I thought thhis might interest or help some of you ladies. I haven't read it the whole way through as i'm tired and can't be bothered lol!
How to Observe and Record Your Fertility Signs
Your Fertility Signs
Your primary fertility signs are your cervical fluid and your basal body temperature (BBT). These are the ones that are essential to check when you are charting your fertility. Other fertility signs that can also shed light on your fertility status and your fertility pattern are cervical position, ovulation predictor kits (OPKs), ferning devices and fertility monitors. These are considered secondary fertility signs and are useful for cross-checking your primary fertility signs, though they are not usually essential. Other personal observations of your own body that you may come to notice over a few cycles can also offer added insight.
Cervical Fluid
Cervical fluid is produced by your cervix as you approach ovulation due to increased estrogen. It flows from the cervix into the vagina where it can easily be observed. Your cervical fluid changes throughout your cycle, increasing in quantity and becoming more clear and stretchy as you get closer to ovulation. Noticing and recording these changes will help you better time intercourse and recognize your own fertility pattern.
In the most common pattern, cervical fluid starts out dry after your period and then gets sticky, then creamy, then wet and watery, becoming most like eggwhite as you get closer to ovulation. You may get different types of cervical fluid on the same day. Always record your most fertile cervical fluid to make sure that you do not miss a potentially fertile day.
How to check for cervical fluid externally
Avoid checking your cervical fluid just before or after intercourse as arousal and seminal fluids will skew your observations. The best way to check your cervical fluid is to make observations when you go to the bathroom. After you wipe, you can wipe outside your vagina a second time and note what, if anything, you find on the bathroom tissue. This will soon become second nature and you will find yourself noticing your cervical fluid every time you go to the bathroom.You can also use your clean fingers to check and you may also notice some cervical fluid in your underwear.
Things to notice when checking your cervical fluid
* Does the vagina feel wet or dry?
* Is there any fluid on the tissue?
* How does it look?
* What color is it?
* What consistency is it?
* How much is there?
* How does it feel when you touch it?
* Can you stretch it between your thumb and index finger?
If you are having trouble finding cervical fluid, doing kegel exercises (tensing and relaxing the muscles that control the flow of urine) helps to push cervical fluid to the vaginal opening and makes observation easier. (Avoid doing kegels immediately after intercourse though as this could push the semen and therefore the sperm away from the cervix, which is exactly where you want them to be). Exercise and bowel movements also push cervical fluid to the vaginal opening making observation easier. You may find that the best time to check your cervical fluid is after a bowel movement. If you are still having trouble finding cervical fluid, you may consider checking it internally. This can be helpful if you have decreased estrogen as caused by breastfeeding or perimenopause or if cervical fluid seems scant. If you are easily able to check your cervical fluid externally, it is best to do it that way consistently and not check internally at all. As with all aspects of charting, consistency is key.
Checking your cervical fluid internally
If you check your cervical fluid by internal observation, only the method for gathering the fluid is different. Otherwise, follow the same steps and observations as for external observation. To collect cervical fluid internally follow these steps:
1. Insert two fingers in your vagina until you can feel your cervix.
2. One finger should be on each side of the cervix.
3. Press gently against your cervix.
4. Collect the fluid by moving your fingers to the opening of the cervix.
5. Remove your fingers and pull them apart slowly.
6. Make your observations as outlined for external fluid observation.
How to record your cervical fluid
No matter how you observe your cervical fluid (with your hands, toilet tissue, or in your underwear, or internally if necessary) the way to record it will be the same. Always record your most fertile type of cervical fluid, even if you noticed more than one type of cervical fluid in a given day or even if it is scant. This is so you will not miss a potentially fertile day and so that you have a consistent way of keeping track of your cervical fluid from cycle to cycle.
Below are the types of cervical fluid to record in Fertility Friend. Not everyone experiences every type of cervical fluid. Just record the types you do get. You may also have some cervical fluid that does not seem to "fit" perfectly into any category. In this case, record it in the most fertile category that best seems to fit. For example, if you notice in a day that you have cervical fluid that seems to fit somewhere in between creamy and eggwhite, record it as eggwhite. Likewise, if you get both creamy and eggwhite fluid in the same day, record eggwhite on your chart.
* Dry: Record your cervical fluid as "dry" if you have no cervical fluid present at all; if you notice no cervical fluid in your underwear; and if the outside of your vagina feels dry. You can expect to see dry days both before ovulation after your period and after ovulation. Record "dry" if you are not able to gather or see any cervical fluid, even if your vagina feels slightly moist inside.
* Sticky: Record your cervical fluid as "sticky" if it is glue-like, gummy, stiff or crumbly and if it breaks easily and quickly and if it is not easily stretched. It will probably be yellowish or white, but could also be cloudy/clear. You may or may not see some sticky cervical fluid before and after ovulation.
* Creamy: Record your cervical fluid as "creamy" if it is like hand lotion, white or yellow or cloudy/clear, like milk or cream, mayonnaise or like a flour/water solution. It may stretch slightly but not very much and break easily.
* Watery: Enter "watery" if your cervical fluid is clear and most resembles water. It may be stretchy also. This cervical fluid is considered fertile and this may be your most fertile cervical fluid or you may get it before you get eggwhite cervical fluid or you may not get this type of fluid at all.
* Eggwhite: This is your most fertile cervical fluid. Record "eggwhite" if your cervical fluid looks at all like real eggwhite, is stretchy and clear, or clear tinged with white, or even clear tinged with pink. It also resembles semen (and has a lot of the same physical properties to allow the sperm to travel and be nourished). You should be able to stretch it between your thumb and index finger.
* Spotting: Record "spotting" when you have any pink or dark red/brown spots that leave a small mark on your underwear or pantyliner or that you only see when you wipe. If it does not require a pad or tampon, record it as spotting rather than menses. You may see spotting before or after your period, around the time of ovulation or around the time of implantation if you conceive. Do not start a new chart until you have red flow.
* Menses: When you record "menses" you can choose light, normal and heavy. Always start a new chart on your first day of menses. That is the first day that you have red blood flow that requires a pad or tampon. This is cycle day one. Fertility Friend will automatically start a new chart for you when you enter menses.
Note: To see the abbreviations that represent each cervical fluid entry in Fertility Friend, see the chart legend beside your chart graph.
Factors that can influence your cervical fluid pattern
Certain factors may influence the quality and quantity of cervical fluid that you produce and could thus impact the interpretation of your chart. Some factors may be a result of hormonal factors, while others may be related to lifestyle or medications. If any of these applies to your case, make sure to record it in the notes section of the data entry field in Fertility Friend so that you can recognize why a particular entry may seem unusual or different. You also have the option of displaying those days on your chart with a special square (rather than a circle) so that you can see with a quick glance those days where special circumstances may apply. (See the setting section).
In most cases the effects are not great enough to seriously hamper your charting efforts or skew the analysis enough to dramatically alter your results. Nonetheless, the following factors may impact cervical fluid patterns and should be noted when possible:
* medications such as antihistamines and diuretics
* fertility medications, such as clomid (ask your doctor)
* tranquilizers
* antibiotics
* expectorants (ask your doctor before using an expectorant to increase cervical fluid)
* herbs (ask your doctor before taking herbs while trying to conceive)
* vitamins
* vaginal infection or sexually transmitted disease (ask your doctor if you think this is a possibility)
* illness
* delayed ovulation (can cause multiple cervical fluid patches)
* douching (not recommended unless advised by your doctor)
* being overweight (can cause increased cervical fluid)
* arousal fluid (can be mistaken for eggwhite cervical fluid)
* semen residue (can be mistaken for eggwhite cervical fluid)
* lubricants (not recommended when trying to conceive as they can be hostile to sperm)
* breastfeeding
* decreased ovarian function
* just stopping birth control pills
If you notice anything that concerns you about your cervical fluid (like if it is smelly or is causing you discomfort or itchiness or if you are bleeding or spotting when you do not expect to), call your doctor.
More about Cervical Fluid
Intercourse Timing and Cervical Fluid:
Your cervical fluid is probably your best sign to indicate when to start having baby making intercourse since it offers a sign that ovulation is approaching. Your chances of conception are best when you have intercourse just before ovulation. You should begin to have intercourse every other day or every 36 hours from the time you first observe fertile cervical fluid or even before if you do not get fertile cervical fluid for at least a few days before ovulation. If you know or suspect you know the day you will ovulate based on past BBT charts, Fertility Friend's analysis or from an ovulation predictor kit, change your intercourse pattern to every day from the day before ovulation until ovulation is confirmed by a few sustained elevated temperatures. Ideally, you want to have healthy sperm waiting in fertile cervical fluid when your egg is released. The best thing to do is to look at the Fertility Analyzer in Fertility Friend which will take into account all of your fertility signs from both your current and past cycles if applicable.
