Fertility awareness

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Fertility awareness
Background
B.C. type	Behavioral
First use	1950s (mucus) mid-1930s (BBT) 1930 (Knaus-Ogino) Ancient (ad hoc)
Failure rates (first year)
Perfect use	Symptoms-based: 1-3% Calendar-based: 5-9%
Typical use	3-25%
Usage
Reversibility	Yes
User reminders	Dependent upon strict user adherence to methodology
Clinic review	None
Advantages and Disadvantages
STD protection	No
Periods	Increased prediction
Benefits	no side effects, can aid pregnancy achievement

Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynecological health.

Methods of identifying infertile days have been used for over a thousand years, but scientific knowledge gained during the past century has greatly increased the accuracy of these systems. From 1930 to 1980, all research and promotion of fertility awareness was done by those associated with the Roman Catholic Church. Fertility awareness organizations continue to be predominately Catholic, but some secular organizations now exist.

Systems of fertility awareness rely on observation of changes in one or more of the primary fertility signs (basal body temperature, cervical mucus, and cervical position), records of menstrual cycle length, or both. Other signs may also be observed: these include breast tenderness and mittelschmerz (ovulation pains), urine analysis strips known as ovulation predictor kits (OPKs), and microscopic examination of saliva or cervical fluid. Also available are computerized fertility monitors.

Contents [hide] 1 Terminology 2 History 2.1 Development of calendar-based methods 2.2 Introduction of temperature and cervical mucus signs 2.3 First symptoms-based teaching organizations 2.4 Ongoing development 3 Fertility signs 3.1 Primary signs 3.2 Cycle history 3.3 Secondary signs 3.4 Other techniques 4 Benefits and drawbacks 5 As birth control 5.1 Advantages 5.2 Disadvantages 5.3 Effectiveness 5.4 Reasons for lower typical-use effectiveness 6 To achieve pregnancy 6.1 Intercourse timing 6.2 Problem diagnosis 6.3 Pregnancy testing and gestational age 7 Further reading 8 Footnotes

[edit] Terminology

Symptoms-based methods involve tracking one or more of the three primary fertility signs - basal body temperature, cervical mucus, and cervical position.^[1] Systems relying exclusively on cervical mucus include the Billings Ovulation Method, the Creighton Model, and the Two-Day Method. Symptothermal methods combine observations of basal body temperature (BBT), cervical mucus, and sometimes cervical position. Calendar-based methods rely only on a history of cycle lengths. While the World Health Organization classifies both symptoms-based and calendar-based methods as "fertility awareness",^[2] some teachers of symptoms-based methods do not consider calendar-based methods to be fertility awareness.^[3]

Systems of fertility awareness may be referred to as fertility awareness-based methods (FAB methods);^[2] the term Fertility Awareness Method (FAM) refers specifically to the system taught by Toni Weschler. The term natural family planning" (NFP) is sometimes used to refer to any use of FA methods. However, NFP specifically refers to practices that are approved by the Roman Catholic Church: breastfeeding infertility, and periodic abstinence during fertile times. A method of FA may be used by NFP users to identify these fertile times.

Women who are breastfeeding a child and wish to avoid pregnancy may be able to practice the lactational amenorrhea method (LAM). LAM is distinct from fertility awareness, but because it also does not involve devices or chemicals, it is often presented alongside FA as a method of natural birth control.