12. Achieving Pregnancy
Some women have a poor mucus secretion and may not see any. The
development of a soft, moist, swollen vulva may be the only sign
of fertility. Intercourse at this time often succeeds in achieving
conception.
Mucus may not accompany ovulation in every cycle, in which case
conception will not occur.
After 6 months, if conception has not occurred, and during which
time the mucus pattern seems to be normal and the history of the
man and the woman do not suggest an abnormality, if conception has
not occurred, further investigations are recommended, beginning
with a Huhner's test at the time of the Peak, to access sperm adequacy.
The test should be done within 6 hours of intercourse at the Peak.
An examination by microscopy of cervical mucus normally shows actively
swimming sperm.
A general physical examination of both partners is made. If the
Huhner's test is positive, further gynaecological examination should
be made. Both male and female factors contribute to low fertility.
Some contributing male factors are:
-
Genetic.
-
No sperm or a low sperm count.
-
Abnormalities of reproductive organs, e.g. maldescended testicles.
-
Sexually transmitted diseases.
-
Other infections, e.g. mumps.
-
Hormonal ... low sperm production.
-
Smoking.
-
Certain occupations (e.g. transport drivers, cooks) in which
scrotal temperature is raised leading to low sperm counts.
-
Chronic fatigue.
-
Inadequate intercourse.
-
Poor couple relationship.
Some contributing female factors are:
-
Age.
-
Stress.
-
Abnormalities of reproductive organs -- malformation, and some
genetic disorders.
-
Hormonal: pituitary tumour, hyperprolactinaemia, thyroid disorders,
ovarian cysts, disturbances of ovulation due to chemical contraception.
-
Sexually transmitted diseases: blocked tubes, cervical infection.
-
Endometriosis.
-
Smoking.
-
Obesity.
-
Fatigue.
-
Poor couple relationship.
Management
-
Apply Early Day Rules to BIP (alternate evenings).
-
When change occurs, wait until slippery sensation
develops.
-
Intercourse over the days of the slippery sensation
give the best chance of conception.
-
When intercourse occurs on successive days, as
in this case (see Chart 12, days 13, 14 and 15), the seminal
fluid obscures the change in the mucus which defines the Peak.
Conception is common following a single act of intercourse occurring
just as the slippery Peak symptom is changing to sticky and/or
clear fluid mucus is becoming thick and cloudy. This procedure
provides good definition of the Peak when the mucus is too little
to be seen. It may be necessary to wait until a definite change
in sensation occurs before having intercourse. Pay attention
to vulval swelling and softness.
-
If the lubricant KY Jelly is used it must be free
of spermicides.
-
The Lymph Node Sign is helpful in about 75% of
cases. Around ovulation a lymph gland in the groin on the same
side as the ovulating ovary enlarges to about the size of a
pea and becomes tender when pressed. Daily examination of this
gland will reveal the increase in size and tenderness. This
is best done lying down with fingers straight, and pointing
to the leg, so that the middle finger can feel the pulsating
artery to the leg. The index finger will then be over the gland.
See diagram below.
Lymph Node Sign
Predetermination of the Sex of the Baby
Success has been claimed for pre-determination of the sex of the
child according to the following guidelines:
Chart a cycle with careful attention to the slippery sensation
and the Peak symptom (the last day of any slippery or wet sensation).
For a boy -- one act of intercourse only during the fertile phase,
just after the Peak, when the slippery sensation has just finished.
For a girl -- one act of intercourse only during the fertile phase,
just as the mucus is becoming slippery before the Peak.
Chart 12. Achieving pregnancy by acts of intercourse
at about the time of the peak symptom. Application of the Early
Day Rules enables the woman to identify the change which indicates
approaching ovulation. Waiting until the mucus develops a slippery
quality enables the seminal fluid and sperm count to reach an optimal
level nearing ovulation. On days 1 and 2 the mucus is changed but
the seminal fluid is wet. The Peak is therefore indefinite. The
vulval swelling subsides.
A harmonious relationship facilitates conception and is essential
in rearing a child.
Cycle Day |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
14 |
| Stamp |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Symbol |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Sensation/
Appearance
of discharge |
|
|
|
|
|
dry |
wet seminal fluid |
dry |
wet seminal fluid |
wet |
wet clear |
wet clear |
slippery strings |
slippery clear
Peak swollen vulva |
Rules |
Alternate evenings
for intercourse
|
When change occurs
wait until slippery sensation begins |
Cycle Day |
15 |
16 |
17 |
18 |
19 |
20 |
21 |
*22 |
*23 |
*24 |
25 |
26 |
27 |
28 |
| Stamp |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Symbol |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Sensation/
Appearance
of discharge |
wet seminal fluid |
wet |
dry |
dry |
dry |
dry |
dry |
wet bleed |
wet bleed |
sticky spotting |
dry |
dry |
wet cloudy |
wet cloudy |
Comment |
A luteal phase of longer than
16 days indicates pregnancy, in a cycle which has not been
manipulated by hormones.
* Bleeding due to implantation of the embryo into the endometrium.
May occur from about 6 days after conception. This is not
to be confused with menstruation. Intercourse on days 13,
14 and 15 of the cycle has resulted in conception. |
Cycle Day |
29 |
30 |
31 |
32 |
33 |
34 |
35 |
36 |
37 |
38 |
39 |
40 |
41 |
42 |
| Stamp |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Symbol |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Sensation/
Appearance
of discharge |
dry |
wet |
dry |
dry |
dry |
|
|
|
|
|
|
|
|
|
Comment |
A luteal phase of longer than
16 days indicates pregnancy, in a cycle which has not been
manipulated by hormones. |
Reference: Evelyn L. Billings and John J. Billings,
Teaching the Billings Ovulation Method Part 2. Variations of
the Cycle and Reproductive Health, Ovulation Method Research
and Reference Centre of Australia, pp. 24-25, Melbourne, 1997 |