Multiple Eggwhite Cervical Fluid Patches:
Several patches of eggwhite fluid with no clear thermal shift probably means that you are having an anovulatory cycle. You can have fertile-like cervical fluid and still not ovulate. If you have several cycles that show this pattern, you should ask your doctor to look at why you might not be ovulating. If you have several patches of eggwhite cervical fluid and a temperature rise, then your ovulation was probably delayed due to some external reason. One of the factors that can affect cervical fluid (mentioned above) may apply. In any case, you should still have intercourse every other day when you see eggwhite cervical fluid to make sure not to miss an opportunity.
No Eggwhite Cervical Fluid:
If you do not see any fertile looking cervical fluid, the first thing to do is to make sure about how you are checking your cervical fluid, especially if you are new to charting. See the guidelines above. If you are sure you are checking your cervical fluid properly, the next thing you want to do is check if you are ovulating by seeing if your temperatures show a clear thermal shift. A lack of cervical fluid along with no temperature rise, or with erratic temperatures may indicate that you are not ovulating. If you are not ovulating for a few cycles, you need to talk to your doctor. If you are ovulating, then cervical fluid production may be affected by one of the factors mentioned above. You may want to check your cervical fluid internally at your cervix. You will also want to find out what your own most fertile cervical fluid looks like and treat this as eggwhite fluid. It is important that you have intercourse as close to ovulation as possible as your partner's sperm may not be able to thrive while waiting for the egg to be released.
Fertile Cervical Fluid after Ovulation:
Some cervical fluid after ovulation is possible because the corpus luteum, though its main function is to produce progesterone, produces estrogen in small amounts and this may cause you to see some cervical fluid. If your chart does not show clearly that you already ovulated, do not stop having intercourse. If your temperatures show clearly that you ovulated, then you are likely no longer fertile. It is also not uncommon to confuse semen and eggwhite or watery cervical fluid.
Cervical Fluid and Semen:
If you find that you have more watery or eggwhite days than you would expect and that these often follow days or nights that you had intercourse, then you may be mistaking seminal and cervical fluid. They are quite similar but you will find that fertile cervical fluid (eggwhite) is clear and stretchy and shiny. It will stretch a couple of inches without breaking. Semen may be more whitish and will break when pulled. If you are in doubt and it is near your fertile time, always record eggwhite cervical fluid, even if it may be obscured by seminal fluid so that you do not miss a potentially fertile time and so that Fertility Friend will give you its most accurate analysis.
Basal Body Temperature (BBT)
Your BBT, your body temperature at rest, is a critical fertility sign because it is the only sign that will tell you definitively that you ovulated. It also is the only sign that will let you pinpoint (to as close a degree as possible) when ovulation occurred. All your other signs tell you only that ovulation is approaching. Charting your BBT will also tell you how long your luteal phase is so you will know when to test for pregnancy, when you may be pregnant and also if it is sufficiently long to allow for a pregnancy to occur. It is best to use your cervical fluid and other signs in conjunction with charting your BBT to get the most out of charting and to get the most out of Fertility Friend's analysis tools. The cervical fluid data along with your BBT data can offer you amazing insight into your fertility pattern.
After ovulation, the corpus luteum (the remains of the follicle that released an egg at ovulation) produces progesterone. Progesterone causes an increase in your body temperature that is observable when you measure your BBT with a special BBT thermometer just upon waking in the morning.
How to take and record your BBT
It is important to use a special Basal Body Temperature thermometer rather than a fever thermometer. Both digital and mercury thermometers will be effective, however, we recommend using a digital BBT thermometer. A digital BBT thermometer will give a quicker reading, will beep when it is finished recording the temperature, and is easier to read. This can make a difference when you are bleary-eyed first thing in the morning. Both will store your reading, though it is best to enter your temperature in Fertility Friend or record it on your bedside notepad as soon as possible. It is best if you can establish a routine where you enter your data at the same time every day just to establish the habit so you will not forget. Missing data, especially temperature data can skew the interpretation of your chart. Make sure you are using a BBT thermometer. A fever thermometer or an ear thermometer will not be effective. You can find a BBT thermometer at most pharmacies. Fertility Friend accepts readings in both Fahrenheit and Celsius.
Some important guidelines to follow when taking your BBT
Your temperature data will be most reliable if you follow these guidelines. Not following these guidelines may make your chart difficult to read and may make detecting ovulation more difficult as well. It is essential that you use a special BBT thermometer and that you take your temperature in the morning right after waking. Please note that these are ideal guidelines. We recognize that the realities of your life may make meeting these ideals difficult or impossible at times. Fertility Friend is able to detect ovulation and make its analysis even under less than ideal conditions. The closer you can get to the ideal, the more accurate and reliable your ovulation detection, analysis and interpretation will be.
* Take your temperature before rising in the morning as any activity can raise your BBT.
* If you use a mercury thermometer, shake it down the previous night. (Or ask your partner to do it)
* Take your temperature at the same time every morning.
* Take your temperature after at least 3 consecutive hours of sleep.
* Keep your thermometer accessible from your bed so you do not have to get up to get it.
* Use the same thermometer throughout your cycle if possible. If it breaks or the battery dies and you use a new one, make a note of it on your charts.
* Keep a spare thermometer in case one breaks (especially if you are using a glass thermometer).
* Temperatures can be taken orally or vaginally but must be taken in the same place throughout the cycle since the temperatures of the different parts may vary. Most women prefer to take their temperatures orally and this is usually fine, though some women find that they get a clearer reading by temping vaginally.
* Record your temperature soon after you take it (or ask your partner to) since most thermometers only store a reading until the next use. If you have to do something else or want to stay in bed, you can record it later, but we recommend recording it right away when possible to avoid forgetting. Fertility Friend includes a printable bedside notepad in case you are not able to log in right away.
* If you must use a heating pad or electric blanket, keep it at the same setting throughout your cycle. Make a note of its use.
* Take your temperature before doing anything else including eating, drinking or going to the bathroom. If circumstances arise that prevent you from taking your temperature right away, take it as soon as you are able and make a note of the circumstances.
* If you have special circumstances on a temporary or an ongoing basis and you are unable to follow all of the above guidelines, keep temping anyway following the guidelines as closely as possible. Make a note of your special circumstances in the notes section of your chart and/or in your charting profile and Fertility Friend and our team will do our best to interpret your chart. There is still a good chance that you will be able to chart and see your fertility pattern.
* Enter your temperature and always record the time you took it in the data entry page on Fertility Friend. The time you took your temperature is also important for the analysis.
Factors that can influence your BBT
As with your cervical fluid, there are certain factors that can influence your basal body temperature. These should be noted in the notes section of Fertility Friend. Again, as with the factors that influence cervical fluid, these factors will usually not make charting and chart analysis impossible, especially if they occur only rarely, though it may be more challenging. In most cases, even when these factors apply on an ongoing basis, they will not skew your data so much that reading the chart is impossible. It is important to make a note of the factors, however to help with the interpretation of the chart. The following factors may influence your BBT:
* fever
* illness and infections (even those that do not produce a fever)
* cold, sore throat
* drugs and medications
* alcohol (especially in large quantities, though all alcohol consumption should be recorded)
* smoking (if you smoke, you should consider quitting before you are even pregnant)
* emotional stress
* physical stress
* excitement
* sleep disturbances (insomnia, night-waking, upsetting dreams, poor sleep)
* change in waking time
* jet lag
* travel
* change of climate
* use of electric blanket
* change of room temperature
* discontinuing birth control pills
* breastfeeding
We recommend entering your temperature data as early as you can in the morning before you get caught up in the routine of your day. It is much easier to remember when it is a habit and your thermometer will likely only store your reading for one day. If you are unable to log into Fertility Friend right away, record your observations on paper until you are able to log in. A printable bed side notepad is provided for this purpose. If you have questions about your BBT pattern or are wondering about your specific circumstances, you can write to the Fertility Friend Team at any time for advice, encouragement or an evaluation of your chart.
