Fertility Awareness Method

What is fertility?

• Fertility means the biological ability to produce children.
• People with testicles* are fertile through their ability to produce sperm in the testicles, which is released during ejaculation. They are fertile all day every day once they start to ejaculate semen (cum) containing sperm (at puberty, ages 11-15 years).
• People with ovaries* are fertile through their ability to release mature eggs from the ovaries that can be fertilized by sperm. They are born with every egg they will ever have. They start to release those eggs around their first period (at puberty, ages 9-14 years) and are only fertile (can become pregnant) on certain days of their cycle.

* People with testicles are usually designated male at birth while people with ovaries are usually designated female at birth. People with testicles don’t always identify as male and people with ovaries don’t always identify as female.

**We know that these aren’t the words everyone uses for their bodies (e.g. trans folks) and support you using the language that feels best for you.

What happens during the fertility cycle?

• A fertility cycle for a person with ovaries (sometimes called menstrual cycle) is the time from the first day of bleeding (their period) to the day before they start their next period.
• While 28 days is often used to describe a “normal” cycle length, normal cycles can actually range from 23-35 days. Only 15% of people have a 28-day cycle.
• The cycle begins when a person bleeds/menstruates (shed the lining of their uterus). A period can last 3-7 days.
• After menstruation, the uterine lining starts to build up again. At the same time, an egg in one of the ovaries starts to mature.
• Hormones trigger the egg’s release from the ovary into the fallopian tube (ovulation). Ovulation happens once per cycle, but sometimes 2 eggs can be released during the same ovulation. Eggs live for about 24 hours after they are released.
• If an egg is fertilized by sperm it travels down the fallopian tube to the uterus. If a fertilized egg attaches to the uterine lining it becomes a pregnancy.
• Because eggs live about 24 hours and sperm can live up to 5 days, pregnancy is possible if sperm enters the vagina** from about 5 days before ovulation until about 24 hours after ovulation.
• If the egg is not fertilized by sperm it disintegrates, hormone levels drop and the uterine lining sheds (menstruation), restarting the cycle.
• The time from the first day of a period until the next ovulation can vary between different people and between cycles for one person. The time from ovulation until the next period begins is usually about 14 days but can vary a little from person to person.

Fertility signs for people with ovaries

• Cervical mucus is produced in the cervix (the opening to the uterus) and comes out through the vagina. During fertile times, the mucus becomes more wet, slippery and stretchy (like egg whites) and helps sperm to swim up through the uterus towards the egg.
• Basal (resting) body temperature: After ovulation, there is a small increase in basal body temperature.
• Cervical position: During fertile times, the cervix becomes softer and more open and changes angle.

What are Fertility Awareness Methods (FAMs)?

FAMs are different methods that help people track their fertility/menstrual cycle and identify their body’s fertility signs to predict when they are fertile. If you are trying to prevent a pregnancy, all FAMs involve avoiding getting sperm in your vagina or using another form of birth control (e.g. condoms, spermicides, a diaphragm, etc.) during fertile times.

Different FAMs may use different information to predict fertile times. Some methods may use:

Tracking periods (retrospective):

• These methods track the length of your cycle and assume which days are fertile based on averages.
• You can use a calendar, a ring of colour-coded beads, or a phone app to help keep track.
• Only require tracking when you get your period.
• Don’t account for differences in cycle timing from person to person or cycle to cycle.
• May recommend using backup/avoiding getting sperm in your vagina on more days each cycle (fewer “safe days”) than other FAMs.
• Example: Standard Days Method (SDM)/CycleBeads: Tracks the length of your cycle using beads or a phone app and assumes the greatest chance of fertility is between days 8-19. Only applicable if your menstrual cycle is consistently 26-32 days long. For more info visit cyclebeads.com.
• Phone apps include: iCyclebeads

Tracking temperature and daily signs (symptothermal):

• These methods track basal body temperature, cervical mucus, and/or cervical position.
• Require checking your temperature and fertility signs every day.
• They may be more responsive to differences in cycle timing from person to person and cycle to cycle.
• May recommend using backup/avoiding getting sperm in your vagina on fewer days each cycle (more “safe days”) than other FAMs
• Example: Justisse method. For more info, to download a handbook or use the web app: justisse.ca
• Example: Taking Charge of Your Fertility/Weschler’s FAM: Famous & very influential FAM book & system by Toni Weschler. (For more info, to access guides, charts, or a phone app: tcoyf.com. “Taking Charge of Your Fertility” may also be available at a library.)
• Phone apps include: Lily, Kindara, Lady Cycle

About Apps

Apps can be great tools to help keep track of your fertility cycle and fertility signs, and some apps will use the data you put in to try to predict your fertile times for you. Some apps that try to predict fertile times do so based on evidence-based FAMs and some don’t, and some stick to the method they’re using more accurately than others. Checking how the app you’re using makes its predictions can help you figure out how accurate those predictions are likely to be for you.

Effectiveness

• Effectiveness rates vary for each type of FAM but can range from 95% (Standard Days) to 99% (Symptothermal) effective.
• Because FAMs may be used incorrectly or inconsistently, they are closer to 76% effective with typical use.

Advantages of FAMs

• There are no side effects and you can use FAMs if you don’t want to or can’t use other birth control methods.
• FAMs can be low cost or free. Books or guides on FAM may be available at a library or online.
• You learn about your body and fertility cycle. Some people enjoy being personally in control of their fertility. If you want to plan a pregnancy in the future, knowledge from FAMs can help.
• If you don’t want to avoid sex or use a backup method of birth control during fertile times, you can use those times to explore types of sex that have lower or no risk of pregnancy, like oral sex, anal sex, mutual masturbation, etc.

Disadvantages of FAMs

• If using a daily symptoms method you have to do something every day (e.g. write something in a chart, check your temperature).
• You will have to use another nonhormonal method of birth control or avoid getting sperm in your vagina at certain times in your cycle.
• To use beads or a chart or app you may need to pay for them. You may need to buy a thermometer to check your temperature.
• You have to touch your genitals if using a daily symptoms method.
• FAMs don’t reduce the risk of getting or passing sexually transmitted infections (STIs).
• FAMs, especially methods that don’t track daily symptoms, may be more difficult to use if you have irregular cycles.
• It can take time to learn and use FAMs effectively.
• FAM coaches can be hard to find and coaching can be expensive.
• Educational materials, coaching, or apps may be very gendered.