ovulate. So in essence, you would expect to see about a two or three day delay from the LH surge to your thermal shift. The order is: LH, ovulation, and then thermal shift. But keep in mind that it is possible to have an LH surge, and still not actually ovulate. If this happens, you temperature will not rise to a sustained higher level.

Does ovulation occur when my cervical fluid is most abundant, or afterwards? 2015-11-19T23:02:51+00:00

This is actually a very interesting question, because the answer is not intuitive. Every single woman has one day in her cycle that is more fertile than any other day, but that day is not usually the day she ovulates! How can that be? Generally speaking, your most fertile day is considered the last day that you produce fertile quality cervical fluid or have a wet vaginal sensation for any given cycle. It is called the “Peak Day,” because it denotes your peak day of fertility. But this day usually occurs a day or two before you ovulate, or occasionally on the day of ovulation itself (Unfortunately, the only way to know precisely when you ovulate would be to have an ultrasound every month-not a very practical solution).

One of the obvious drawbacks of charting the Peak Day is that you will only be able to determine it in retrospect, on the following day. This is because you can only recognize it after your cervical fluid and vaginal sensation have already begun to dry up. This concept should become intuitive fairly quickly, though. Also be aware that the Peak Day is not necessarily the day of the greatest quantity of cervical fluid. In fact, the longest stretch or greatest amount could occur a day or two before your Peak Day.

Do women feel more sexual around ovulation? 2015-11-19T23:02:33+00:00

Many women do. Because estrogen peaks around ovulation, women typically experience a wet, slippery sensation due to the fertile cervical fluid they produce. This cervical fluid feels similar to sexual lubrication, and can therefore be experienced as a sexual feeling. A woman who practices FAM needn’t worry about confusing the two, because cervical fluid is checked periodically throughout the day, and not when she is sexually aroused.

Can you “feel” ovulation happen? 2015-11-19T23:02:11+00:00

The most obvious outward sign of impending ovulation is increasing wet and slippery cervical fluid. In fact, it can be so abundant that women notice a string of cervical fluid literally hang down when they are using the toilet (Bon appetite, by the way). If a woman notices this, she should assume that ovulation is about to happen within a day or two. This is what is referred to as a primary fertility sign.

Some women are lucky enough to notice other signs on a regular basis, all of which are very helpful in being able to further understand their cycles. These signs are referred to as secondary fertility signs, because they do not necessarily occur in all women, or in every cycle in individual women. Yet they are still very practical for giving women additional information to identify their fertile and infertile phases.

Secondary signs as ovulation approaches may include:

* Mid-cycle spotting
* Pain or achiness near the ovaries and uterus (called “mittelschmerz”)
* Increased sexual feelings
* Fuller vaginal lips
* Abdominal bloating
* Water retention
* Increased energy level
* Heightened sense of vision, smell and taste
* Increased sensitivity in breasts and skin
* Breast tenderness

Do women always ovulate on Day 14 of their cycle? 2015-11-19T23:01:33+00:00

No! The day of ovulation can vary among women as well as within each individual woman. However, once a woman ovulates, the time between ovulation and her menstruation is very consistent, almost always between 12 and 16 days. Within most individual women, this length of time generally doesn’t change by more than a day or two. In other words, if there is going to be variation in the cycle, it is the first preovulatory phase that may vary. The second (postovulatory) phase generally remains constant.

Is it safe to start trying to get pregnant right after stopping The Pill? 2015-11-19T23:00:02+00:00

It used to be that women were encouraged to wait several cycles before trying to conceive following the use of the Pill. But nowadays, many physicians suggest trying shortly after discontinuing it, since some speculate there is a higher chance of conceiving within the first few months after stopping.

When a woman comes off the Pill or other hormones, her cycles will usually revert back to the way they were before. However, the length of time it takes varies among women. For some, it is almost immediate. But for most, there is at least a short delay. And for others, it could take many months. This variation is a function of the type and dosage of hormones used, as well as the basic physiology of the woman.

Is FAM better for someone avoiding pregnancy or for someone trying to get pregnant? 2016-10-20T21:10:51+00:00

I personally think a more appropriate question should be: what women would not benefit from charting her cycle? The Fertility Awareness Method (FAM) is an incredibly liberating and effective method of understanding your fertility on a day-to-day basis, whether or not you need contraception or an aid to pregnancy achievement. It also happens to be a wonderful tool for maintaining your gynecological health.

As an empowering method of natural birth control, women from all over the world have been drawn to FAM simply because it is free of the chemicals associated with hormonal methods such as the Pill. Just as importantly, it allows them to minimize the time that they need to use the chemicals and hardware that makes other methods unpleasant, impractical, or unspontaneous.