More about BBT
Different Waking Times
One or two temperatures taken at different times during your cycle should not have too much impact on your chart especially if they are not close to ovulation time. Normally there is no need to adjust your temperature. If you want to use the temperature adjuster once or twice when it is not too close to ovulation, that should not pose a significant problem. More than a couple of temperatures taken at different times, however, can adversely effect the interpretation of your chart. You should try to avoid using the temperature adjuster if possible since adjusted temperatures are not nearly as accurate as those you record daily at the same time. You may find it useful to set an alarm so that you can take your temperature at the same time every day. You can just take your temperature and go right back to sleep if you do not have to get up right away. If your partner gets up at the same time every day, you can ask to be briefly woken up so you can take your temperature. Your BBT thermometer will store the reading for you until you can record it.
Night Waking
If you have to get up in the night and it is unavoidable, like having to take care of a small child, or if you have to go to the bathroom, just do the best you can. Take your temperature as close as you can to the same time each morning and choose a time that is likely to be when you have had the most sleep. For example, if your toddler wakes up every morning at 6 am, then take your temperature at that time, even if you go back to sleep. Try to avoid taking your temperature in the middle of the night, though, even if you seem to always get up at the same time in the middle of the night. Temperatures taken in the morning show a clearer biphasic curve and the time is more predictable.
Multiple Temperature Readings
Taking your temperature more than once can cause unnecessary confusion. We really recommend that you only take your temperature once and go with that one. If you wake up in the middle of the night or earlier than your usual wake up time and you know you are going back to sleep, resist the urge to take your temperature. If you do take your temperature twice (or more) then choose the temperature that was taken closest to the time you usually take it. The only good reason for taking your temperature more than once is if you wake up early and you do not know if you will be able to get back to sleep. If you did not go back to sleep, choose the temperature right after you woke up. If you have two temperatures taken before and after your regular wake up time and you slept before both of them, then you can use the temperature adjuster to give you an adjusted temperature. Try to avoid this though, as relying too heavily on it can adversely effect the interpretation of your chart.
Shift Work
It is not impossible to take your BBT if you work shifts, but it will be more challenging. Take your temperature at the time you wake up when you are most likely to have had the most sleep. Be as consistent as you can. On your days off, take your temperature after you wake up as well, even if it is at a different time. Make a note on your chart of changes in your waking schedule. You may take your temperature in the afternoon before you go to work if that is your usual waking time and the time after which you are most likely to have had the most sleep. It is not useful to take your temperature when you are already awake and active.
Travel
If you travel within your own time zone, just keep on taking your temperature at the same time. You may notice a slight fluctuation if the climate is warmer/colder but this should not have a huge impact on your chart. Make a note in the notes section that you were traveling so you can explain unusual temperature patterns. If you are traveling to a different time zone, the disturbance is usually only limited to the day of travel and the day after. Keep taking your temperature as before, using the same time in the local time. We recommend not adjusting any temperatures, but again, make a note of the circumstances. Unless you are traveling right around the time of ovulation, you should still be able to discern your pattern. When BBT is less reliable because of such a special circumstance, pay extra close attention to your other fertility signs to avoid missing a potential fertile opportunity.
Daylight Saving Time
The effect of Daylight Saving Time (DST) on your temperature is usually limited to the day of the change because you adjust quite quickly. In addition, the exact effect depends strongly on your own metabolism. Some people will see no effect at all while others will see a slight change (increase or decrease). Because in general having one temperature slightly off will not change your chart interpretation, Fertility Friend's recommendation is to record your temperature as usual without correcting it in any manner. We recommend that you keep taking the temp at the same time. If you took it at 6 in the morning before the change, then take it at 6 in the morning after the change.
Erratic Temperatures
If your temperatures are erratic, the first thing you should do is review the guidelines about taking your BBT and make sure you are using a special basal body temperature thermometer. If you are following the guidelines (taking your temperature at the same time each morning, before getting up and using a BBT thermometer) and still have erratic temperatures, the first thing to do is review your data to see what could be disturbing the temperature. You may also consider changing your thermometer or replacing the battery in your thermometer to see if this helps. You may also want to talk to a Fertility Friend guide to get her opinion about what could be causing the erratic temperatures. If you have several cycles that are erratic and you are taking and recording your BBT properly, and you are unable to see an ovulation pattern, you should talk to your healthcare provider.
"Flat" Temperatures
If your temperatures seem to be around the same level all the time, the culprit is usually your thermometer. Even when you are taking your temperature at the same time, following all the guidelines, there is usually some fluctuation in temperatures. Your first step is to check your thermometer's battery or get a new thermometer. If your temperatures are still flat, and/or show no sign of a biphasic (ovulatory) pattern when you would expect them to, this is something to ask your doctor about if it happens for a few cycles.
Timing Intercourse using BBT
By the time you see a rise in temperature, you have probably already ovulated and it may be too late to time intercourse for conception purposes. You should still have intercourse though until ovulation is confirmed by a sustained rise in temperatures. You can predict ovulation, however, based on when you ovulated in previous cycles as pinpointed with your BBT and other fertility signs. The best thing to do is to follow the Fertility Analyzer in Fertility Friend which takes into account all signs and previous cycles as well.
You now have enough information to begin charting your fertility signs and let Fertility Friend do its analysis. If you choose to record and observe secondary fertility signs, read the rest of this section for a brief how-to.
Changes in the Position and Firmness of your Cervix
Your cervical position is an optional, secondary fertility sign.
It may take a few cycles to notice the changes your cervix experiences throughout your fertility cycle. It is a good idea to check when you know you are fertile as indicated by your cervical fluid and then again when you know you are not fertile (as indicated by your thermal shift in your luteal phase) when you are getting started. With this correlation, you will feel more easily the differences between your fertile and non-fertile times.
When you are approaching ovulation, your cervix will be high and soft (and you may notice that it feels more open also). When you are no longer fertile, your cervix will feel lower, more firm and you may notice that it is more closed. If you are not comfortable checking your cervix or you find the changes difficult to observe, and you are able to observe your cervical fluid easily, checking your cervix is not absolutely essential. If you are comfortable checking your cervix and are able to identify changes, you will benefit from the additional information that will help cross-check your other signs.
Checking your Cervix
If you choose to check your cervical position as an indicator of fertility here are some guidelines:
* To avoid the possibility of infection, always check the cervix with clean hands.
* Check the cervix once a day after menses. You only need to check once a day, unlike cervical fluid which you may check several times a day.
* Check your cervix at the same time every day as it may change throughout the day.
* Use the same position for checking your cervix throughout the cycle as changing positions will change your observation of cervical height.
* Squatting or placing one foot on a stool (or toilet seat) are good positions.
* Relax. (You will be able to more easily relax as you gain more experience).
* Insert one or two fingers into the vagina. At the back of the vagina, you should be able to feel your cervix. If you feel something at the back of your vagina that stops your fingers, then you have found your cervix. If you apply gentle pressure you will notice that it feels smooth, round and firmer that the surrounding vaginal tissues.
* Feel your cervix and make the following observations:
o Is the cervix high or low? (it is more difficult to reach it is high)
o Does the cervix feel soft or firm?
o Does the cervix feel open or closed? (Women who have already had children may notice that the cervix always feels slightly open).
o Does the cervix feel wet or dry?
o Do you feel any bumps on your cervix? (If you feel bumps that do not seem to be related to your fertility pattern, talk to your doctor right away)
* Record observations.
Recording Cervical Changes
Fertility Friend offers three fields on the data entry page that relate to cervical position. You can record the position, firmness, and openness of your cervix.
* Position: Your cervical position may be: low, medium or high. Your cervix heightens and becomes harder to reach as you approach your most fertile time. The important thing is to notice how it changes throughout your cycle in relation to your fertility. Observations can be subjective so you need to notice your own unique changes. There are really no rules to apply as you have to notice the changes relatively as they change. This may take a few cycles to really notice.
o Low: Record "low" for your least fertile cervical position. This is the position where it is easiest to feel and reach your cervix.
o Medium: Record "medium" for the position between your lowest and highest.
o High: Record "high" when your cervix is hardest to reach. You may not even be able to reach it. You will notice that it feels more wet, soft and open at this time as well. This is your most fertile cervical position.
