1. Fertility Awareness Methods
Sexual and Reproductive Health

2. Fertility Background Information
An egg can live up to 24 hours in the uterus following ovulation
Sperm usually live up to 5 days in the uterus following intercourse
Ovulation happens 13 to 15 days before the first day of the next menstrual period
Progesterone released by the ovary after ovulation causes the basal body temperature to rise

3. Background Information
There are changes in the cervical mucus that provides information about the phase in the cycle
Cervical mucus is:
scant, slippery and may be milky coloured prior to ovulation
abundant and becomes sticky and stretchy during ovulation when a female is fertile
Mucus becomes scant and rubbery after ovulation when woman is no longer fertile during the cycle
Women are more likely to become pregnant when ovulating

4. How Do Fertility Awareness-Based Methods Work?
FAMs work by keeping sperm out of the vagina in the days near ovulation, when a woman is most fertile — most likely to become pregnant.
To prevent pregnancy, women can abstain from vaginal intercourse on their fertile days. Or they can use withdrawal, a condom, a sponge, a diaphragm, or a cap on those days. Or they may enjoy other kinds of sex play instead of vaginal intercourse on their fertile days.

5. Understanding Your Fertility Pattern
In order to know when you are most likely to get pregnant, you have to become familiar with your menstrual cycle.
Before pregnancy can begin, a woman's egg must join with a man's sperm. This is called fertilization. For a healthy woman, there are days when fertilization can happen. There are days when it can't. And there are some days when it's unlikely — but still possible. To begin a pregnancy, a woman can have vaginal intercourse — without protection — during the days when it's possible for the egg and sperm to join. We call those days your fertile days.
A woman's fertile days depend on the life span of the egg and the sperm. Her egg lives for about a day after ovulation. Sperm can live inside her body for about six days.

6. Understanding Your Fertility Pattern
A woman has a chance of her egg joining a sperm about seven days of every menstrual cycle.
This includes the five days before ovulation.
It includes the day of ovulation.
It also includes the day or two after ovulation — even though it's less likely to happen then.
Knowing when your fertile days will happen can help you avoid a pregnancy. It can also help you plan one. The key is to figure out when you will ovulate. This will let you figure out the other fertile days that come before and after you ovulate. Then you can track your fertility pattern — the days of the month when you are fertile and the days of the month when you are not. You must do this carefully. Women don't all have the same fertility pattern. And some women have different patterns from one month to the next.

7. Types of FAMS
The fertile period of the menstrual cycle may be calculated 4 ways;
Basal Body Temperature (BBT) method: daily temperature readings detect ovulation
Cervical Mucus (Billings) method: changes in cervical mucus show signs of ovulation
Sympto-thermo method: a combination of the temperature and cervical mucus methods
Calendar method: the length of the past menstrual cycles predicts the fertile period. WARNING: This method depends on a consistency of cycle length. It is common for young women’s cycles to vary from month to month. For these young women, this method should NOT be recommended.

8. How the Methods Work! Basal Body Temperature Method
Temperature is taken in the morning and graphed as well as notes on days of menstruation, sexual activity, and any factors influencing your temperature.
Effectiveness: Perfect use 2%, typical use 20%

9. How the Methods Work! Cervical Mucus Method
Mucus is examined daily and recordings are made of texture (dry, moist, wet), colour of secretions (yellow, white, clear) and consistency of mucus (slippery, sticky, rubbery)
Effectiveness: Perfect use 3%, typical use 20%

10. How the Methods Work! Sympto-thermo method
a combination of the temperature and cervical mucus methods

11. How the Methods Work! Calendar Method
Keep a record of your cycles for at least 6 months. Count the first day of menstruation as day one. The last day of the cycle is the one just before the next period begins. Subtract 18 from your shortest cycle to get the first fertile day. Subtract 11 from your longest cycle to get the last fertile day.
Effectiveness: perfect use: probability of pregnancy 5%, typical use 20%

12. How Effective Are Fertility Awareness-Based Methods?
Effectiveness is an important and common concern when choosing a birth control method. Like all birth control methods, fertility awareness- based methods are more effective when you use them correctly.
Twenty-four out of every 100 couples who use fertility awareness-based methods each year will have a pregnancy if they don't alwaysuse the method correctly or consistently. Always practicing these methods correctly will make them more effective.
How well fertility awareness-based methods work depends on both partners. That's why it is important for both to learn about the methods and support each other in their use.
These methods can work best for you if you
have received careful instruction
have only one sex partner and he is as committed to fertility awareness- based methods as you are
have the discipline you need to check and chart your fertility signs
don't mind abstaining or using withdrawal, a cervical cap or diaphragm, a sponge, spermicide, or latex or female condoms on your unsafe days

13. How Safe Are Fertility Awareness-Based Methods?
Fertility awareness-based methods are very safe — there are no side effects.

14. What Are the Benefits of Fertility Awareness-Based Methods?
They cost very little.
They are safe.
They can be stopped easily to plan a pregnancy.
Calendars, thermometers, and charts are easy to get.
Medication is not needed.

15. What Are the Disadvantages of Fertility Awareness-Based Methods?
Fertility awareness-based methods may not work for you if you
have more than one sex partner
have a sex partner who isn't as committed to fertility awareness-based methods as you are
don't want to keep close track of your safe days
are not able to abstain or use another method for at least 10 unsafe days during each cycle
take medicine that may affect reading the signs of these methods
Do not depend on tracking your fertility if you
have irregular periods
have a partner who is not cooperative
have a sexually transmitted infection or frequent abnormal vaginal discharges
cannot keep careful records
It may be more difficult to track your fertility if you are breastfeeding, are a teenager, or are getting close to menopause. The hormone shifts may make the signs unpredictable.
Don't switch to a fertility awareness-based method after using a hormonal one, such as the pill. The hormones will affect your cycle. Use a method without hormones while you're learning to track your fertility.

16. How Do I Learn How to Use a Fertility Awareness-Based Method
How Do I Learn How to Use a Fertility Awareness-Based Method? How Much Does It Cost?
Couples can learn how to use fertility awareness-based methods by taking a course. Or they can be taught by a specially trained health professional. Both partners should learn the methods together. This way, both will know exactly what needs to be done to make the methods work. This will make them work better. And many couples report that they become more intimate by sharing responsibility for birth control.
Classes on charting fertility patterns and keeping ovulation calendars for contraception are offered by women's health centers, church-affiliated instructors, and Catholic hospitals. There is often little or no cost.
You can find instructors in certain religious settings. But they may not give you information about other methods. And they may not allow the use of barrier methods. For instruction that is not associated with a religion, ask for a referral from a women's clinic with no religious association. Or contact your state or county health department or your nearest Planned Parenthood health center.
Fertility charts or ovulation calendars cost little or nothing. They are easy to get from women's health centers and from private instructors and organizations. You can also print out this fertility pattern chart.Basal body temperature thermometers cost about $10 to $12. You may have to pay a fee for classes to learn fertility awareness-based methods. In some states, Medicaid will cover the cost of classes taken at a clinic or when authorized by a private physician.