Because properties of cervical mucus determine whether sperm will be capable of survival and transport to the ovum Moghissi, ; Yudin et al.
In particular, consistent with the well known role of estrogenic mucus in enhancing progressive sperm motility Eriksen et al. Our data provide additional information not available in the World Heath Organization study evaluating the use of vulvar mucus observations in estimating the fertile interval. The European Study of Daily Fecundability is a prospective cohort study conducted to determine the daily probability of conception on each cycle day relative to ovulation for healthy women in their reproductive years.
From to , women were recruited from seven European centres providing services in fertility awareness and natural family planning NFP. Women enrolled were experienced in NFP, married or in a stable heterosexual relationship, 18—40 years of age, had at least one menses after cessation of breastfeeding or delivery if applicable , and were not currently taking hormonal medication or drugs affecting fertility. In addition, neither partner could have a history of fertility problems, and couples were required not to use barriers or spermicide generally.
Additional details on the inclusion and exclusion criteria, the demographics of the cohort, and other study methods and initial results have been published elsewhere Colombo and Masarotto, Women kept daily records of basal body temperature BBT , cervical mucus symptoms and intercourse. The daily mucus observations were classified according to Table I , ranging from a score of 1 no discharge and dry to 4 transparent, stretchy, slippery.
If a discharge exhibited mixed characteristics, or if a woman observed multiple types of mucus through the course of the day, the highest matching category was chosen to assign the score. A primary goal of this study is to assess directly the extent to which the different levels of the mucus score predict a real difference in the conception probability.
In a previous analysis of these data, Dunson et al. Cycles were excluded from the analysis if there were insufficient BBT data to determine the ovulation day, if there were no reported intercourse acts during the fertile interval, or if there was a day within the fertile interval on which intercourse occurred but mucus information was missing. Out of menstrual cycles of data with pregnancies, cycles remained in the analysis, with pregnancies. For the purposes of this study, pregnancy is defined as either an ongoing pregnancy of at least 60 days from the last menses or a clinically identified spontaneous abortion within 60 days of the last menses.
Modelling and estimation of pregnancy probabilities were carried out using a Bayesian hierarchical modelling approach Dunson, This involves choosing prior distributions for unknown parameters in a statistical model based on previous information and updating this information with the data in the study to obtain posterior distributions, which represent the current state of knowledge about the unknown parameters.
In a cycle where intercourse occurred on more than one day during the fertile period, it is impossible to determine which act resulted in the pregnancy. Following Barrett and Marshall , Wilcox et al. The analyses presented in this article are based on the methods of Dunson and Stanford The significant trend was attributable to a steady increase in the pregnancy probability with each unit increase in the mucus score. Specifically, the posterior probability of an increase in the pregnancy probability in going from a mucus score of 1 to 2 was 0.
The day of lowest fertility was 5 days before ovulation, and the day of highest fertility was 3 days before ovulation. The difference in pregnancy probability between these two days ranged from 0. Thus the gain in pregnancy probability attributable to an increase from the lowest to highest mucus score is generally higher than the gain attributable to having intercourse 3 days before ovulation instead of 5 days before ovulation. Within the fertile window, the type of mucus observed on the day of intercourse is more predictive of conception than the timing relative to ovulation.
Figure 2 shows the distribution of the reported mucus scores according to timing within the fertile interval. On each day, type 4 mucus is the most common, with the largest proportion occurring 2 days before ovulation, which is also the day on which the smallest proportion of cycles had no vaginal discharge type 1 mucus. It is important to note that each of the days had a substantial proportion of women in each of the mucus categories.
Although fewer women reported type 2 mucus and that proportion remained essentially constant across the fertile window, there was a significant difference in the pregnancy probabilities between type 2 mucus and the other categories. These results provide direct evidence that mucus plays a role in fertility that is more important than its previously identified role as a marker of the fertile window of the menstrual cycle.
Previous estimates of pregnancy probabilities on days relative to ovulation did not account for daily observations of the quality of mucus, though researchers have identified increased conception probabilities on days when secretions were observed compared with no secretions Dunson et al. Our study demonstrates that the quality of mucus explains most of the relationship between the pregnancy probability and the timing of intercourse relative to ovulation.
