Taking Charge of Your Fertility

by Toni Weschler

  Fertility Factors You Can Detect Through Waking Temps

  As you saw from the previous couple, cervical fluid is the crucial fertility sign to chart when trying to get pregnant. But basal temps can be equally beneficial, for altogether different reasons. One of the most common mistakes couples make is trying to time intercourse by the waking temperature.

  Remember, temps are useful to determine if you are ovulating, and how long your luteal phase is. But they are not helpful for identifying impending ovulation, which is the most fertile phase of the cycle. So waiting for either the dip or rise in temps is virtually useless for timing sex. The dip occurs only in a small percentage of cycles, and by the time the temperature rises, it’s usually too late.

  However, I want to reiterate that taking your temps is very useful for several reasons besides timing intercourse. Using a typical cycle like Sylvia’s chart as a standard of comparison, you can see how temps can reflect numerous things about your fertility. Your waking temps show whether:

  •you are ovulating at all (Sylvia’s and Blakely’s charts)

  •your luteal phase is long enough for implantation, thereby preventing the need for painful and unnecessary diagnostic tests such as an endometrial biopsy (Jennie’s chart)

  •your progesterone levels are high enough in your luteal phase (Marianna’s chart)

  •you are still fertile any given cycle as reflected by low temps (Rena’s chart)

  •you may have gotten pregnant, as reflected by more than 18 high temps (Anna’s chart)

  •you may have gotten pregnant, as reflected by more than 18 high temps, even though you have menstrual-like bleeding at about the time of your expected period (Lynn’s chart)

  •you may be in danger of having a miscarriage, as determined by a sudden drop in temps (Amber’s chart)

  •you were pregnant before having what seemed to be just a “late period” (Charlotte’s chart)

  DETERMINING YOUR LUTEAL PHASE LENGTH

  You can calculate about how many days your luteal phase is by counting from the first day of the thermal shift through to the day before your period (a more thorough description is here).

  Sylvia’s chart. A typical ovulatory temperature pattern. Note that Sylvia had almost certainly ovulated by the thermal shift on Day 17. Her luteal phase was 15 days, determined by counting the high temperatures from Day 17 through to the last day before her period on Day 32.

  Blakeley’s chart. An anovulatory temperature pattern. Blakeley’s temperatures indicate that she didn’t ovulate because she had no thermal shift from a range of lows to a range of highs. The bleeding she experiences on Day 32 of her cycle is technically not menstruation but anovulatory bleeding. For charting purposes, it should still be treated as Day 1 of a new cycle.

  Jennie’s chart. A short luteal phase. Note that while her 31-day cycle length is normal, Jennie’s 9 postovulatory high temperatures indicate a short luteal phase (counting Days 23 to 31). In order for implantation to successfully occur, women usually need a postovulatory phase of at least 10 days.

  Marianna’s chart. Low postovulatory progesterone. Note that Marianna’s high temperatures hover around the coverline following ovulation, around day 16. This could be an indication of low progesterone levels.

  Rena’s chart. A delayed ovulation. Rena was able to determine that she was still fertile as late as Day 21, because her temperature had not yet risen and her cervical fluid was still wet. Therefore, she timed intercourse accordingly and got pregnant.

  Anna’s chart. A pregnancy chart. Anna could tell she got pregnant by Day 31, because she had 18 high temperatures after ovulation. (The postovulatory phase is rarely more than 16 days unless a woman is pregnant.)

  Lynn’s chart. A rare and confusing pregnancy chart. On Day 26, Lynn assumed she started her period but was baffled when her temperatures remained high well into the next cycle. After 13 days of continued high temps, she took a pregnancy test, only to discover that she was indeed pregnant. Were she not charting, she would never have thought to take it. (See her story here.)

  Amber’s chart. Pregnancy followed by a miscarriage. Amber was almost certainly pregnant, as seen by the fact that she had her 18th high temperature on Day 33; she confirmed her suspicion with a positive pregnancy test, but she then got a warning that she was probably about to miscarry by the pattern of falling temperatures starting about Day 36.

  Charlotte’s chart. Miscarriage that would have seemed like a late period. Note that if Charlotte had not been charting, she wouldn’t have been able to observe the 18 high temperatures, and thus she might have thought that her bleeding on Day 34 was simply a late menstruation, rather than a miscarriage.

  How Charting Temps Can Indicate Conception and Prevent Unnecessary Interventions During Pregnancy and Delivery

  One of the most practical benefits of recording your temps is to determine if and when you got pregnant. Of course, the most important reason to know the date of conception is to determine when the true due date will be, rather than the one based on a pregnancy wheel’s assumption of a Day 14 ovulation. Knowing this will prevent inappropriately timed tests such as amniocentesis. In addition, it may allow you to avoid an unnecessarily induced labor due to a miscalculation of the due date. (This is especially problematic in women who tend to have long cycles.) While it’s true that ultrasound clarifies many of these ambiguities, many couples still prefer to avoid such procedures.