* Firmness: Again, the issue is to notice the changes in the texture of your cervix relatively throughout your cycle as it changes. Like your cervical position, it may take a few cycles to notice your own pattern. To get an idea of what you are looking for, check when you know you are fertile (when you have eggwhite cervical fluid) and when you are sure you are not (after ovulation has been confirmed by 3 high temperatures) so that you know what you are looking for. At your least fertile time, both before and after ovulation, your cervix will feel the most hard and firm, a bit like the tip of your nose. As you approach ovulation, your cervix will soften, feeling more like your lips. You can record the firmness of your cervix as Firm, Medium, or Soft.
o Firm: Record "firm" as the most hard and firm texture you experience throughout your cycle. Your cervix will likely also be low and quite easy to reach at this time.
o Medium: Record "medium" when your cervix feels between your most firm and most soft. You may feel this just before you approach your more fertile time before ovulation and after ovulation as well.
o Soft: Record "soft" when your cervix feels the most soft. It will probably feel quite wet and high at this time as well and you may even notice that it also feels open. It may be hard to reach. This is your most fertile cervical texture.
* Openness: Not everyone is able to observe this sign, but you may also notice that your cervix feels more open when you are most fertile. If you are not able to observe this sign (many people are not), simply do not use it. The firmness and position of your cervix should provide enough additional insight into the changes in your cervix to allow you to cross-check your other signs if this is the case. This observation can also be quite subjective because women who have already given birth may notice that their cervix always feels slightly open. Women who have never given birth, may not notice the change at all or may notice that the cervix only opens slightly at their most fertile time. Like your other cervix signs, you should record how your cervix changes relatively throughout your cycle. If you are certain that you can notice the change in the openness of your cervix you should record the following:
o Closed: Record closed when your cervix feels at its most closed, least open position.
o Medium: Record medium when your cervix is slightly open.
o Open: Record open when your cervix feels at its most open position.
Devices and Tests for Measuring Fertility
There are an increasing number of products on the market designed to indicate possible fertility. They rely on changes in hormones that can be detected in your urine or saliva. When using these kits and devices, the most important thing is to follow the manufacturer's instructions as closely as possible. Questions that relate specifically to a certain product are best answered by that manufacturer and most products have 1-800 numbers on the package to allow you to ask questions.
These kits and devices can give additional, secondary clues about your fertility status that can complement the observations you make from your primary fertility signs. You may find them especially useful if you have irregular cycles, occasional anovulatory cycles, or if you find that you are not able to get clear readings from your cervical fluid and BBT signs. In most cases such devices are not essential, especially if you are easily able to recognize the changes in your cervical fluid, but you may find you like to have the added information for cross-checking.
No device or kit that you can do at home can pinpoint ovulation as well as your temperature data since only a thermal shift shows increased progesterone which is the hormone you release after ovulation. They can be quite useful though for timing intercourse and showing you when you have increased fertility.
Fertility Friend's analysis supports (but in no way requires) the use of OPKs, the Clearplan Fertility Monitor and Saliva Microscopes. If the data is entered, the analysis will make use of the data. For the Clearplan Fertility Monitor you may record Low, High or Peak. For saliva microscopes, you can record No Ferning, Partial Ferning or Full Ferning. For OPKs, you can record positive or negative.
A few words about Ovulation Prediction Kits (OPKs)
Ovulation Prediction Kits have become quite popular and can be quite useful to help you find your fertile time. OPKs work by measuring the presence of Luteinizing Hormone (LH) in your urine. A surge of LH which is sent to your ovary causes your ovary to produce enzymes which in turn causes the dominant follicle to rupture and release the egg into the Fallopian tube. This is ovulation and it is expected to occur within 24 hours of the surge of LH. An OPK is thus expected to be positive the day before you ovulate. Following a few guidelines can help you get the most out of your OPK.
* Like any product, follow the manufacturer's instructions carefully.
* If you do not test every day from before you expect to be most fertile, you may miss the surge. Likewise, if you test too late, you may miss the surge. Also, it may not be possible to tell if you are about to ovulate or if you just ovulated since you will have increased LH in both cases. Usually, though, the positive OPK means that you are about to ovulate.
* Testing daily once you have started to test is the best strategy since your first positive OPK result probably means that you are about to ovulate and your last positive OPK, if you get more than one, may mean that you just ovulated. Since OPK packages include only a limited number of test strips, timing when to start testing is crucial.
* If you use OPKs, use the Fertility Friend OPK optimizer to help you choose when to start testing to make sure you do not waste tests and so that you can get optimal results. Based on your average cycle length and previous cycles entered in Fertility Friend, if applicable, the OPK optimizer can tell you when to begin testing so that you will not miss your opportunity but you will not waste tests either.
* Follow the manufacturer's instructions about the time to take your OPK. First morning urine is usually not the best for OPKs since your LH surge usually begins in early morning when you are still sleeping and may not be apparent in your first morning urine. If you test in the early morning, you may miss your surge entirely since LH levels may already be reduced by the next morning. Late morning or early afternoon is usually best unless the instructions suggest otherwise.
* Record your OPK results as positive in the data entry page of Fertility Friend if the test line is as dark as or darker than the control line. Record your results as negative if the test line is lighter than the control line.
* Do not rely exclusively on OPK results to time intercourse as you may not see an LH surge (positive OPK) even though you may be fertile. Your increased fertility begins before you see a positive OPK result since sperm can live in the reproductive tract for a few days in fertile cervical fluid. Keep having intercourse every other day before you see a positive OPK result, but switch to every day once you see a positive result until ovulation has been confirmed by your temperature data. The Fertility Analyzer in Fertility Friend will help you with your timing.
Other Possible Fertility Signs
Some women notice other changes that may offer another indication of increasing fertility. You may or may not notice some of these signs. Not noticing these signs does not in any way indicate a lack of fertility. You may also have signs of your own that you notice throughout your cycle and from cycle to cycle that are not mentioned here. If this is the case you may find it useful to record these observations in your notes section. Because these signs are not consistent, may vary from woman to woman and even from cycle to cycle for the same woman, they are not included as fertility signs. Rather, you can check them on the checklist in the special notes section or record them in your own notes. You can also set up your "custom signs" (see data entry page) to include them on your chart.
Some other possible fertility signs are:
* Ovulation Pain: Also known as mittelschmertz, which means "middle pain" it refers to a slight pain that you may feel near your abdomen or ovary at the time of ovulation. It does not necessarily occur at the exact time of ovulation and not everyone feels ovulation. As such, ovulation pain is useful to cross-check other signs, but cannot be used to definitively confirm or pinpoint ovulation. Also, it is very difficult to know if the pain you feel in your abdomen mid-cycle is related in any way to ovulation or your fertility. Other pains are often mistaken for ovulation pain. It is still useful to record, even if you are unsure if it is related to your fertility. As you become more in tune with your fertility signs, it will become easier to recognize ovulation pain if you experience it. Women who have never noticed ovulation pain often begin to notice it when they begin to chart their fertility signs.
* Increased Sex Drive: You may notice that your sex drive is cyclical (You may also notice that it is not and that may be normal for you). Your sex drive may be highest at around the time before and at ovulation. Another pattern might also be normal for you. If you notice that there is a pattern to your sex drive, it can be helpful to record your observations to make predictions about your fertility.
* Ovulation spotting: Some women see slight spotting at the time of ovulation. This is quite rare, but you may see that your cervical fluid is streaked with blood or has a pink tinge. If you do notice this and it is accompanied by fertile cervical fluid (eggwhite or watery) enter the cervical fluid as eggwhite or watery but make a note about the spotting in your notes section. If it is heavy or lasts longer than a day, you should ask your doctor about it.
* Tender Breasts: While your experience may be different, you may notice a pattern to the sensitivity of your breasts. They may feel more sensitive at around the time of ovulation and they may continue to feel sensitive throughout your luteal phase. Again, if you notice that there is an observable pattern to the sensitivity of your breasts, it is useful to record it in the checklist on the data entry page so that you can make future predictions or notice changes from cycle to cycle. While some women say that tender breasts are an early pregnancy symptom, there is no way to know if you are pregnant by the sensitivity of your breasts. Breast sensitivity may be linked to increased progesterone. Progesterone is increased both during the luteal phase of your menstrual cycle when you are not pregnant and during pregnancy. The sensitivity of your breasts may be useful for you to cross-check other signs if you have a consistent pattern but it is not a useful fertility sign on its own.
* Your own observations: You may notice some specific changes yourself that can offer clues about your fertility pattern. Everyone is different, but there are clues that you may find on your own. Changes in your complexion, your energy level, your moods, or anything else that you notice shows a cyclical pattern can offer insight into your fertility pattern. Use the notes section, the custom signs option, or the checklist on the data entry page to record these observations. You may be surprised to learn that something seemingly unrelated may be related to your fertility.
