Fertility Friend Handbook

Fertility Charting For Conception

Fertility Friend Online
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 Fertility Friend Handbook

Table of Contents
Making the Most of Fertility Charting For Pregnancy Achievement............................................................1
What is Fertility Charting?......................................................................................................................1
What are Fertility Signs?.........................................................................................................................1
The Benefits of Charting Your Fertility...................................................................................................2
What can charting my fertility signs tell me?....................................................................................2

Your Hormones are Driving Your Fertility Signs...........................................................................................5

Your Menstrual Cycle and Your Hormones............................................................................................5

Your Hormones and Your Fertility Signals.....................................................................................................7

Estrogen and Your Fertility Signs...........................................................................................................7
Estrogen and Cervical Fluid..............................................................................................................7
Estrogen and Cervical Position and Texture....................................................................................8
Estrogen and Devices........................................................................................................................9
Progesterone and Your Fertility Signs.....................................................................................................9
Basal Body Temperature (BBT) and Progesterone.........................................................................10
Luteinizing Hormone (LH) and Your Fertility Signs...........................................................................11
Ovulation Prediction Kits (OPK)....................................................................................................11

How to Observe and Record Your Fertility Signs.........................................................................................13

Your Fertility Signs...............................................................................................................................13
Cervical Fluid..................................................................................................................................13
How to check for cervical fluid externally...............................................................................13
Things to notice when checking your cervical fluid.................................................................13
Checking your cervical fluid internally....................................................................................14
How to record your cervical fluid.............................................................................................14
Factors that can influence your cervical fluid pattern...............................................................15
More about Cervical Fluid........................................................................................................16
Basal Body Temperature (BBT)......................................................................................................17
How to take and record your BBT............................................................................................17
Some important guidelines to follow when taking your BBT..................................................18
Factors that can influence your BBT........................................................................................18
More about BBT.......................................................................................................................19
Changes in the Position and Firmness of your Cervix....................................................................21
Checking your Cervix...............................................................................................................22
Recording Cervical Changes....................................................................................................22
Devices and Tests for Measuring Fertility......................................................................................23
A few words about Ovulation Prediction Kits (OPKs).............................................................24
Other Possible Fertility Signs..........................................................................................................24

Fertility Chart Patterns....................................................................................................................................26

Ovulation Patterns..................................................................................................................................26
Regular (Ideal) Pattern....................................................................................................................26
Variations on the Ovulatory Chart Pattern......................................................................................27
Anovulatory Patterns.............................................................................................................................29
Pregnancy Patterns.................................................................................................................................31

1
 Fertility Friend Handbook

Table of Contents
A last word or just a starting point.................................................................................................................34

Glossary.............................................................................................................................................................35

Common Abbreviations....................................................................................................................................38

A last word or just a starting point... 2

Making the Most of Fertility Charting For Pregnancy
Achievement
What is Fertility Charting?
Fertility charting involves observing and recording your fertility signs so that you can easily see your daily
fertility status and identify your most fertile time. It is highly effective because your body provides clues, or
signs, that tell you about your fertility status throughout your cycle.

There are only a few days each cycle when conception is possible. Charting your fertility helps you to find
those days so that you can best time intercourse to get pregnant.

You may have been told that you ovulate or are most fertile on day 14 of your menstrual cycle, mid−cycle or
even 14 days before your period is expected. These are myths. While this may be the case for some women, it
may not be true for you, even if your cycles are regular. Your own fertility pattern is unique to you and
charting your fertility will help you to see it.

What are Fertility Signs?

The most important, or primary, fertility signs are your basal body temperature (BBT) and your cervical
fluid. Your basal body temperature can be measured when you wake up with an inexpensive special
thermometer that you can buy at your [Link] cervical fluid can easily be observed when you go to the
bathroom.

Your basal body temperature increases after ovulation due to increased progesterone in your bloodstream.
Your cervical fluid is the fluid that is produced by your cervix that you can see and feel in or outside your
vagina. Cervical fluid, which is sometimes called cervical mucous (CM), changes throughout your cycle
depending on your fertility status.

