According to this article, a surprising number of women seeking infertility care don’t know when to effectively focus their efforts. Australian researcher (and SMCR member) Kerry Hampton asked women seeking infertility advice about the normal ovulatory menstrual cycle, and found that most women lack basic knowledge about the menstrual cycle, ovulation, and when the optimal time is to conceive.

A study of 204 women who attended assisted-reproduction clinics in Melbourne during 2007 and 2008 showed only 13 per cent had a good knowledge of the ”fertility window” in their monthly menstrual cycle when pregnancy can occur.

Fertility nurse specialist and Monash University researcher, Kerry Hampton, told the Fertility Society of Australia’s annual scientific meeting yesterday that 11 per cent of the women had no knowledge of the fertility window and 52 per cent had poor levels of awareness.

Ms Hampton said most of the women had been trying to conceive for one year or more when they were surveyed, and that if they had of known more about natural conception, they would have had a better chance of success.

”A lot of these women were not able to optimise their chance of natural conception because they didn’t understand the window,” she said.

Quote from Australian publication The Age (link above)

The article goes on to quote a number of infertility specialists who remark that timing conception to a woman’s menstrual cycle is too stressful, arguing that the stress of precise timing can itself cause fertility problems.

But does withholding information about a woman’s own fertility signs really reduce stress? And how stressful is it to learn to read the signs?

Using a daily charting tool, such as CeMCOR’s free Menstrual Cycle Diary, can help women to become aware of the cyclic changes that precede ovulation. You can spend a lot of money on LH kits, waiting for a one-day window that tells you that ovulation is impending. Or you can track changes in your own body, and get to know what will predict ovulation.

Keeping the diary itself can be interesting and informative, and also gives you some sense of predictability and understanding. Here are some signs to look for:

Mid-cycle stretchy mucous (like egg-white), followed by a change to more tacky mucous. The mucous is a response to the estrogen produced by a growing follicle surrounding the egg. Peak mucous precedes the release of an egg, and the mucous itself helps with sperm motility and conception. Following ovulation, progesterone changes the mucous texture to a drier, tackier secretion.

Menstrual Cycle Diary records – Over time, by comparing your own patterns of experience with the date of ovulation estimated by the basal temperature, you will come to understand your own fertility signs. Some women find that breast tenderness is helpful, most will find stretchy mucous helpful.

To understand how these patterns are related to ovulation, the least expensive reliable method is to use Basal Body Temperature. Body temperature rises slightly following ovulation, which is a direct effect of the progesterone that is produced following ovulation. Using a basal thermometer (one that reads to 2 digits) each morning before rising, and writing down the temperatures each day gives the information needed to estimated when ovulation occurred. Digital thermometers with a memory for the previous temperature are an inexpensive investment.
To formally calculate the date of likely ovulation, calculated the average value (add them up & divide by the number), then look for whether there was a shift from below the average to above the average. A “normally ovulatory” menstrual cycle needs to have at least 10 days of higher temperatures at the end of the cycle. This period of higher temperatures is called the luteal phase, it is generated by the progesterone that is made following the release of an egg, and if the interval is too short, there is not enough time for the fertilized egg to get started in the uterus (implanted) before your period starts. That’s pretty common, especially related to stress, and also to ageing (more common in perimenopause).

If you keep the diary for a few months, you will start to see patterns in your own body, and get to predict when you will ovulate. The temperature rise follows progesterone rise, which follows ovulation – ovulation likely occurred within 1-2 days prior to the temperature rise.

That kind of pattern indicates ovulation, and you want to be trying to conceive during the stretchy mucous phase.

Keeping daily track of body changes over the menstrual cycle can become a routine part of your day.. It brings women into better awareness of body changes, which itself can be helpful. And it can give an area of self-knowledge and empowerment, in the often disempowering journey of not conceiving a much wanted child.

Disclaimer: Chris Hitchcock is a Research Associate at CeMCOR. Other SMCR members are engaged in fertility awareness training and methods (including Kerry Hampton).