And as an aid to pregnancy achievement, the Fertility Awareness Method should always be the first step in the pursuit of pregnancy. When trying to get pregnant, dispense with all the misinformation well-meaning friends and clinicians seem to perpetuate. Charting your cycle will allow you to finally take control and understand not only when you are most fertile in any given cycle, but what impediments you may have to achieving pregnancy.

Is FAM a good method for everybody? 2015-11-19T22:59:12+00:00

No, not as a method of birth control. It is only appropriate for those women who have the discipline to learn the method well, and then to follow the rules once they have internalized them. In addition, it is only recommended for monogamous couples, given the danger of HIV and other STDs.

However, as a method of pregnancy achievement, it is highly advised as the first step that every couple should take to maximize their chances of conception, and to determine if there may be anything impeding their ability to get pregnant. In addition, Fertility Awareness can be very effective in helping couples plan the timing of their baby’s birth.

FAM is also highly beneficial for all cycling women who simply want to educate themselves about their own bodies. So even if you have no interest in using the method for avoiding or achieving pregnancy, it is an empowering means of taking control of your gynecological health.

Myth: Fertility Awareness is based on the moon and the stars and astrology. 2015-11-19T22:58:10+00:00

Actually, Fertility Awareness is based upon medically accurate and purely biological occurrences within the woman’s body.

Myth: The Fertility Awareness Method is the Rhythm Method. 2015-11-19T22:57:49+00:00

The Fertility Awareness Method is NOT the Rhythm Method. The Rhythm Method is nothing more than an obsolete, ineffective guessing game that uses past cycles to predict future fertility. The Fertility Awareness Method, on the other hand, is a scientifically-validated, effective, and natural method that involves charting three primary fertility signs on a daily basis, so that a woman’s fertility can be accurately determined.

The three primary fertility signs are waking temperature, cervical fluid, and cervical position. The method is based upon the functioning of estrogen, progesterone, luteinizing hormone, and the corpus luteum. Unlike the Rhythm Method, whose contraceptive effectiveness cannot be taken seriously, the Fertility Awareness Method, when used properly, is 98% effective.

Myth: Women run out of eggs at menopause. 2015-11-19T22:57:29+00:00

Wrong. Women are born with over 400,000 eggs, but have nowhere near that many periods in their life, thank goodness! Instead, at menopause, the woman’s body stops responding to the hormones that cause the eggs to mature in the ovary before being released at ovulation.

Myth: Infertility is a reflection of a person’s sexuality. 2016-10-20T21:10:51+00:00

In reality, fertility and sexuality are totally unrelated. Fertility refers to a person’s ability to procreate. Sexuality is completely independent of that ability.

Myth: A woman is more likely to become pregnant if the couple adopts a child. 2015-11-19T22:56:45+00:00

This is simply not true. For one thing, stress does not necessarily stop once a couple adopts! The other point is that a woman is not statistically more likely to conceive after adopting. People tend to hear about those cases and not all the cases where women did not get pregnant following adoption.

Myth: Infertility is primarily a female problem. 2015-11-19T22:56:03+00:00

In reality, it is about 40% female, 40% male, 20% both.

Myth: Stress causes infertility. 2015-11-19T22:55:44+00:00

Actually, the role that stress plays on one’s fertility is fairly complex. Stress, per se, does not prevent conception. However, it can delay ovulation by suppressing the hormones necessary for it to occur. If a couple adheres to the myth of ovulation always occurring on Day 14, they then may inadvertently prevent pregnancy by timing intercourse at the wrong time, thus triggering a vicious circle of misperceived infertility causing more stress. Charting her cycle would allow the couple to regain control by correctly identifying the woman’s fertile phase.

Myth: A woman’s cycle is such a mystery that there is no way to understand it. 2015-11-19T22:55:22+00:00

Wrong! We’ve all been led to believe that the menstrual cycle is so confusing that it is best left to medical professionals to interpret our cycles. In reality, a woman can easily take control of her fertility by understanding her cycle on a day-to-day basis.

Myth: Sperm can only live up to three days. 2015-11-19T22:54:57+00:00

Actually, sperm can survive up to five days in the woman’s reproductive tract. This is the reason why even though a woman’s egg can only live for 12-24 hours, she is potentially fertile for about one week per cycle — five days for sperm viability, plus two days for the possibility of two eggs being released in any given cycle.

Myth: Conception occurs in the uterus. 2015-11-19T22:54:26+00:00

Conception actually occurs in the outer third of the fallopian tubes, and not in the uterus, as many people think. The reason for this is that an egg can only live 12-24 hours, so by the time 24 hours have passed, the egg has only traveled as far as the outer third of the tubes. Implantation on the other hand, does occur in the uterus.