Taking note of these observations and recording them is enough to provide the clues you need to help time
intercourse appropriately to get pregnant and see when (and if) you ovulate. Other, secondary, optional signs
can add extra insight and help to cross−check the interpretation from your primary fertility signs.

Secondary, optional fertility signs that you may or may not choose to observe include: observations of the
position, texture and opening of your cervix, results from tests and devices, and other personal observations
that you learn to associate with your fertility.

Recording these fertility signs, you can see when you are fertile on a graph. The information can be analyzed
and interpreted and the feedback lets you see when you are approaching ovulation, when you have already
ovulated, when you should expect your period or a positive pregnancy test, along with other insights that will
help you get pregnant and learn about your unique fertility pattern.

Charting with Fertility Friend, you enter your daily observations about your fertility signs online on your
personal account on an easy−to−use data entry form. The feedback, interpretation and analysis is interactively
and automatically provided for you. The analysis will tell you the best time to have intercourse to maximize
your chances each cycle. It will show you when you are fertile, when you have ovulated, when you are no
longer fertile, when to expect your period if you are not pregnant, and when you can expect a reliable
pregnancy test result.

Making the Most of Fertility Charting For Pregnancy Achievement 1

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It can take a cycle or two to really get the hang of charting your fertility signs. Once you understand the signs,
however, it quickly becomes second nature. Indeed, many women who start to chart are amazed to discover
that their bodies have been offering these signs all along. Some are even outraged that they were not taught to
recognize these signs sooner.

Our bodies are providing a bounty of knowledge and it only takes a couple of minutes a day to tap into it.
With a little bit of awareness and support, what you gain can be tremendous.

Your fertility signs, what they mean, and how to observe and record them are discussed in great detail in the
following Handbook chapter: How to Observe and Record Your Fertility Signs.

The Benefits of Charting Your Fertility

What can charting my fertility signs tell me?

There are only a few days each menstrual cycle that you can get pregnant. Charting your fertility signs can
help you find those days so that you can maximize your intercourse timing to increase your chances of
conception each cycle. It can also help you make sense of your entire cycle. Even if you do not get pregnant in
a given cycle, what you learn from charting your fertility signs that cycle will help you increase your chances
in future cycles.

Your fertility signs are directly related to the hormonal changes your body experiences throughout your cycle.
Recognizing and understanding the role of these signs can offer you the information you need to help you
achieve pregnancy, understand your own fertility pattern, and make informed choices at every stage of your
Trying To Conceive (TTC) journey.

Charting your fertility signs offers a way to visually make sense of these signs and unravel the mystery of
your fertility. Many people are astonished at just how much they can learn by taking a few minutes a day to
observe and record their fertility signs. Many more are delighted to discover that charting their fertility signs
is all that is needed to time intercourse and achieve pregnancy. Others find that they can identify fertility
issues early and decide on a course of action early. It can be an enlightening and empowering experience.

Observing and recording your fertility signs takes just a couple of minutes a day, but allows you to see the
following:

• Determine if and when you ovulate: This is a logical first step and is probably the first thing you will
want to know if it is taking you longer than expected to conceive. While this is not the only
information you need, knowing whether or not you ovulate will help you learn if you should consider
seeking medical attention. If you do ovulate, knowing when you ovulate will help you better time
intercourse and to know if you are timing intercourse well.

• Determine the start and length of your fertile phase. Knowing when your fertile phase begins and
how long it is will help you better time intercourse and know how often and when to have intercourse
to maximize your chances of conception. This information can offer you control, guide you, and if
necessary help your doctor help you with your unique situation.
• Determine the end of your fertile phase. While the end of your fertile phase is not as critical to
pregnancy achievement as its start, it does provide clues about your cycle and lets you know when
you can stop having scheduled intercourse. It also lets you know when you enter your post−ovulatory,
or luteal phase of your cycle which also offers clues about your fertility.

