Click for a more in depth breakdown

For methods that use an algorithm to determine the opening of the fertile window (i.e. Marquette, Couple to Couple League and other sympto-hormonal methods), the bare minimum calculation for the fertile window is 9 days: 5 days of sperm life + peak day + 3 days post peak to account for a potential second ovulation. This number of days prior to peak will increase for women with longer cycles (longer than 28-30 days). Methods such as Creighton or Billings (mucus-only methods) determine fertility on a day-to-day basis, which may result in a longer or shorter fertile window based on the presence or absence of mucus. This number may vary depending on a woman’s level of confidence identifying her biomarkers, but confidence increases with frequent contact with a responsible instructor. In order to avoid a pregnancy, couples abstain from vaginal intercourse during the fertile window. In order to achieve pregnancy, couples engage in vaginal intercourse every other day once the fertile window opens leading up to ovulation. Shared Responsibility This definition of the fertile window emphasizes the shared responsibility of fertility, and rejects the notion that fertility is purely a woman’s responsibility to deal with or solve. Whether a couple is trying to avoid or achieve a pregnancy, they make and bear the consequences of their decision together. Successful practice therefore requires partners to engage in frequent open and honest communication regarding their fertility, family planning intentions, and sexual needs and desires. This aspect of the practice can present difficulties when partners differ in faith practice, expectations of sex, or in the intention to avoid or achieve pregnancy. This is why developing open and honest communication is of vital importance. Couples who work at this communication, even during difficult times, often report feeling respected and heard by their partners which in turn fosters a deeper intimacy and authentic equality.

Click to see how natural hormones benefit our bodies

Estrogen promotes: muscle gain insulin sensitivity long-term health of bones, brain, an cardiovascular system Progesterone promotes: reduces inflammation regulates immune function supports thyroid, brain, bones, and breast tissue Ovulation doesn’t only promote health, but is a sign of health. Some refer to it as “The Fifth Vital Sign” because ovulation occurs in a healthy woman. If ovulation is not taking place, that provides information to the woman that one or more things are not working as they should. The Secret Powers of Ovulation (It's Not Just for Making a Baby) (larabriden.com)). All methods of fertility awareness provide valuable health benefits. A woman can learn how her fertility system functions, identify a healthy luteal phase, be able to predict when her next period starts, how stress affects the cycle, and some methods provide even more in depth information about the woman’s health and further treatment options.

What is Fertility Awareness? Let's Dive In!

What is Fertility Awareness?

Fertility Awareness is the scientific discipline by which a woman can learn to chart and interpret the fertility signs her body produces over the course of a menstrual cycle to determine the approximate timing of ovulation and gather a variety of beneficial health information.

The signs of fertility used to determine the fertile window, known as biomarkers, include:

Each fertility awareness method will use one or more of these biomarkers within the discipline of charting.

Biomarkers that can be used to evaluate the health of the menstrual cycle include:

the length of the menstrual cycle
pre-ovulatory and post-ovulatory phases
occurence of the peak day (presumed ovulation)
presence or absence of the mucus cycle
intensity of mucus flow
variations of bleeding

*Hilgers, MD, Dip. ABOG, CFCE, T., Daly, RN, CFCE, D., Hilgers, BA, CFCE, S., & Prebil, RN, BSN, CFCE, A. (2017). (First, p. 223) [Review of The Creighton Model FertilityCare System Book II: Advanced Teaching Skills]. Pope Paul VI Institute Press.

The information women collect through charting can serve three main purposes:

Women understand the health benefits of ovulation, and the information gained from charting can be used to diagnose and treat various health and fertility issues through consulting appropriate medical professionals.
Couples can use the information to abstain from vaginal intercourse during the fertile window to avoid a pregnancy.
Couples can use the information to engage in vaginal intercourse during the fertile window to achieve a pregnancy.

Clarifying Terms: NFP, FABM and FAM

Is there a difference between FABM AND

FAM?

FABM stands for “Fertility Awareness Based Method,” and FAM stands for “Fertility Awareness Method.”
They both use the same scientific evidence-based methods of identifying the fertile window. They differ in some of the practices of family planning. FAM users utilize non-hormonal contraceptive measures to avoid pregnancy during the fertile windows, while FABM users rely solely on abstinence during fertile times to avoid pregnancy.
Both FABM and FAM users can be religious or not, though certain faiths do not permit the use of some or all forms of contraception.

What is NFP?

Within religious circles, fertility awareness is most commonly known as Natural Family Planning (NFP), and is best described as fertility awareness plus discernment. Discernment means that the couple seeks spiritual guidance in the decision making process of whether to avoid or achieve a pregnancy on a cycle-to-cycle basis. Pregnancy is avoided solely through abstinence during fertile times. Any issues with fertility that impact a couple’s ability to achieve and sustain pregnancy are addressed through restorative measures alone. Couples who understand and use fertility awareness in this way seek to directly invite God into their family planning in an intentional and ongoing way. To find a restorative reproductive medical professional, visit our external resources tab.

Determining the Fertile Window.

Though fertility awareness only tracks a woman’s menstrual cycle, the fertile window is a combination of both male and female fertility. The factors taken into account to determine a couple’s combined window of fertility are as follows:

Men are always fertile (with the exception of male infertility).
Sperm can live for up to 5 days in the presence of cervical mucus, whether the mucus indicates ovulation or not.
The precise timing and occurence of ovulation cannot be predicted or confirmed outside of daily ultrasounds, and occasionally, a second ovulation can occur within 24 hours of the first (i.e. in the case of non-identical twins).
Eggs live for a maximum of 24 hours.