Myth: Vaginal secretions usually indicate an infection. 2015-11-19T22:53:59+00:00

Perhaps the most prevalent undiscussed biological phenomenon that women experience is their vaginal fluids. Their natural and healthy secretions are no doubt something that virtually all women occasionally notice on their underwear. Yet because they are not taught what this is, they often assume it is infectious “discharge” needing to be treated or douched away. Women are not unhealthy or dirty, just uninformed.

Myth: Worrying about a late period may only delay it. 2015-11-19T22:53:39+00:00

This myth is often perpetuated by the most well-meaning friends. But the reason it’s not true is that stress does not delay one’s menstrual period; it can only delay ovulation. Once ovulation has occurred, the woman’s body has already determined when she will menstruate. In other words, the time from ovulation to menstruation varies little from cycle to cycle.

Myth: Ovulation occurs on the day of the drop or the day of the rise in BBT. 2015-11-19T22:53:15+00:00

This is one of the most common myths perpetuated by the medical community. In reality, the exact day of ovulation cannot be determined by the basal body temperature. Only about 10% of women even have a drop in basal temperature. And once the temperature has risen, it is virtually certain that the egg is already gone (assuming conception hadn’t occurred beforehand.) This is because an egg only lives 12-24 hours, and by the time the temperature has risen, the egg is no longer viable. Therefore, if a couple wants to achieve a pregnancy, the sign to focus on is not the basal temperature, but the cervical fluid.

Myth: Women cannot get pregnant from intercourse during their period. 2015-11-19T22:52:25+00:00

This is tricky, because there is potential ambiguity in the phrasing of the assertion. In other words, whether or not a woman can get pregnant during her period depends on the precise question asked. “Can a woman get pregnant during her period?” is quite different from, “Can a woman get pregnant from intercourse during her period?”

A woman can NOT get pregnant during her period because the hormonal levels that trigger ovulation are completely opposite during menstruation.

However, a woman CAN get pregnant from intercourse during her period if she has an early ovulation and has sex on Day 5 or later of her cycle.

Myth: Orgasms cause women to release eggs. 2015-11-19T22:51:53+00:00

This is an especially intriguing myth — that orgasm can lead to spontaneous ovulation. In fact the process that leads to ovulation is the gradual increase of estrogen over a period of several days, not a sudden surge.

Myth: Women are fertile all the time. 2015-11-19T22:50:47+00:00

Not true! Women are only fertile the few days around ovulation. In fact, a human egg can only survive 12-24 hours after being released from the ovary, and thus the only reason women are considered fertile for longer than 24 hours (or 48 hours in the case of a multiple ovulation) is because sperm can live for up to five days if fertile quality cervical fluid is present. Interestingly enough, it is men who are always fertile!

MYTH: A woman can spontaneously ovulate at any time in the cycle. 2015-11-19T22:50:20+00:00

This is simply not true. Even though the timing of ovulation can vary from cycle to cycle, once a woman ovulates, it is virtually impossible for her to ovulate again until the following cycle. This is because once ovulation occurs, the hormone progesterone will suppresses the release of all other eggs until the following cycle.

Even in the case of a multiple ovulation, the eggs are released within 24 hours of each other. During those 24 hours, one or more eggs will be released, and then no more until the next cycle.

MYTH: A woman can get pregnant only one day per cycle. 2015-11-19T22:49:49+00:00

While it is true that a human egg is only viable for 12 to 24 hours, a woman can actually get pregnant from an act of intercourse occurring anytime from about five days prior to ovulation to even occasionally two days after, for a total of about seven days.

The reason for this is that the sperm can survive up to five days inside the woman’s reproductive tract, and a woman can release two or more eggs within a 24 hour period.. Hence, for all intents and purposes, a women can get pregnant for about one week per cycle.

MYTH: A normal menstrual cycle is 28 days. 2015-11-19T22:49:26+00:00

Actually, a normal menstrual cycle can vary from about 24-36 days. And not only do cycles vary substantially among women, they often vary within each individual woman. One of the most unfortunate results of this myth is the needless anxiety that it causes women desiring to avoid pregnancy, who are led to believe over and over again that they may be pregnant because their periods are “late.”

The perpetuation of this belief is related, in part, to people’s perception of the perfect Pill cycle (boy, that’s a mouthful of p’s!). What people often do not understand is that oral contraceptives, by definition, hormonally manipulate the woman’s cycle to be a perfect 28 days. This belief in the perfect cycle is probably less widely accepted among women who have never been on the Pill.