The Benefits of Charting Your Fertility 2

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• Determine the length of your luteal phase. Your luteal phase is the time between ovulation and
menstruation. In most cases your luteal phase is fairly constant and does not vary much from cycle to
cycle for the same woman. Knowing the length of your luteal phase will let you know if your luteal
phase is sufficiently long to sustain a pregnancy.
• Plan and predict your cycles. While your cycles may vary slightly (or greatly) and we know that they
can vary a great deal from woman to woman, charting your fertility signs will help you predict when
you are most fertile, when ovulation is likely to occur and when your period is expected. Each cycle
charted will give you an increased awareness and better ability to predict what is likely in future
cycles. With this awareness you can improve your intercourse timing. You will have advanced
warning of the beginning of your fertile phase and will know when to expect ovulation. If you are
aware of your own typical cycle you can also know early if you conceived in a particular cycle.
• Determine the length of your cycles. Knowing your usual cycle length or the range of your cycle
length if it varies can help you know when you are most likely to be fertile, if you are likely to be
pregnant and when you can test for pregnancy on an early pregnancy test. This information is also
useful for your doctor and is something you are likely to be asked should you seek medical attention.
• Time intercourse or fertility treatments to maximize the chances of conception. Knowing your
unique fertility pattern will help you time intercourse increasingly well as you gain greater awareness
of your fertility. When you know when you are fertile and when you ovulate, intercourse timing can
be maximized for conception purposes.
• Time when to use ovulation predictor kits (OPKs). It is not necessary for everyone to use OPKs, but
if you do use them, you want to maximize their use since they are expensive and often only allow for
about 5 days of tests. Knowing when you are entering your fertile phase and knowing about your past
cycles will help you make the best possible use of OPKs.
• Bring clear, clean and accurate data to your doctor. Whether your doctor has suggested that you
chart your fertility signs, or if it becomes evident that you need to seek medical attention after you
have charted for a few cycles, your doctor will appreciate your charting efforts. Doctors are becoming
increasingly supportive of women charting their fertility and they are also becoming more
experienced at reading and interpreting fertility charts. The more data you have, the better able your
doctor will be to evaluate, analyze and make sense of your charts with you. Having several cycles
charted can help you and your doctor decide on the best course of treatment if treatment is necessary.
Having charted cycles available for your doctor in advance can also minimize your waiting. This is
especially important if age is a factor.
• Maximize the timing of fertility tests and treatments and medications. Your charted cycle data will
help your doctor offer you the best possible care by timing tests and treatments to coincide with the
most appropriate time in your cycle. Many tests and treatments are most effective when they are
well−timed and you can avoid the guesswork if you are charting your fertility signs.
• See if you timed intercourse well. Many people find the time after ovulation to be the most stressful.
They are waiting and hoping to have conceived. Once your fertile time has passed and ovulation has
been confirmed by your fertility signs, you can examine your chart to see if conception was possible
in any particular cycle. Though your chances are only about 20% in any given cycle, you will know if
you have reason to be hopeful. If you do not conceive for several cycles, in spite of well−timed
intercourse, you will know that there may be factors that require medical attention.
• Know early if conception occurred. Your chart offers clues that can tell you that you may have
conceived.
• Know when conception occurred to better estimate your due date. Once pregnancy is confirmed,
doctors typically estimate your due date based on your Last Menstrual Period (LMP). This estimation
assumes a typical cycle length and ovulation date that may not apply to you. If you know when
ovulation occurred, then you can more accurately determine your baby's due date.
• Time when to take an early pregnancy test. If you know when your period is really "late" then you
can decide when you can reliably take a pregnancy test. This can help to avoid the disappointment of
seeing negative pregnancy tests and the anxiety of ambiguous results and early false−negatives caused

The Benefits of Charting Your Fertility 3

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by testing too early.
• Gain awareness of your hormonal profile and your body. Charting your fertility signs eliminates the
mystery that may have surrounded your fertility. It is really no mystery at all when you are aware.
Each sign is tied to processes that are governed by the hormones that are running through your body.
Recognizing these signs and knowing what they mean is eye−opening and enlightening.
• Take control of your Trying to Conceive experience. Charting your fertility signs and learning what
they mean and how they are related to your fertility is something you can do to take control of your
trying to conceive experience. This is something proactive that you can do to dramatically increase
your chances of conception every cycle. You are informed and in control. There is nothing to lose by
doing it and everything to gain.