How to Observe and Record Your Fertility Signs
Your Fertility Signs
Your primary fertility signs are your cervical fluid and your basal body temperature (BBT). These are the ones that are essential to check when you are charting your fertility. Other fertility signs that can also shed light on your fertility status and your fertility pattern are cervical position, ovulation predictor kits (OPKs), ferning devices and fertility monitors. These are considered secondary fertility signs and are useful for cross-checking your primary fertility signs, though they are not usually essential. Other personal observations of your own body that you may come to notice over a few cycles can also offer added insight.
Cervical Fluid
Cervical fluid is produced by your cervix as you approach ovulation due to increased estrogen. It flows from the cervix into the vagina where it can easily be observed. Your cervical fluid changes throughout your cycle, increasing in quantity and becoming more clear and stretchy as you get closer to ovulation. Noticing and recording these changes will help you better time intercourse and recognize your own fertility pattern.
In the most common pattern, cervical fluid starts out dry after your period and then gets sticky, then creamy, then wet and watery, becoming most like eggwhite as you get closer to ovulation. You may get different types of cervical fluid on the same day. Always record your most fertile cervical fluid to make sure that you do not miss a potentially fertile day.
How to check for cervical fluid externally
Avoid checking your cervical fluid just before or after intercourse as arousal and seminal fluids will skew your observations. The best way to check your cervical fluid is to make observations when you go to the bathroom. After you wipe, you can wipe outside your vagina a second time and note what, if anything, you find on the bathroom tissue. This will soon become second nature and you will find yourself noticing your cervical fluid every time you go to the bathroom.You can also use your clean fingers to check and you may also notice some cervical fluid in your underwear.
Things to notice when checking your cervical fluid
* Does the vagina feel wet or dry?
* Is there any fluid on the tissue?
* How does it look?
* What color is it?
* What consistency is it?
* How much is there?
* How does it feel when you touch it?
* Can you stretch it between your thumb and index finger?
If you are having trouble finding cervical fluid, doing kegel exercises (tensing and relaxing the muscles that control the flow of urine) helps to push cervical fluid to the vaginal opening and makes observation easier. (Avoid doing kegels immediately after intercourse though as this could push the semen and therefore the sperm away from the cervix, which is exactly where you want them to be). Exercise and bowel movements also push cervical fluid to the vaginal opening making observation easier. You may find that the best time to check your cervical fluid is after a bowel movement. If you are still having trouble finding cervical fluid, you may consider checking it internally. This can be helpful if you have decreased estrogen as caused by breastfeeding or perimenopause or if cervical fluid seems scant. If you are easily able to check your cervical fluid externally, it is best to do it that way consistently and not check internally at all. As with all aspects of charting, consistency is key.
Checking your cervical fluid internally
If you check your cervical fluid by internal observation, only the method for gathering the fluid is different. Otherwise, follow the same steps and observations as for external observation. To collect cervical fluid internally follow these steps:
1. Insert two fingers in your vagina until you can feel your cervix.
2. One finger should be on each side of the cervix.
3. Press gently against your cervix.
4. Collect the fluid by moving your fingers to the opening of the cervix.
5. Remove your fingers and pull them apart slowly.
6. Make your observations as outlined for external fluid observation.
How to record your cervical fluid
No matter how you observe your cervical fluid (with your hands, toilet tissue, or in your underwear, or internally if necessary) the way to record it will be the same. Always record your most fertile type of cervical fluid, even if you noticed more than one type of cervical fluid in a given day or even if it is scant. This is so you will not miss a potentially fertile day and so that you have a consistent way of keeping track of your cervical fluid from cycle to cycle.
Below are the types of cervical fluid to record in Fertility Friend. Not everyone experiences every type of cervical fluid. Just record the types you do get. You may also have some cervical fluid that does not seem to "fit" perfectly into any category. In this case, record it in the most fertile category that best seems to fit. For example, if you notice in a day that you have cervical fluid that seems to fit somewhere in between creamy and eggwhite, record it as eggwhite. Likewise, if you get both creamy and eggwhite fluid in the same day, record eggwhite on your chart.
* Dry: Record your cervical fluid as "dry" if you have no cervical fluid present at all; if you notice no cervical fluid in your underwear; and if the outside of your vagina feels dry. You can expect to see dry days both before ovulation after your period and after ovulation. Record "dry" if you are not able to gather or see any cervical fluid, even if your vagina feels slightly moist inside.
* Sticky: Record your cervical fluid as "sticky" if it is glue-like, gummy, stiff or crumbly and if it breaks easily and quickly and if it is not easily stretched. It will probably be yellowish or white, but could also be cloudy/clear. You may or may not see some sticky cervical fluid before and after ovulation.
* Creamy: Record your cervical fluid as "creamy" if it is like hand lotion, white or yellow or cloudy/clear, like milk or cream, mayonnaise or like a flour/water solution. It may stretch slightly but not very much and break easily.
* Watery: Enter "watery" if your cervical fluid is clear and most resembles water. It may be stretchy also. This cervical fluid is considered fertile and this may be your most fertile cervical fluid or you may get it before you get eggwhite cervical fluid or you may not get this type of fluid at all.
* Eggwhite: This is your most fertile cervical fluid. Record "eggwhite" if your cervical fluid looks at all like real eggwhite, is stretchy and clear, or clear tinged with white, or even clear tinged with pink. It also resembles semen (and has a lot of the same physical properties to allow the sperm to travel and be nourished). You should be able to stretch it between your thumb and index finger.
* Spotting: Record "spotting" when you have any pink or dark red/brown spots that leave a small mark on your underwear or pantyliner or that you only see when you wipe. If it does not require a pad or tampon, record it as spotting rather than menses. You may see spotting before or after your period, around the time of ovulation or around the time of implantation if you conceive. Do not start a new chart until you have red flow.
* Menses: When you record "menses" you can choose light, normal and heavy. Always start a new chart on your first day of menses. That is the first day that you have red blood flow that requires a pad or tampon. This is cycle day one. Fertility Friend will automatically start a new chart for you when you enter menses.
Note: To see the abbreviations that represent each cervical fluid entry in Fertility Friend, see the chart legend beside your chart graph.
Factors that can influence your cervical fluid pattern
Certain factors may influence the quality and quantity of cervical fluid that you produce and could thus impact the interpretation of your chart. Some factors may be a result of hormonal factors, while others may be related to lifestyle or medications. If any of these applies to your case, make sure to record it in the notes section of the data entry field in Fertility Friend so that you can recognize why a particular entry may seem unusual or different. You also have the option of displaying those days on your chart with a special square (rather than a circle) so that you can see with a quick glance those days where special circumstances may apply. (See the setting section).
In most cases the effects are not great enough to seriously hamper your charting efforts or skew the analysis enough to dramatically alter your results. Nonetheless, the following factors may impact cervical fluid patterns and should be noted when possible:
* medications such as antihistamines and diuretics
* fertility medications, such as clomid (ask your doctor)
* tranquilizers
* antibiotics
* expectorants (ask your doctor before using an expectorant to increase cervical fluid)
* herbs (ask your doctor before taking herbs while trying to conceive)
* vitamins
* vaginal infection or sexually transmitted disease (ask your doctor if you think this is a possibility)
* illness
* delayed ovulation (can cause multiple cervical fluid patches)
* douching (not recommended unless advised by your doctor)
* being overweight (can cause increased cervical fluid)
* arousal fluid (can be mistaken for eggwhite cervical fluid)
* semen residue (can be mistaken for eggwhite cervical fluid)
* lubricants (not recommended when trying to conceive as they can be hostile to sperm)
* breastfeeding
* decreased ovarian function
* just stopping birth control pills
If you notice anything that concerns you about your cervical fluid (like if it is smelly or is causing you discomfort or itchiness or if you are bleeding or spotting when you do not expect to), call your doctor.
More about Cervical Fluid
Intercourse Timing and Cervical Fluid:
Your cervical fluid is probably your best sign to indicate when to start having baby making intercourse since it offers a sign that ovulation is approaching. Your chances of conception are best when you have intercourse just before ovulation. You should begin to have intercourse every other day or every 36 hours from the time you first observe fertile cervical fluid or even before if you do not get fertile cervical fluid for at least a few days before ovulation. If you know or suspect you know the day you will ovulate based on past BBT charts, Fertility Friend's analysis or from an ovulation predictor kit, change your intercourse pattern to every day from the day before ovulation until ovulation is confirmed by a few sustained elevated temperatures. Ideally, you want to have healthy sperm waiting in fertile cervical fluid when your egg is released. The best thing to do is to look at the Fertility Analyzer in Fertility Friend which will take into account all of your fertility signs from both your current and past cycles if applicable.