MYTH: Ovulation usually occurs on Day 14 of the cycle. 2015-11-19T22:49:00+00:00

Probably the most widely held fertility myth is the notion that women always ovulate on Day 14 of their cycle. If this were indeed true, there would be virtually no need for birth control, since couples could simply avoid that one day. And scores of couples desiring a child would simply have intercourse on Day 14, and Bingo, get pregnant.

There are several serious consequences to the Day 14 fallacy:

* Many unplanned pregnancies occur because couples think they are safe for unprotected intercourse on any day but Day 14.
* Many couples who desire to get pregnant actually impede pregnancy by timing intercourse on Day 14, when, in reality, the woman may ovulate either much earlier or later than that one particular day.
* Many diagnostic tests and therapies are performed at an inappropriate time in the woman’s cycle. These include infertility procedures such as post-coital tests and endometrial biopsies, as well as general health procedures such as mammograms and diaphragm fittings.
* If a woman does get pregnant, the doctor’s office will usually utilize a “pregnancy wheel” to determine her due date. But this device assumes that women ovulate on Day 14, and therefore could be off by several weeks, leading physicians to perform diagnostic tests at inappropriate times (e.g. amniocentesis) or even induce labor before the baby is fully developed.

How does the Pill work? 2016-10-20T21:10:51+00:00

In essence, the Pill works by tricking the body into thinking it’s already pregnant. It does this by manipulating the normal hormonal feedback system. The end result is that the body doesn’t release the hormones necessary to stimulate the ovary to release an egg.

As a back-up, every other facet of the woman’s reproductive system is also altered. The uterine lining is prevented from producing a suitable environment for egg implantation, and the cervical fluid doesn’t develop the fertile quality necessary for sperm survival.

How long can a human egg survive? 2015-11-19T22:46:14+00:00

Most ova probably survive about six to twelve hours after ovulation. However, for the purposes of contraception, you must count on a 24-hour survival period, plus an additional 24 hours in case there is a multiple ovulation.

Can you be pregnant and still have your period? 2015-11-19T22:45:55+00:00

It’s fairly unusual to be pregnant and still have a normal period. This is because the very thing that causes women to menstruate is the drop in progesterone that occurs only if fertilization does not happen. If a woman were pregnant, her progesterone levels would remain high, thus preventing her from having a period. Of course, there are times when pregnant women do indeed bleed, but by definition, these bleeding episodes are not true menstrual periods:

1. Implantation spotting: This is usually brownish spotting that occurs in some women about a week or two following fertilization. It is due to the egg implanting in the uterine lining, causing a small amount of the lining to be shed.
2. Bleeding due to hormonal shifts occurring with pregnancy: In this case, it may be perfectly normal, or it may signal a potential problem requiring a physician’s observation.

Then there are the cases where the opposite occurs, in which a woman actually thinks she is pregnant when she really is not. The most common cause of this is when women have a delayed ovulation, which causes them to menstruate later than usual, often leading them to think that they are pregnant because their period is late.

Regardless the easiest way to determine why you are or are not bleeding is to chart your waking temperature. Once you do so, you will probably find that it provides so much valuable information that you’ll wonder how you got by while being so unaware.

Can a woman get pregnant during her period? 2015-11-19T22:45:35+00:00

The answer lies in the wording of the question. More precisely, it is essentially impossible for a woman to get pregnant during her period, but on rare occasions it is possible for a woman to get pregnant from intercourse during her period. Since sperm can live for five days, a couple could have sex near the end of the woman’s period, and the sperm could then live long enough to fertilize an egg several days later, if the woman had a very early ovulation. (Conception is more likely in these cases if intercourse occurs at the end of a 6- or 7-day menstruation.) It’s also possible that women who think they got pregnant from intercourse during their period were actually having sex during ovulatory spotting.

What percent of a woman’s cycle is fertile? 2015-11-19T22:44:23+00:00

The answer to this question is somewhat tricky. The general answer is that most women are fertile for only a few days per cycle. However, there are several factors to consider:

1. The woman’s egg can only live up to 24 hours. Two or more eggs may be released over a maximum of 24 hours. So, in a vacuum, a woman is only fertile for about a day or two. But the man’s sperm can live up to 5 days, so the combined fertility of the two individuals is about a week.
2. For a couple trying to get pregnant, the woman’s fertile phase is as long as she has fertile quality cervical fluid, up through ovulation. That might be several days, or as few as one.
3. For a couple trying to prevent pregnancy, FAM adds a buffer zone of a few days to assure that an unplanned pregnancy does not occur. This usually results in about 7-10 days being considered fertile per cycle.