Our results have important clinical implications. Because vulvar observations of cervical mucus predict not only the fertile days of the cycle but also the probabilities of conception within the fertile interval, monitoring of mucus provides additional information not provided by other methods for identifying the fertile interval. This is the best time to have sex if you want to get pregnant. Don't check your cervical mucus during or right after sex.
Also, avoid checking when you're feeling sexually aroused. Checking after sex is also a bad idea because it's too easy to confuse semen with cervical secretions. You can check your cervical mucus by looking at the toilet paper or your underwear. Not everyone is comfortable with putting their finger inside to check themselves. But you don't have to. You can instead pay attention to how wet your vulva feels on a day-to-day basis, pay attention to the discharge on your underwear, or look at the toilet paper after urination.
There is, in fact, an entire method based on this: the Billings Ovulation Method , With all that said, however, it's easier for many women to physically check themselves and reach inside. Consider checking your cervical mucus after bowel movements. Of course, first, wash your hands well! But if you have trouble finding cervical mucus, it may be easier after a bowel movement. Having a bowel movement moves down any vaginal discharge closer to the entrance of your vagina.
If you have multiple patches of fertile cervical mucus, look for additional ovulation signs besides CM. Some women, especially those with PCOS , have several patches of fertile-looking cervical mucus throughout their cycle. If this is your situation, predicting ovulation by tracking cervical mucus might not work well for you. You should consider paying attention to other ovulation signs, like cervical position changes. You may also want to chart your basal body temperature, so you know which if any of the fertile cervical fluids indicated ovulation.
Some medication may interfere with your cervical fluids. Antihistamines dry up more than your sinuses — they also dry up your cervical fluids. Ironically, Clomid can prevent you from having fertile quality cervical mucus. In this case, you might not find as much fertile cervical mucus before ovulation. So, you might want to try using an ovulation predictor kit to detect ovulation instead. If you never get fertile quality cervical mucus, tell your doctor.
Lacking fertile quality cervical mucus can be a sign of a hormonal imbalance or fertility problem. A ripening egg grows inside an enclosure, called a follicle, in the uterus. The follicle grows and produces estrogen. When the follicle ruptures, the body ovulates, releasing an egg. The estrogen that the follicle produces softens the cervix and opens it slightly.
Estrogen also changes the texture of cervical fluid, making it more able to support fertility. So, to detect fertile discharge, a person should monitor their cycle for several months. The days that discharge changes vary from person to person. Those who ovulate later in their cycle, for example, should expect fertile discharge after day In general, the cycle of discharge follows this pattern :.
Ovulation plays a significant role in determining the consistency of cervical fluid. A person who does not ovulate may notice fewer changes in their vaginal discharge. Fertile cervical fluid is a good signal of increased fertility. Anyone trying to get pregnant should have intercourse during the time when they notice the fertile discharge. An egg only lives 12—24 hours after ovulation, but sperm can live much longer, often 3—5 days in fertile cervical fluid.
This means that, for people wishing to become pregnant, the best time to have intercourse is right before ovulation, as sperm can live in the reproductive tract for several days. If they are already there when ovulation occurs, they can immediately fertilize the egg. To determine fertility, check the appearance of cervical fluid at least once a day, beginning on the first day after a period. Several factors can influence the way that cervical fluid looks, which is why a person should monitor the appearance and consistency over time, to get a sense of what is normal for them.
Some people find that their cervical fluid looks different after sex. A simpler version of the cervical mucus method is an approach called the TwoDay Method. With the TwoDay Method, you note whether you've seen cervical secretions that are clear, stretchy, wet and slippery — a sign of peak fertility — either today or yesterday.
If the answer is "yes," then consider yourself fertile. Abstain or use a barrier method of birth control to avoid unintended pregnancy. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Sections for Cervical mucus method for natural family planning About. Overview The cervical mucus method is a type of natural family planning. Request an Appointment at Mayo Clinic.
Share on: Facebook Twitter. Show references Hatcher RA, et al. Fertility awareness-based methods. In: Contraceptive Technology.
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