Women's cervical mucus observations identify their most fertile days
A 2015 commentary by Joseph B. Stanford states that women's cervical mucus observations mark the days when intercourse most likely results in pregnancy. The commentary reviews an analysis by Ecochard and colleagues. The analysis timed ovulation by serial ultrasound among experienced fertility-awareness users.
Study at a glance, commentary of experienced fertility-awareness users: Cervical mucus observations mark a woman's most fertile days. Source: Stanford JB, 2015, PMID 25772771.
Key Findings
Stanford concludes that estrogenic or peak cervical fluid, observed at the vulva, marks the days of greatest pregnancy potential from intercourse and the approximate timing of ovulation.
Ecochard and colleagues report that women's own checks of cervical fluid 2–3 times per day, noting specific features, can optimize both sensitivity and specificity for finding the days of highest pregnancy probability.
One theoretical algorithm marks 8 or more days before ovulation through 3 or more days after, 12 days or more in all, with very high sensitivity and low specificity.
Another theoretical algorithm marks the two or three days before ovulation plus ovulation day, with high sensitivity and high specificity for the days of highest pregnancy potential.
In the Ecochard analysis, qualifying mucus has a wet, slippery sensation with or without clear, stretchy appearance, and need not necessarily resemble raw egg white.
Interpretation
The article is a commentary, a written appraisal of a published study. It presents the author's reading of the evidence. The author notes that the data came from experienced users who had learned fertility-awareness methods from natural family planning teachers. Recent work cited by the author suggests that many women can learn mucus observation from a written or electronic brochure. Stanford proposes randomized trials of mucus observation. The comparison would be one or more of urine luteinizing hormone (LH) tests, calendar calculation, or advice for consistent intercourse 2–3 times per week. The trials would assess how much mucus observation may shorten time to pregnancy, particularly among couples with reduced fertility.
RRM Context
Restorative reproductive medicine works with the cycle and with both partners. A woman's daily observations give the couple a shared record of the fertile window. Mucus observation is the central sign in Creighton Model FertilityCare charting, and other fertility-awareness based methods teach it.
Our editorial summary of this paper, not the article's abstract.
Abstract
Ovulation occurs on 1 day during each menstrual cycle (even if multiple follicles are involved), and the several days preceding ovulation are when intercourse is most likely to result in pregnancy. Collectively, the potentially fertile days up to and including the day of ovulation are called the “fertile window” (1). Since the 1930s, several biomarkers of the fertile window have been investigated for the purposes of empowering women and couples seeking to use fertility-awareness based methods or natural family planning to avoid pregnancy, as well as to expand understanding of human reproductive physiology.
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