Multiple Eggwhite Cervical Fluid Patches:
Several patches of eggwhite fluid with no clear thermal shift probably means that you are having an anovulatory cycle. You can have fertile-like cervical fluid and still not ovulate. If you have several cycles that show this pattern, you should ask your doctor to look at why you might not be ovulating. If you have several patches of eggwhite cervical fluid and a temperature rise, then your ovulation was probably delayed due to some external reason. One of the factors that can affect cervical fluid (mentioned above) may apply. In any case, you should still have intercourse every other day when you see eggwhite cervical fluid to make sure not to miss an opportunity.
No Eggwhite Cervical Fluid:
If you do not see any fertile looking cervical fluid, the first thing to do is to make sure about how you are checking your cervical fluid, especially if you are new to charting. See the guidelines above. If you are sure you are checking your cervical fluid properly, the next thing you want to do is check if you are ovulating by seeing if your temperatures show a clear thermal shift. A lack of cervical fluid along with no temperature rise, or with erratic temperatures may indicate that you are not ovulating. If you are not ovulating for a few cycles, you need to talk to your doctor. If you are ovulating, then cervical fluid production may be affected by one of the factors mentioned above. You may want to check your cervical fluid internally at your cervix. You will also want to find out what your own most fertile cervical fluid looks like and treat this as eggwhite fluid. It is important that you have intercourse as close to ovulation as possible as your partner's sperm may not be able to thrive while waiting for the egg to be released.
Fertile Cervical Fluid after Ovulation:
Some cervical fluid after ovulation is possible because the corpus luteum, though its main function is to produce progesterone, produces estrogen in small amounts and this may cause you to see some cervical fluid. If your chart does not show clearly that you already ovulated, do not stop having intercourse. If your temperatures show clearly that you ovulated, then you are likely no longer fertile. It is also not uncommon to confuse semen and eggwhite or watery cervical fluid.
Cervical Fluid and Semen:
If you find that you have more watery or eggwhite days than you would expect and that these often follow days or nights that you had intercourse, then you may be mistaking seminal and cervical fluid. They are quite similar but you will find that fertile cervical fluid (eggwhite) is clear and stretchy and shiny. It will stretch a couple of inches without breaking. Semen may be more whitish and will break when pulled. If you are in doubt and it is near your fertile time, always record eggwhite cervical fluid, even if it may be obscured by seminal fluid so that you do not miss a potentially fertile time and so that Fertility Friend will give you its most accurate analysis.
Basal Body Temperature (BBT)
Your BBT, your body temperature at rest, is a critical fertility sign because it is the only sign that will tell you definitively that you ovulated. It also is the only sign that will let you pinpoint (to as close a degree as possible) when ovulation occurred. All your other signs tell you only that ovulation is approaching. Charting your BBT will also tell you how long your luteal phase is so you will know when to test for pregnancy, when you may be pregnant and also if it is sufficiently long to allow for a pregnancy to occur. It is best to use your cervical fluid and other signs in conjunction with charting your BBT to get the most out of charting and to get the most out of Fertility Friend's analysis tools. The cervical fluid data along with your BBT data can offer you amazing insight into your fertility pattern.
After ovulation, the corpus luteum (the remains of the follicle that released an egg at ovulation) produces progesterone. Progesterone causes an increase in your body temperature that is observable when you measure your BBT with a special BBT thermometer just upon waking in the morning.
How to take and record your BBT
It is important to use a special Basal Body Temperature thermometer rather than a fever thermometer. Both digital and mercury thermometers will be effective, however, we recommend using a digital BBT thermometer. A digital BBT thermometer will give a quicker reading, will beep when it is finished recording the temperature, and is easier to read. This can make a difference when you are bleary-eyed first thing in the morning. Both will store your reading, though it is best to enter your temperature in Fertility Friend or record it on your bedside notepad as soon as possible. It is best if you can establish a routine where you enter your data at the same time every day just to establish the habit so you will not forget. Missing data, especially temperature data can skew the interpretation of your chart. Make sure you are using a BBT thermometer. A fever thermometer or an ear thermometer will not be effective. You can find a BBT thermometer at most pharmacies. Fertility Friend accepts readings in both Fahrenheit and Celsius.
Some important guidelines to follow when taking your BBT
Your temperature data will be most reliable if you follow these guidelines. Not following these guidelines may make your chart difficult to read and may make detecting ovulation more difficult as well. It is essential that you use a special BBT thermometer and that you take your temperature in the morning right after waking. Please note that these are ideal guidelines. We recognize that the realities of your life may make meeting these ideals difficult or impossible at times. Fertility Friend is able to detect ovulation and make its analysis even under less than ideal conditions. The closer you can get to the ideal, the more accurate and reliable your ovulation detection, analysis and interpretation will be.
* Take your temperature before rising in the morning as any activity can raise your BBT.
* If you use a mercury thermometer, shake it down the previous night. (Or ask your partner to do it)
* Take your temperature at the same time every morning.
* Take your temperature after at least 3 consecutive hours of sleep.
* Keep your thermometer accessible from your bed so you do not have to get up to get it.
* Use the same thermometer throughout your cycle if possible. If it breaks or the battery dies and you use a new one, make a note of it on your charts.
* Keep a spare thermometer in case one breaks (especially if you are using a glass thermometer).
* Temperatures can be taken orally or vaginally but must be taken in the same place throughout the cycle since the temperatures of the different parts may vary. Most women prefer to take their temperatures orally and this is usually fine, though some women find that they get a clearer reading by temping vaginally.
* Record your temperature soon after you take it (or ask your partner to) since most thermometers only store a reading until the next use. If you have to do something else or want to stay in bed, you can record it later, but we recommend recording it right away when possible to avoid forgetting. Fertility Friend includes a printable bedside notepad in case you are not able to log in right away.
* If you must use a heating pad or electric blanket, keep it at the same setting throughout your cycle. Make a note of its use.
* Take your temperature before doing anything else including eating, drinking or going to the bathroom. If circumstances arise that prevent you from taking your temperature right away, take it as soon as you are able and make a note of the circumstances.
* If you have special circumstances on a temporary or an ongoing basis and you are unable to follow all of the above guidelines, keep temping anyway following the guidelines as closely as possible. Make a note of your special circumstances in the notes section of your chart and/or in your charting profile and Fertility Friend and our team will do our best to interpret your chart. There is still a good chance that you will be able to chart and see your fertility pattern.
* Enter your temperature and always record the time you took it in the data entry page on Fertility Friend. The time you took your temperature is also important for the analysis.
Factors that can influence your BBT
As with your cervical fluid, there are certain factors that can influence your basal body temperature. These should be noted in the notes section of Fertility Friend. Again, as with the factors that influence cervical fluid, these factors will usually not make charting and chart analysis impossible, especially if they occur only rarely, though it may be more challenging. In most cases, even when these factors apply on an ongoing basis, they will not skew your data so much that reading the chart is impossible. It is important to make a note of the factors, however to help with the interpretation of the chart. The following factors may influence your BBT:
* fever
* illness and infections (even those that do not produce a fever)
* cold, sore throat
* drugs and medications
* alcohol (especially in large quantities, though all alcohol consumption should be recorded)
* smoking (if you smoke, you should consider quitting before you are even pregnant)
* emotional stress
* physical stress
* excitement
* sleep disturbances (insomnia, night-waking, upsetting dreams, poor sleep)
* change in waking time
* jet lag
* travel
* change of climate
* use of electric blanket
* change of room temperature
* discontinuing birth control pills
* breastfeeding
We recommend entering your temperature data as early as you can in the morning before you get caught up in the routine of your day. It is much easier to remember when it is a habit and your thermometer will likely only store your reading for one day. If you are unable to log into Fertility Friend right away, record your observations on paper until you are able to log in. A printable bed side notepad is provided for this purpose. If you have questions about your BBT pattern or are wondering about your specific circumstances, you can write to the Fertility Friend Team at any time for advice, encouragement or an evaluation of your chart.