  HOW TO DETERMINE YOUR DUE DATE

  If you are charting and prefer not to have ultrasound, there is a simple mathematical formula for calculating your approximate due date, based on when you actually ovulated that cycle. Simply add 9 months to the day of your thermal shift and then subtract one week (7 days) from that date. Thus, for example, if your thermal shift was on January 20, you would jump ahead to October 20, and then go back exactly 1 week, for an approximate due date of October 13. If you ovulated about Day 14, the estimated due date would be about the same for both the formula and pregnancy wheel. But if you ovulated well after Day 14, the formula would be substantially more accurate.*

  More on How to Use Your Temps to Determine If You Are Pregnant

  One of the more interesting examples of temps alerting a woman to a potential pregnancy was that of Lynn, a woman who was trying to conceive after 8 cycles of charting for birth control. Up until then, she had completely normal ovulatory cycles of between 24 and 27 days. This time, though, when she got her period on Day 26, she was naturally disappointed, but assumed they would try again the following cycle. Her period lasted longer than normal, but that was not the only thing that concerned her. Her temps simply did not drop as they should by the end of menstruation. Finally, on Day 13 of the following cycle, with her temps still well above the coverline, she took a home pregnancy test and, much to her amazement, discovered that she was pregnant (see Lynn’s chart).

  She never did learn what caused the bleeding, because she didn’t realize the relevance of the high temps until about a week after it stopped. By then, it was too late for the doctor to determine why. But two doctors she consulted said that her HCG levels were so high that it could have been “vanishing twin syndrome.” Today, she and her husband, Paul, are the delighted parents of a little girl named Jordan.

  As you’ve seen, a general rule is that 18 high temps above the coverline mean that you are pregnant (see Vicky’s chart). And you can determine this without spending a dime on a pregnancy test (of course, you should confirm it with a clinician). In addition, you can usually tell even before 18 high temps whether you are pregnant by two means:

  1. You can be fairly confident you are pregnant if your temps remain high three days beyond your longest luteal phase to date. So, for example, if your luteal phases are typically 12 days, and if your longest one has been 13 days, but one time it’s 16 days, it’s likely you conceived that cycle, on Rosy’s two charts below.

  2. If you notice a third level of temps beyond the typical biphasic pattern you experience every cy
cle, you are almost certainly pregnant. This third level of high temps is thought to be due to the extra progesterone pregnant women produce. Unfortunately, though, many pregnant women don’t experience such a triphasic pattern, and even when they do, the third set of high temps is often more subtle than the second set, as seen in Maya’s chart.

  Rosy’s typical chart. A 13-day luteal phase. Rosy has been charting as a method of birth control for about a year. Her luteal phases have always been 12 or 13 days, never more.

  Rosy’s pregnancy chart. The first cycle she tried to get pregnant, she was able to tell she succeeded as soon as her 16th postovulatory high temperature (by Day 31), because she knew that her normal luteal phase never extended beyond 13 days.

  Maya’s chart. The classic triphasic pregnancy pattern. Note that Maya was able to predict as early as Day 24 that she was probably pregnant because she was starting to observe a third level of high temperatures reflecting additional progesterone at the time of implantation. The fertilized egg burrows into the uterine lining about a week after ovulation, and thus she confirmed her pregnancy on Day 33.

  Copyright © 1982, 1991 by Lynn Johnston Productions Inc. and Lynn Johnston, reprinted from David, We’re Pregnant! with permission of its publisher, Meadowbrook Press.

  USING A COVERLINE

  In order to interpret your chart, you’ll want to draw a coverline to help you differentiate between low and high temps. You should review here if you have not already internalized how to draw one. Though the coverline is not as crucial for getting pregnant as it is for contraceptive purposes, it’s still a useful tool that will allow you to see more easily when you ovulated in any given cycle.

  MALE FERTILITY

  When 15-year-old Niko was 4 years old, his mom was confronted with the all-too-dreaded question of “Where do babies come from?” Wanting to appear cool and nonchalant, she simply stated matter-of-factly that “the man takes his penis and puts it into the woman’s vagina . . .” at which point the little boy’s eyes widened to the size of saucers as he exclaimed with total disbelief: “You mean, I can take it off?!”

  Hopefully, you now understand why basal temps are so revealing for getting pregnant. And of course you already learned how crucial cervical fluid is for conception to occur. But before you combine this information into an efficient strategy to use with FAM, you should at least know some basic information about male fertility and the standard semen analysis.

  It’s important to remember that in determining sperm count, the analysis of your partner’s semen must do more than simply measure the number of sperm per ejaculate. It should also tell you what percentage of those sperm are of normal shape and size (morphology) and what percentage are rapidly moving forward (motility). It’s a complete analysis of these three factors that actually tells you whether your partner’s count is normal, low, or infertile, thus allowing you to strategize accordingly. In reality, this is quite intuitive, for what ultimately defines male fertility is the number of sperm that have the capacity to fertilize an ovum.

