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Determining fertile days yourself: methods

Knowledge of the fertile days in the cycle and the lifespan of the sperm in the female body are the basis for natural family planning (NFP).

The length of the cycle and the time of ovulation and thus the fertile window fluctuate more than is commonly assumed. There is no such thing as an “average woman” with a 28-day cycle and ovulation specifically on the 14th day of the cycle. Studies have shown that in the majority of cycles a high percentage of cycles are between 25 and 35 days and that more than 80% of the cycles fluctuate.

Fluctuations must be recorded using an NFP method. For a NFP that can be safely implemented, it must be demanded that an individualized form of determining the fertile window is necessary and that the principle of double check is more reliable than the use of just one control method.

Overview: Which methods for natural family planning are available?

methodto shapesecurityacceptanceAvailability
calendar

Old rhythm method (e.g. Knaus Ogino),

unsurequite good++
SDM "standard daysmethod" (developing countries)in developing countries, no experience in Europenot known+
temperature

Döringno current dataquite good++
Coverlineno current dataunknown++
Cervical mucus methodsBillings OM ovulation method, method 3-6 safety, 16-28 in usein developing countriesWell++
MMM "modified mucus methods"In developing countriesWell+++
NaProTechnologynot knownhigh learning effort+
TDM "two days method"only in developing countries
tested

not known+
Symptothermal Method (STM)Rötzercurrently unknownquite good+
"Double check"Well
"Single check"mediumWell
Sensiplan (belonging to STM
Method)
very sure
Method security 0.4
Safety in use 1.8
very good at
Sensiplan users

+
Hormone tests / hormone computersLH rise / body temperature rise currently unknownexpensive+
Temperature computerVaginal measurementcurrently unknownLearning effort, expensive+
Oral measurementcurrently unknownLearning effort, expensive+

Calendar methods

In European culture today, calendar methods and numerous self-conceived variants no longer belong to the serious procedures. They are based on calculations and not on the current cycle monitoring. The World Health Organization (WHO) defines the modern NFP procedures as family planning methods based on “observing the naturally occurring signs and symptoms of the fertile and sterile phase of the female menstrual cycle”. It thus rules out the calculation methods as out of date.

"Standard days method" - a simplified calendar method: When used typically, this method led to a pregnancy rate of 11.9% in a safety study, which is an argument against its use outside of developing countries.

Temperature methods

The principle is based on the documentation of an individual symptom, the rise in body temperature after ovulation by around 0.2-0.4 ° C. In its strict, classic application, the temperature method with abstinence from the rise in basal temperature was a safe family planning method. The rules of the method are viewed as too rigid for modern NFP and are no longer recommended in this form (individual symptom). The Anglo-American evaluation regulation "Coverline" should also be seen under this aspect.

A thermometer with at least two decimal places is required for measurement, as the temperature increase is only in the range of a few tenths (0.3-0.5) degrees. It does not matter whether a digital thermometer, a mercury thermometer or a cycle computer is used. The safest method is to measure the waking temperature in the rectum (core temperature). The daily measured values ​​are entered in a cycle calendar and the temperature profile is thus checked.

The measurement should be taken at the same time shortly after waking up before getting up. The measurement can be influenced by medication or illness.

Temperature computer

A plastic vaginal ring with a high-tech sensor that records the body temperature every 5 minutes, 288 times a day, is quite new on the market. The aim is a reliable measurement method with lots of individual data on family planning or contraception
The global market offers similar measuring systems with which women measure body temperature every morning with the temperature sensor under the tongue. The principle is to differentiate between the fertile and the sterile days.

How do I use a temperature computer?

The mini-device is inserted into the vagina like a tampon. At the end of a cycle, the USB stick-like reader is connected to the PC. The temperature data are transmitted to a web-based evaluation software. After three measuring cycles, the system analyzes the temperature pattern and calculates a prognosis for the following cycle.
For the second method, the probe is placed under the tongue near the ligament of the tongue.

Cervical mucus method / ovulation method (OM)

Billings ovulation method:
This single symptom method was developed by the Billings doctors in the 1970s. The fertile days are determined exclusively by observing the cervical mucus, the consistency of which changes with the cycle, at the vaginal entrance. Each bleeding was regarded as a theoretical ovulatory bleeding and periodic abstinence and an extensive, complicated set of rules were set up, which makes the method not recommended for European countries.

A modified form of OM is the Creighton model ("NaProTechnology" for standardizing the observation of slime). The cervical mucus properties were carefully categorized for this purpose, the learning effort is very high, method and operational safety are questionable for a modern NFP.

"Modified mucus methods" (MMM): As a simplified form of OM, MMM should be used in developing countries, the acceptance varies. The MMM was classified as an unsafe NFP method similar to the “Two days method” (TDM).

Symptothermal Methods (STM)

In STM, two body characteristics are used to determine the fertile days: basal temperature and observation of the cervical mucus. This leads to a higher level of security through the combination of methods and mutual protection.

"Rötzer method"
This method was published in 1965 by the doctor J. Rötzer. It contains a number of exception rules that lead to an increased error rate in the application.

"Double check method"
The statements on body temperature and cervical mucus are evaluated in such a way that the information on fertility is at the beginning and the information that finally indicates infertility is at the end. This method serves as the basis for the development of modern NFP methods.

"Sensiplan"
This method is the result of various research centers with the aim of developing a safe and easy-to-use NFP method. The principle is a "double-check method" in which cervical mucus is observed and the body temperature is measured. Both parameters are documented on a cycle sheet; an evaluation can be carried out using simple rules.

Hormone tests (LH test, ovulation or ovulation test)

LH test
The principle of this hormone test is to determine the rise in the LH level in the urine. An increase in the LH level in the urine triggers ovulation and signals the beginning of the fertile days. The measurements must be carried out on several consecutive days. LH tests as strip tests are offered over the counter in pharmacies. Exact knowledge of one's own cycle is a prerequisite for using LH tests. The start of the measurement varies according to the cycle length (for example: cycle length 28 days = test start 9th cycle day, cycle 35 days = test start 14th cycle day).
 
A variant of the LH strip test is the digital ovulation test with the digital display of the result.

Ovulation test - to detect the increase in estrogen in the urine with ovulation
From a simple test device with test sticks for the urine to fertility monitors with data memories for the combined measurement of estrogen and LH with a reminder function, there are many different variants in pharmacies or in the online market.

How do I use a hormone computer?
A uniform, standardized measurement method at the same time should be adhered to. Morning urine should not be used. If the test strip shows an increase in LH, ovulation can be expected in the next 24-36 hours. The result is displayed as a colored strip in a window on the stick or, with the digital measurement method, in a display window of the device.

Author (s): äin-red

Technical support: Dr. Doris Scharrel

Last update: 07/09/2018