More about BBT
Different Waking Times
One or two temperatures taken at different times during your cycle should not have too much impact on your chart especially if they are not close to ovulation time. Normally there is no need to adjust your temperature. If you want to use the temperature adjuster once or twice when it is not too close to ovulation, that should not pose a significant problem. More than a couple of temperatures taken at different times, however, can adversely effect the interpretation of your chart. You should try to avoid using the temperature adjuster if possible since adjusted temperatures are not nearly as accurate as those you record daily at the same time. You may find it useful to set an alarm so that you can take your temperature at the same time every day. You can just take your temperature and go right back to sleep if you do not have to get up right away. If your partner gets up at the same time every day, you can ask to be briefly woken up so you can take your temperature. Your BBT thermometer will store the reading for you until you can record it.
Night Waking
If you have to get up in the night and it is unavoidable, like having to take care of a small child, or if you have to go to the bathroom, just do the best you can. Take your temperature as close as you can to the same time each morning and choose a time that is likely to be when you have had the most sleep. For example, if your toddler wakes up every morning at 6 am, then take your temperature at that time, even if you go back to sleep. Try to avoid taking your temperature in the middle of the night, though, even if you seem to always get up at the same time in the middle of the night. Temperatures taken in the morning show a clearer biphasic curve and the time is more predictable.
Multiple Temperature Readings
Taking your temperature more than once can cause unnecessary confusion. We really recommend that you only take your temperature once and go with that one. If you wake up in the middle of the night or earlier than your usual wake up time and you know you are going back to sleep, resist the urge to take your temperature. If you do take your temperature twice (or more) then choose the temperature that was taken closest to the time you usually take it. The only good reason for taking your temperature more than once is if you wake up early and you do not know if you will be able to get back to sleep. If you did not go back to sleep, choose the temperature right after you woke up. If you have two temperatures taken before and after your regular wake up time and you slept before both of them, then you can use the temperature adjuster to give you an adjusted temperature. Try to avoid this though, as relying too heavily on it can adversely effect the interpretation of your chart.
Shift Work
It is not impossible to take your BBT if you work shifts, but it will be more challenging. Take your temperature at the time you wake up when you are most likely to have had the most sleep. Be as consistent as you can. On your days off, take your temperature after you wake up as well, even if it is at a different time. Make a note on your chart of changes in your waking schedule. You may take your temperature in the afternoon before you go to work if that is your usual waking time and the time after which you are most likely to have had the most sleep. It is not useful to take your temperature when you are already awake and active.
Travel
If you travel within your own time zone, just keep on taking your temperature at the same time. You may notice a slight fluctuation if the climate is warmer/colder but this should not have a huge impact on your chart. Make a note in the notes section that you were traveling so you can explain unusual temperature patterns. If you are traveling to a different time zone, the disturbance is usually only limited to the day of travel and the day after. Keep taking your temperature as before, using the same time in the local time. We recommend not adjusting any temperatures, but again, make a note of the circumstances. Unless you are traveling right around the time of ovulation, you should still be able to discern your pattern. When BBT is less reliable because of such a special circumstance, pay extra close attention to your other fertility signs to avoid missing a potential fertile opportunity.
Daylight Saving Time
The effect of Daylight Saving Time (DST) on your temperature is usually limited to the day of the change because you adjust quite quickly. In addition, the exact effect depends strongly on your own metabolism. Some people will see no effect at all while others will see a slight change (increase or decrease). Because in general having one temperature slightly off will not change your chart interpretation, Fertility Friend's recommendation is to record your temperature as usual without correcting it in any manner. We recommend that you keep taking the temp at the same time. If you took it at 6 in the morning before the change, then take it at 6 in the morning after the change.
Erratic Temperatures
If your temperatures are erratic, the first thing you should do is review the guidelines about taking your BBT and make sure you are using a special basal body temperature thermometer. If you are following the guidelines (taking your temperature at the same time each morning, before getting up and using a BBT thermometer) and still have erratic temperatures, the first thing to do is review your data to see what could be disturbing the temperature. You may also consider changing your thermometer or replacing the battery in your thermometer to see if this helps. You may also want to talk to a Fertility Friend guide to get her opinion about what could be causing the erratic temperatures. If you have several cycles that are erratic and you are taking and recording your BBT properly, and you are unable to see an ovulation pattern, you should talk to your healthcare provider.
"Flat" Temperatures
If your temperatures seem to be around the same level all the time, the culprit is usually your thermometer. Even when you are taking your temperature at the same time, following all the guidelines, there is usually some fluctuation in temperatures. Your first step is to check your thermometer's battery or get a new thermometer. If your temperatures are still flat, and/or show no sign of a biphasic (ovulatory) pattern when you would expect them to, this is something to ask your doctor about if it happens for a few cycles.
Timing Intercourse using BBT
By the time you see a rise in temperature, you have probably already ovulated and it may be too late to time intercourse for conception purposes. You should still have intercourse though until ovulation is confirmed by a sustained rise in temperatures. You can predict ovulation, however, based on when you ovulated in previous cycles as pinpointed with your BBT and other fertility signs. The best thing to do is to follow the Fertility Analyzer in Fertility Friend which takes into account all signs and previous cycles as well.
You now have enough information to begin charting your fertility signs and let Fertility Friend do its analysis. If you choose to record and observe secondary fertility signs, read the rest of this section for a brief how-to.
Changes in the Position and Firmness of your Cervix
Your cervical position is an optional, secondary fertility sign.
It may take a few cycles to notice the changes your cervix experiences throughout your fertility cycle. It is a good idea to check when you know you are fertile as indicated by your cervical fluid and then again when you know you are not fertile (as indicated by your thermal shift in your luteal phase) when you are getting started. With this correlation, you will feel more easily the differences between your fertile and non-fertile times.
When you are approaching ovulation, your cervix will be high and soft (and you may notice that it feels more open also). When you are no longer fertile, your cervix will feel lower, more firm and you may notice that it is more closed. If you are not comfortable checking your cervix or you find the changes difficult to observe, and you are able to observe your cervical fluid easily, checking your cervix is not absolutely essential. If you are comfortable checking your cervix and are able to identify changes, you will benefit from the additional information that will help cross-check your other signs.
Checking your Cervix
If you choose to check your cervical position as an indicator of fertility here are some guidelines:
* To avoid the possibility of infection, always check the cervix with clean hands.
* Check the cervix once a day after menses. You only need to check once a day, unlike cervical fluid which you may check several times a day.
* Check your cervix at the same time every day as it may change throughout the day.
* Use the same position for checking your cervix throughout the cycle as changing positions will change your observation of cervical height.
* Squatting or placing one foot on a stool (or toilet seat) are good positions.
* Relax. (You will be able to more easily relax as you gain more experience).
* Insert one or two fingers into the vagina. At the back of the vagina, you should be able to feel your cervix. If you feel something at the back of your vagina that stops your fingers, then you have found your cervix. If you apply gentle pressure you will notice that it feels smooth, round and firmer that the surrounding vaginal tissues.
* Feel your cervix and make the following observations:
o Is the cervix high or low? (it is more difficult to reach it is high)
o Does the cervix feel soft or firm?
o Does the cervix feel open or closed? (Women who have already had children may notice that the cervix always feels slightly open).
o Does the cervix feel wet or dry?
o Do you feel any bumps on your cervix? (If you feel bumps that do not seem to be related to your fertility pattern, talk to your doctor right away)
* Record observations.
Recording Cervical Changes
Fertility Friend offers three fields on the data entry page that relate to cervical position. You can record the position, firmness, and openness of your cervix.
* Position: Your cervical position may be: low, medium or high. Your cervix heightens and becomes harder to reach as you approach your most fertile time. The important thing is to notice how it changes throughout your cycle in relation to your fertility. Observations can be subjective so you need to notice your own unique changes. There are really no rules to apply as you have to notice the changes relatively as they change. This may take a few cycles to really notice.
o Low: Record "low" for your least fertile cervical position. This is the position where it is easiest to feel and reach your cervix.
o Medium: Record "medium" for the position between your lowest and highest.
o High: Record "high" when your cervix is hardest to reach. You may not even be able to reach it. You will notice that it feels more wet, soft and open at this time as well. This is your most fertile cervical position.