  As of this writing, a man’s sperm count would probably be considered normal if his ejaculate contains at least 20 million sperm per millimeter, and if the total number of sperm is at least 250–300 million. In addition, the percentage of those sperm that are of normal morphology and motility is a crucial factor, but because sources vary so greatly as to what is considered an adequate percentage, it’s best if you discuss this with your doctor. The simple fact is that the standards by which semen analysis is judged vary from lab to lab and evolve over time. Therefore, when your partner gets his sperm analyzed, you should ask that his physician answer two questions as clearly as possible:

  1) Is his sperm count considered normal, low, or infertile?

  2) How did the lab reach this conclusion?

  If a man’s sperm analysis is subfertile, it should be repeated at least one more time within a few weeks. This is because different factors may impact sperm, and an occasional low sperm count may be an inaccurate reflection of his actual number.*

  OPTIMIZING YOUR CHANCES OF GETTING PREGNANT

  If you are just starting to try to get pregnant, there’s no particular reason for your partner to rush out and get a semen analysis. Unless you have reason to think otherwise, you should tentatively consider his sperm count normal and follow the guidelines listed below for normal counts. However, for those who have been trying at random for a year, or have been timing intercourse perfectly by charting for about four cycles, I would encourage you to get a sperm analysis as soon as possible. It’s a simple enough procedure and it’s probably worth doing soon, since its results will help you know how best to time intercourse. Remember, fertility problems are equally divided between men and women.

  Why are millions of sperm needed to fertilize one egg? Because they don’t ask for directions.

  And now you are ready for the nuts and bolts of maximizing your chances of pregnancy. The bottom line is that when deciding how to best time intercourse, the frequency with which you make love should be a function of your combined fertility. That is, it should be determined by your partner’s sperm count and the quality of your fertile cervical fluid.

  If the Man’s Sperm Count Is Normal

  You should have intercourse every day that you have wet cervical fluid or a lubricative vaginal sensation, through to and including the day of the first rise in temperature. Of course, the closer you time intercourse to your Peak Day, the more likely you are to conceive. If you don’t have eggwhite, follow this guideline with the wettest cervical fluid you have.

  Vicky’s chart. When to time intercourse with normal sperm count. Note that Vicky started timing intercourse the first day she noticed wet (creamy) cervical fluid on Day 16, and continued every day through to the morning of the rise in temperature on Day 20. She was able to confirm that she conceived 18 high temperatures later, by Day 37.

  If the Man’s Sperm Count Is Low

  For the first few months, you may want to try having intercourse every day that you have eggwhite. But if that doesn’t work, try having intercourse every other day instead. Either way, though, you should continue to have sex through to and including the day of the first rise in temperature. Again, if you don’t have eggwhite, follow this guideline with the wettest cervical fluid you have.

  The reason you should consider having intercourse less frequently is because men with low sperm counts may need the extra day to build up to higher, more fertile levels. In fact, he might try abstaining from ejaculation for a few days until your cervical fluid becomes slippery, enabling the sperm count to reach an optimal level just before ovulation.

  The list below includes different strategies that may work for you. Again, you may want to try one for a couple of cycles and, if that doesn’t work, switch to another for the next cycle. The combined factors of each couple’s fertility make some of them work better than others. Regardless of which strategy you choose, try to time intercourse for your Peak Day.

  •Have sex every day from the first day of wet cervical fluid through to and including the first day of your thermal shift.

  •Have sex every other day from the first day of wet cervical fluid through to and including the first day of your thermal shift.

  •Have sex every other day from the first day of eggwhite through to and including the first day of your thermal shift. (See Brianna’s chart.)

  •If your partner’s sperm count is low and you produce a maximum of only two days of slippery-quality cervical fluid, you might want to try abstaining on the first day of wet and have sex the second, or Peak Day (See Kelsey’s chart below).*

  Brianna’s chart. An optional way of timing intercourse with low sperm count. After several cycles in a row of having intercourse every single day that she had eggwhite-quality cervical fluid, this couple decided to change their strategy and had sex only every other day through to the morning of the rise in temperature on Day 16 of this cycle. This may have allowed the sperm count to build up on the “off
days.” It worked, and she was able to confirm that they succeeded through a blood test on Day 25, since she started noticing a third level of higher temps that day. Of course, she could have waited to do a home pregnancy test on Day 18 of her luteal phase, which was Day 33 of her cycle.

  Kelsey’s chart. An optional way of maximizing your chances of conception when your partner’s sperm count is low and you have minimal fertile cervical fluid. Note that Kelsey only has about 2 days of wet cervical fluid per cycle. Since his sperm count is low, they chose to time intercourse on the second and last day of her wet cervical fluid, perhaps optimizing their chances of pregnancy by reserving the highest number of sperm for her Peak Day of fertility. They were able to confirm that they succeeded 18 high temperatures later, by Day 30.

  Tips That Apply to Men with Both Normal and Marginal Sperm Quality

  A tip that may help men with either type of sperm count is to abstain from any ejaculation for a couple of days just before your cervical fluid begins to appear fertile. Of course, you may think this is like telling your partner to get off the bus at the stop before you. How would he know ahead of time when that is? But if you’re really in tune with your body, you’ll be able to anticipate when it just begins to become slightly fertile. He should try to abstain from any type of ejaculation for those few barely fertile sticky days to build up a high enough count to take advantage of your ideal cervical fluid.