‘Fertility awareness’ means that a woman learns how to tell when the fertile time of her menstrual cycle starts and ends. This fertile time is the time when she can become pregnant.

A woman can use several methods to determine when her fertile time begins and ends:

• Calendar calculation: A woman can count calendar days to identify the start and end of the fertile time. The number of days depends on the length of previous menstrual cycles.
• Cervical secretions: When a woman sees or feels cervical secretions, she may be fertile. Can be just a sense of vaginal wetness.
• Basal body temperature (BBT): A woman’s resting body temperature goes up slightly around the time of ovulation (release of an egg), when she could become pregnant.
• Feel of the cervix: As the fertile time begins, the opening of the cervix feels softer, opens slightly and is moist. When she is not fertile, the opening is firmer and closed. (This is seldom used as the only sign.)

To tell when the fertile time starts, she can use calendar calculations and cervical secretions. To tell when the fertile time ends, she can use BBT, cervical secretions and calendar calculations.

Deciding about Fertility Awareness-based Methods

How do they work?
Fertility awareness helps a woman know when she could become pregnant. The couple avoid pregnancy by changing their sexual behavior during the fertile days. They can:

• Abstain from vaginal intercourse--- avoiding vaginal sex completely during the fertile time. Also called periodic abstinence and Natural Family Planning (NFP).
• Use barrier methods--- condoms, diaphragm and spermicide, or spermicide alone.
• Use withdrawal--- taking the penis out of the vagina before ejaculation. This is also called ‘coitus interuptus’ and ‘pulling out’. Or the couple can have sexual contact without vaginal intercourse.

Infertility | How effective is the method?