* Firmness: Again, the issue is to notice the changes in the texture of your cervix relatively throughout your cycle as it changes. Like your cervical position, it may take a few cycles to notice your own pattern. To get an idea of what you are looking for, check when you know you are fertile (when you have eggwhite cervical fluid) and when you are sure you are not (after ovulation has been confirmed by 3 high temperatures) so that you know what you are looking for. At your least fertile time, both before and after ovulation, your cervix will feel the most hard and firm, a bit like the tip of your nose. As you approach ovulation, your cervix will soften, feeling more like your lips. You can record the firmness of your cervix as Firm, Medium, or Soft.
o Firm: Record "firm" as the most hard and firm texture you experience throughout your cycle. Your cervix will likely also be low and quite easy to reach at this time.
o Medium: Record "medium" when your cervix feels between your most firm and most soft. You may feel this just before you approach your more fertile time before ovulation and after ovulation as well.
o Soft: Record "soft" when your cervix feels the most soft. It will probably feel quite wet and high at this time as well and you may even notice that it also feels open. It may be hard to reach. This is your most fertile cervical texture.
* Openness: Not everyone is able to observe this sign, but you may also notice that your cervix feels more open when you are most fertile. If you are not able to observe this sign (many people are not), simply do not use it. The firmness and position of your cervix should provide enough additional insight into the changes in your cervix to allow you to cross-check your other signs if this is the case. This observation can also be quite subjective because women who have already given birth may notice that their cervix always feels slightly open. Women who have never given birth, may not notice the change at all or may notice that the cervix only opens slightly at their most fertile time. Like your other cervix signs, you should record how your cervix changes relatively throughout your cycle. If you are certain that you can notice the change in the openness of your cervix you should record the following:
o Closed: Record closed when your cervix feels at its most closed, least open position.
o Medium: Record medium when your cervix is slightly open.
o Open: Record open when your cervix feels at its most open position.
Devices and Tests for Measuring Fertility
There are an increasing number of products on the market designed to indicate possible fertility. They rely on changes in hormones that can be detected in your urine or saliva. When using these kits and devices, the most important thing is to follow the manufacturer's instructions as closely as possible. Questions that relate specifically to a certain product are best answered by that manufacturer and most products have 1-800 numbers on the package to allow you to ask questions.
These kits and devices can give additional, secondary clues about your fertility status that can complement the observations you make from your primary fertility signs. You may find them especially useful if you have irregular cycles, occasional anovulatory cycles, or if you find that you are not able to get clear readings from your cervical fluid and BBT signs. In most cases such devices are not essential, especially if you are easily able to recognize the changes in your cervical fluid, but you may find you like to have the added information for cross-checking.
No device or kit that you can do at home can pinpoint ovulation as well as your temperature data since only a thermal shift shows increased progesterone which is the hormone you release after ovulation. They can be quite useful though for timing intercourse and showing you when you have increased fertility.
Fertility Friend's analysis supports (but in no way requires) the use of OPKs, the Clearplan Fertility Monitor and Saliva Microscopes. If the data is entered, the analysis will make use of the data. For the Clearplan Fertility Monitor you may record Low, High or Peak. For saliva microscopes, you can record No Ferning, Partial Ferning or Full Ferning. For OPKs, you can record positive or negative.
A few words about Ovulation Prediction Kits (OPKs)
Ovulation Prediction Kits have become quite popular and can be quite useful to help you find your fertile time. OPKs work by measuring the presence of Luteinizing Hormone (LH) in your urine. A surge of LH which is sent to your ovary causes your ovary to produce enzymes which in turn causes the dominant follicle to rupture and release the egg into the Fallopian tube. This is ovulation and it is expected to occur within 24 hours of the surge of LH. An OPK is thus expected to be positive the day before you ovulate. Following a few guidelines can help you get the most out of your OPK.
* Like any product, follow the manufacturer's instructions carefully.
* If you do not test every day from before you expect to be most fertile, you may miss the surge. Likewise, if you test too late, you may miss the surge. Also, it may not be possible to tell if you are about to ovulate or if you just ovulated since you will have increased LH in both cases. Usually, though, the positive OPK means that you are about to ovulate.
* Testing daily once you have started to test is the best strategy since your first positive OPK result probably means that you are about to ovulate and your last positive OPK, if you get more than one, may mean that you just ovulated. Since OPK packages include only a limited number of test strips, timing when to start testing is crucial.
* If you use OPKs, use the Fertility Friend OPK optimizer to help you choose when to start testing to make sure you do not waste tests and so that you can get optimal results. Based on your average cycle length and previous cycles entered in Fertility Friend, if applicable, the OPK optimizer can tell you when to begin testing so that you will not miss your opportunity but you will not waste tests either.
* Follow the manufacturer's instructions about the time to take your OPK. First morning urine is usually not the best for OPKs since your LH surge usually begins in early morning when you are still sleeping and may not be apparent in your first morning urine. If you test in the early morning, you may miss your surge entirely since LH levels may already be reduced by the next morning. Late morning or early afternoon is usually best unless the instructions suggest otherwise.
* Record your OPK results as positive in the data entry page of Fertility Friend if the test line is as dark as or darker than the control line. Record your results as negative if the test line is lighter than the control line.
* Do not rely exclusively on OPK results to time intercourse as you may not see an LH surge (positive OPK) even though you may be fertile. Your increased fertility begins before you see a positive OPK result since sperm can live in the reproductive tract for a few days in fertile cervical fluid. Keep having intercourse every other day before you see a positive OPK result, but switch to every day once you see a positive result until ovulation has been confirmed by your temperature data. The Fertility Analyzer in Fertility Friend will help you with your timing.
Other Possible Fertility Signs
Some women notice other changes that may offer another indication of increasing fertility. You may or may not notice some of these signs. Not noticing these signs does not in any way indicate a lack of fertility. You may also have signs of your own that you notice throughout your cycle and from cycle to cycle that are not mentioned here. If this is the case you may find it useful to record these observations in your notes section. Because these signs are not consistent, may vary from woman to woman and even from cycle to cycle for the same woman, they are not included as fertility signs. Rather, you can check them on the checklist in the special notes section or record them in your own notes. You can also set up your "custom signs" (see data entry page) to include them on your chart.
Some other possible fertility signs are:
* Ovulation Pain: Also known as mittelschmertz, which means "middle pain" it refers to a slight pain that you may feel near your abdomen or ovary at the time of ovulation. It does not necessarily occur at the exact time of ovulation and not everyone feels ovulation. As such, ovulation pain is useful to cross-check other signs, but cannot be used to definitively confirm or pinpoint ovulation. Also, it is very difficult to know if the pain you feel in your abdomen mid-cycle is related in any way to ovulation or your fertility. Other pains are often mistaken for ovulation pain. It is still useful to record, even if you are unsure if it is related to your fertility. As you become more in tune with your fertility signs, it will become easier to recognize ovulation pain if you experience it. Women who have never noticed ovulation pain often begin to notice it when they begin to chart their fertility signs.
* Increased Sex Drive: You may notice that your sex drive is cyclical (You may also notice that it is not and that may be normal for you). Your sex drive may be highest at around the time before and at ovulation. Another pattern might also be normal for you. If you notice that there is a pattern to your sex drive, it can be helpful to record your observations to make predictions about your fertility.
* Ovulation spotting: Some women see slight spotting at the time of ovulation. This is quite rare, but you may see that your cervical fluid is streaked with blood or has a pink tinge. If you do notice this and it is accompanied by fertile cervical fluid (eggwhite or watery) enter the cervical fluid as eggwhite or watery but make a note about the spotting in your notes section. If it is heavy or lasts longer than a day, you should ask your doctor about it.
* Tender Breasts: While your experience may be different, you may notice a pattern to the sensitivity of your breasts. They may feel more sensitive at around the time of ovulation and they may continue to feel sensitive throughout your luteal phase. Again, if you notice that there is an observable pattern to the sensitivity of your breasts, it is useful to record it in the checklist on the data entry page so that you can make future predictions or notice changes from cycle to cycle. While some women say that tender breasts are an early pregnancy symptom, there is no way to know if you are pregnant by the sensitivity of your breasts. Breast sensitivity may be linked to increased progesterone. Progesterone is increased both during the luteal phase of your menstrual cycle when you are not pregnant and during pregnancy. The sensitivity of your breasts may be useful for you to cross-check other signs if you have a consistent pattern but it is not a useful fertility sign on its own.
* Your own observations: You may notice some specific changes yourself that can offer clues about your fertility pattern. Everyone is different, but there are clues that you may find on your own. Changes in your complexion, your energy level, your moods, or anything else that you notice shows a cyclical pattern can offer insight into your fertility pattern. Use the notes section, the custom signs option, or the checklist on the data entry page to record these observations. You may be surprised to learn that something seemingly unrelated may be related to your fertility.
