Billings Ovulation Method

1. Billings Ovulation Method Natural Fertility Regulation

2. Billings Ovulation Method • A natural way to: • Achieve Pregnancy • Postpone Pregnancy • Monitor Reproductive Health

3. Billings Ovulation Method • easy to learn • simple to use • no drugs or devices • no side effects • reliable • morally acceptable to all cultures

4. Female Fertility Begins from puberty Cyclic – potentially fertile for approx 5-7 days Finishes at menopause Male Fertility Sperm production begins at puberty Production of sperm continues throughout life + = Couple Fertility

5. THE FEMALE REPRODUCTIVE ORGANS

6. THE OVARIES – whose function is the cyclic maturation of ova (eggs), produce hormones oestrogen and progesterone

7. FALLOPIAN TUBES – tubes through which sperm cells are assisted in their passage from the uterus to the ovum (egg)

8. FALLOPIAN TUBES – the fertilized ovum (embryo) is actively transported to the body of the uterus

9. THE UTERUS - the organ of the female in which the embryo implants and develops

10. ENDOMETRIUM – the inner lining of the uterus which is shed at menstruation

11. THE CERVIX – the neck of the uterus which bears the mucus-producing crypts

12. THE VULVA – the external parts of the female genital organs. It is the sensing organ for cervical mucus

13. THE VAGINA – the birth canal, the passage through which the baby is deliveredThe lining of the vagina has no glands

14. POCKETS OF SHAW – after ovulation, under hormonal control, mucus is dried as it passes through the vagina

15. Keeping a Record • Observations made at the vulva as the woman goes about her normal daily activities No internal examination • Most fertile characteristic of day recorded each evening • One or two words recorded to describe sensation and appearance Coloured stamps or symbols used on chart

16. The woman will both feel and see the bleed as it arrives at the vulva

17. Sensation/Appearance of discharge Menstruation, indicated by a red stamp or the symbol 

18. Following menstruation cervix occluded with thick, dense plug of mucus

19. Plug prevents passage of sperm into cervix and protects body from infection Sperm cells kept out in vagina quickly become incapable of fertilizing ovum and destroyed by surrounding cells

20. The ovaries are quiescent Nothing leaving the cervix, vulva feels dry

21. BASIC INFERTILE PATTERN (BIP) UNCHANGING PATTERN - DRY DRY - nothing is felt, nothing is seen Recorded with a plain green stamp or the symbol |

22. BASIC INFERTILE PATTERN (BIP) UNCHANGING PATTERN - DISCHARGE Discharge remains same day after day, cycle after cycle Small fragments breaking off lower part of plug results in discharge

23. Basic Infertile Pattern of mucus remains the same day after day, cycle after cycle. Initially recorded with white baby stamp or the symbol O Then recorded with yellow stamp or the symbol = when pattern is seen to be unchanging

24. Basic Infertile Pattern of mucus remains the same day after day, cycle after cycle. Three cycles are studied in order to identify correctly the point of change of sensation or appearance of the mucus or both

25. Basic infertile pattern of mucus remains the same day after day, cycle after cycle. There is no entry of sperm into the cervix because of the plug of mucus This unchanging pattern of infertility is common for many women

26. oestrogen Ovaries are active and are producing oestrogen Cervix is stimulated – fluid mucus is produced,this frees the plug, sperm can now enter cervix

27. Change in sensation – no longer dry Recorded with white baby stamp or symbol O

28. Change in vulval sensation or appearance of mucus Ovaries are active and are producing oestrogen Cervix is stimulated – fluid mucus is produced,this frees the plug, sperm can now enter cervix

29. CHANGING PATTERN OF FERTILITY Changing pattern of fertility Ovaries producing greater amounts of oestrogen Mucus progressively changing to a wet, slippery sensation Clear strings of mucus may be noticed

30. CHANGING PATTERN OF FERTILITY Maximum amount of mucus may diminish Slippery sensation may continue for a day or two Last day of slippery sensation the most fertile day of the cycle - PEAK OF FERTILITY Very close to the time of ovulation

31. THE PEAK • the last day of the slippery sensation • associated with increased sensitivity and with swelling of the vulva

32. THE PEAK oestrogen progesterone The ovary is now producing progesterone,preparing follicle to shed ovum (ovulation)

33. RECOGNISING THE PEAK Peak is recognised on the day of change No longer any lubricative sensation at the vulva Peak is marked with a cross on the record

34. Ovulation occurs on Peak day or days 1 or 2 after Peak The ovum can live for up to 24 hours

35. DAY 1 to 3 PAST PEAK Cervix gradually closes with thick plug of mucus Small channels remain through which sperm can travel

36. DAY 1 to 3 PAST PEAK The three days following the Peak are markedwith a numbered green or yellow baby stamp ora numbered symbol | or =

37. THE LUTEAL PHASE From the fourth day past Peak, cervix is closed Sperm cannot enter If not fertilized, the egg will have disintegrated

38. THE LUTEAL PHASE Plain yellow or green stamps are now used or the symbols = for discharge or | for dry

39. MENSTRUATION Occurs 11-16 days after ovulation Plug has left the cervix allowing flow of blood Start of next cycle

40. Billings Ovulation Method 4 Rules 3 Early Day Rules Peak Rule

41. Early Day Rule 1 Avoid intercourse on days of heavy bleeding during menstruation.

42. Early Day Rule 1 Reason: Ovulation might occur quite early in the cycle and menstrual bleeding could obscure mucus

43. Early Day Rule 1 Ovulation can occur as early as day 5 Menstrual bleeding would obscure beginning of fertile phase

44. Early Day Rule 2 Alternate evenings are available for intercourse when these days have been recognised as infertile. (Basic Infertile Pattern)

45. Early Day Rule 2 Reason: Seminal fluid on the day following intercourse could obscure the mucus. It is important to allow time for the seminal fluid to disappear and to confirm the BIP is still present by avoiding intercourse on consecutive evenings. If the woman is lying down the fluid mucus that leaves the cervix in the beginning of the fertile phase, collects in the upper part of the vagina. The woman needs to be in an upright position for a few hours for this cervical mucus to make its presence felt at the vulva.

46. Early Day Rule 2 Alternate evenings are available for intercourse when these days have been recognised as infertile. (Basic Infertile Pattern)

47. Early Day Rule 2 Alternate evenings are available for intercourse when these days have been recognised as infertile. (Basic Infertile Pattern)

48. Early Day Rule 3 Avoid intercourse on days of discharge or bleeding which interrupts the Basic Infertile Pattern. Allow 3 days of BIP afterwards before intercourse is resumed on the fourth evening. Rule 2 continues

49. Early Day Rule 3 Reason: Waiting will enable the woman to either recognise the Peak in which case the Peak Rule is used……………….

50. Early Day Rule 3 Waiting will enable the woman to either recognise the Peak in which case the Peak Rule is used, or ……………………