Fertility Awareness Method

When you’re trying to conceive, knowing when you ovulate is one of the most important things. The fertility awareness method (FAM) is a natural form of birth control that does not use any drugs or devices. It combines the calendar method, basal body temperature, and cervical mucous to give you awareness of when your body is most fertile.

Contrary to popular belief, you actually can’t get pregnant any day of the month (assuming you have a regular cycle). An egg can live inside a woman’s body for 12-24 hours. Sperm, on the other hand, can live in a woman’s body for up to 5 days after intercourse. Pregnancy is most likely to occur if intercourse occurs anywhere from 3 days before ovulation until 2-3 days after ovulation. Therefore, there’s really only a 5 day span where a woman is most fertile and able to conceive.

Note: When considering using FAM as a form of contraception, i.e. knowing what days not to have sex on in order to not get pregnant, it is best to do it when you’re in a committed relationship. It takes several months, ideally up to a year, of tracking cycles, BBT, and cervical mucous, to get a good gauge on when you are ovulating. It is great to do this in order to know your body and your cycle better, but it is also recommended to use a second form of contraceptive, such as a condom or IUD, in order to prevent unwanted pregnancy.

Now let’s get into how to track ovulation:

• Calendar Method:

  1. Keep track of menstrual cycle lengths for 8-12 months

  2. Pick the shortest and longest cycles from your months of tracking

  3. The first day of your fertile window is determined by subtracting 18 days from the length of your shortest cycle.

  If your shortest cycle was 27 days, subtract 18 from this, giving you 9. This means that the first day of your fertility window starts at day 9 of your cycle.

  4. The last day of your fertile window is determined by subtracting 11 days from the length of your longest cycle.

  If your longest cycle was 33 days, subtract 11 from this, giving you 22. This means that the last day of your fertility window is day 22 of your cycle.

This means that days 9-22 of your cycle are the days when ovulation will occur. These are not all the days that you can get pregnant, but the days that you can conceive fall within this timeframe.

using a paper calendar is a great way to track all menstrual signs

• Basal Body Temperature:

  • Take your temperature every single morning…

    • right after waking

    • before getting out of bed

    • the same way (orally)

    • at the same time

  • Temperature rises at least 0.5 degree at or after ovulation occurs, and will remain elevated until menstruation occurs due to the elevated levels of progesterone that naturally occur in the luteal phase of the cycle.

  • In some women, a drop in temperature occurs 12-24 hours before ovulation occurs

an example of a basal body temperature chart

• Cervical Mucus Monitoring:

Cervical mucus is completely normal and it fluctuates in consistency throughout the menstrual cycle. Right after menses, you may experience minimal discharge for a few days. Throughout the follicular phase, mucus wetness increases daily, lasting approximately 9 days until the wettest day, which should be your ovulation day.

1. Collect the mucus from your vaginal opening with your fingers

2. Note the color, consistency, and feel of the cervical mucus

• color: white, yellow, clear, cloudy…

• consistency: thin, thick, stretchy, sticky…

• feel: dry, wet, slippery…

3. On the days of ovulation, cervical discharge will be clear, stretchy, and slippery - similar to an egg white consistency.

While using fertility awareness method, it’s important to discontinue use of any douches or spermicides, as they can increase risk of infection and may wash away or change the appearance of mucus.

a visualization of cervical mucus change throughout cycle

• Ovulation Predictor Kits (OPKs)

  Additionally, if you are trying to conceive, ovulation predictor kits are a great tool to use that ensures you are ovulating on a certain day. The most common type of OPK is a urine LH test, which detects ovulation based on urinary concentration of LH. An LH spike occurs approximately 12-36 hours prior to ovulation, so this test gives a good baseline of whether or not you should be engaging in sexual activity at the given time.

How Effective is Fertility Awareness Method?

When used correctly, FAM could be about 90% effective. The effectiveness depends on how diligent you are about tracking and recording your fertility pattern. In addition to this, it is important to either abstain from or use of a backup contraception on the days you are fertile in order to prevent pregnancy. As noted above, it is recommended to only use FAM when you are in a longterm relationship, as this method of contraception requires both partners to be involved and attentive. This method does not prevent against STIs, so make sure to use a condom if you are having sex with multiple partners.