Click for a more in depth breakdown
- For methods that use an algorithm to determine the opening of the fertile window (i.e. Marquette, Couple to Couple League and other sympto-hormonal methods), the bare minimum calculation for the fertile window is 9 days: 5 days of sperm life + peak day + 3 days post peak to account for a potential second ovulation. This number of days prior to peak will increase for women with longer cycles (longer than 28-30 days).
- Methods such as Creighton or Billings (mucus-only methods) determine fertility on a day-to-day basis, which may result in a longer or shorter fertile window based on the presence or absence of mucus. This number may vary depending on a woman’s level of confidence identifying her biomarkers, but confidence increases with frequent contact with a responsible instructor.
- In order to avoid a pregnancy, couples abstain from vaginal intercourse during the fertile window. In order to achieve pregnancy, couples engage in vaginal intercourse every other day once the fertile window opens leading up to ovulation.
Shared Responsibility
- This definition of the fertile window emphasizes the shared responsibility of fertility, and rejects the notion that fertility is purely a woman’s responsibility to deal with or solve. Whether a couple is trying to avoid or achieve a pregnancy, they make and bear the consequences of their decision together. Successful practice therefore requires partners to engage in frequent open and honest communication regarding their fertility, family planning intentions, and sexual needs and desires.
- This aspect of the practice can present difficulties when partners differ in faith practice, expectations of sex, or in the intention to avoid or achieve pregnancy. This is why developing open and honest communication is of vital importance. Couples who work at this communication, even during difficult times, often report feeling respected and heard by their partners which in turn fosters a deeper intimacy and authentic equality.

Ovarian hormones are beneficial to a woman’s health whether or not sex and pregnancy are options. The only way these hormones are produced is through the process of ovulation. Our bodies are designed to receive monthly doses of estrogen and progesterone over a significant portion of our lifetime.

Click to see how natural hormones benefit our bodies
Estrogen promotes:
- muscle gain
- insulin sensitivity
- long-term health of bones, brain, an cardiovascular system
Progesterone promotes:
- reduces inflammation
- regulates immune function
- supports thyroid, brain, bones, and breast tissue
Ovulation doesn’t only promote health, but is a sign of health. Some refer to it as “The Fifth Vital Sign” because ovulation occurs in a healthy woman. If ovulation is not taking place, that provides information to the woman that one or more things are not working as they should. The Secret Powers of Ovulation (It's Not Just for Making a Baby) (larabriden.com)). All methods of fertility awareness provide valuable health benefits. A woman can learn how her fertility system functions, identify a healthy luteal phase, be able to predict when her next period starts, how stress affects the cycle, and some methods provide even more in depth information about the woman’s health and further treatment options.

Ovulation and Women’s Health.

Is Fertility Awareness Effective?

Most of us have been told that fertility awareness is really just the rhythm method, and is therefore not an effective means of family planning. You have read enough by now to know that’s not the case – and we wouldn’t have created this resource if it were. But you’re probably still wondering: is fertility awareness effective, and if so, how does it compare to other birth control methods?

We’ll be honest. Fertility awareness statistics are tricky. In statistical terminology, the data collected in studies produced by each method cannot be generalized to the population because they are not truly random samples, meaning there are many variables that cannot be isolated and have a direct impact on outcomes. Effectiveness statistics are impacted by factors such as: social, economic or political environments; religious practice; nationality; and cultural views of children.

There are two key factors that determine the effectiveness of any method that transcend the above variables. These are:

Charters receive formal instruction from a licensed or certified instructor, and are confident in their observations to accurately determine their fertile window.
Charters maintain a commitment with their partners to apply and observe the protocols of the method precisely in order to achieve their family planning goals.

Basically – How well charters understand how the method works and the extent to which they use it correctly.

Therefore, the effectiveness of every method applies only to those charters who fit the above two factors. Based on that understanding, below is a comparative chart of different methods and their effectiveness.

Effectiveness Statistics of Methods

In the table below, you'll see an outline of the effectiveness for each method. Please see information below the table to read more about what perfect use and typical use is.

Method	Perfect Use	Typical Use
Billings Ovulation Method+	97.9-100%	94.9-99.5%
Creighton Model Fertility Care	99.5%	96.8%
FEMM Health++	-----	98-92%
Marquette Method	98.4%	98%
Sympto-Thermal Method(Double Check)	99.6%	98.2%
Hormonal Birth Control (pill)	99.7%	91%
Condoms	98%	85%

+ Billings numbers are given in a range since studies have been conducted individually by country, and numbers therefore vary country-to-country.

++Since FEMM Health was more recently developed (2012), concrete studies of method effectiveness have not yet been completed, thus the range of typical use effectiveness only.

___________________

“In medical research, effectiveness rates come in pairs. Effectiveness studies report a perfect use effectiveness rate (also called the correct use effectiveness rate) and a typical use effectiveness rate. Both numbers are important, and they are meant to be compared to each other.”

“A large discrepancy between the perfect use and typical use rates for a medical treatment would be a bit of a red flag. What it suggests is that a significant portion of the study participants found it difficult to follow the instructions perfectly, and that in that struggle, they weren’t able to experience the therapeutic effects of the treatment.”

Excerpts from, “How Effective is Natural Family Planning (NFP)” by Louise Boychuk at Vitae Fertility

difficult but worth it!

Learning a fertility awareness based method is fundamentally different than using birth control. It requires extra time and hard work to initially learn your method of choice from a trained instructor, and continued effort to maintain successful use. It can require abstinence if avoiding pregnancy is the goal. But we believe – and a growing number of women agree – that it’s worth the effort. It’s not always easy and sometimes the reward isn’t immediate. But that’s why we’re here, to arm you with the facts and support your need to practice this lifestyle the best way you can!