Charting your fertility signs is something that you can do to increase your chances of conception, understand
your own fertility pattern and put you in control of your trying to conceive experience. If you have decided to
chart your own fertility signs, read on for more about how they relate to your hormones and how best to
observe and record them. It is also not possible to underestimate the role of support when you are trying to
conceive. Talk to others who share your experience and ask for advice and hints from those who can offer
guidance.

The Benefits of Charting Your Fertility 4

Your Hormones are Driving Your Fertility Signs
Your Menstrual Cycle and Your Hormones
You may wonder why we are talking about your hormones and not just getting to the details of how to best
identify, chart and interpret your fertility signs. While it is possible to chart without fully understanding the
role of your hormones, understanding what triggers your fertility signs and what they mean will make the
clues more meaningful. Seeing the role that hormones play will show you how each of your fertility signs is
directly related to your hormonal changes and demystify the entire process.

Your fertility signs, whether they are those you observe yourself (your temperature, cervical fluid, cervical
position), or those measured by devices (OPKs, fertility monitors, microscopes), are related to this hormonal
process. Your hormones, while giving you clues about your fertility status via your fertility signs, are also
responsible for triggering the responses needed to prepare your body for a possible pregnancy. The diagram
below shows you how your hormone levels change in relation to your menstrual cycle.

Your menstrual cycle is driven by your hormones. Hormones are biochemical substances that are produced in
one area of your body and carried in your bloodstream to send signals that trigger responses in another part of
your body. The hormones that control your fertility signals are produced in your hypothalamus (in your
brain); your anterior pituitary gland (also in your brain, located behind and attached to the hypothalamus);
your ovaries; and your adrenal glands (located on top of your kidneys). A series of hormonal steps trigger the
events of your menstrual cycle.

1. The first thing that happens, at the beginning of your menstrual cycle, is that the hypothalamus
produces GnRH (gonadotropin−releasing hormone). The GnRH pulses through your bloodstream
from the hypothalamus to the pituitary gland in spurts every 60−90 minutes from menstruation until
ovulation. The GnRH signals the anterior pituitary gland to secrete FSH (Follicle Stimulating
Hormone) and later LH (Luteinizing Hormone). This is what is going on when you have your period
and in the days before ovulation.
2. The Follicle Stimulating Hormone (FSH) as its name suggests, stimulates the development and
maturation of follicles in the ovaries. One of these follicles will become dominant and contains the

Your Hormones are Driving Your Fertility Signs 5

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egg that will be released at ovulation. The developing follicles begin to produce estrogen.
3. The estrogen released by the developing follicles, and later by the dominant follicle, causes the lining
of the uterus, the endometrium, to grow and thicken in preparation of implantation of a fertilized egg.
4. By about the seventh day of your cycle on average (but this can vary widely) the dominant follicle
takes over. The egg within the other follicles loses its nourishment and dies as do the follicular cells.
5. The dominant follicle produces a sharp rise in estrogen. (You can recognize this stage of your cycle
by closely monitoring your cervical fluid). Estrogen is at its peak one to two days prior to ovulation.
6. This estrogen surge signals the release of LH (Luteinizing Hormone) which is what is measured by
ovulation predictor kits (OPKs). LH goes through the bloodstream to the ovary where it causes the
ovary to release enzymes that make a hole in the sac that is the dominant follicle. This causes the
dominant follicle to rupture and release the egg into the Fallopian tube where it can be fertilized. This
is ovulation. The LH surge is necessary for ovulation to occur. The LH surge (the highest
concentration of LH) occurs 12−24 hours prior to ovulation but LH begins to rise about 36 hours
before ovulation.
7. Estrogen drops dramatically after ovulation.
8. The dominant follicle, transformed by LH, becomes the corpus luteum after ovulation. This phase of
your cycle after ovulation is called the luteal phase since hormone production is governed by the
corpus luteum. The corpus luteum continues to produce some estrogen, but now also produces
progesterone which is the hormone that dominates this phase of your cycle. Progesterone, like
estrogen, is needed to develop the endometrium so that a fertilized egg can implant and be nourished
should fertilization occur. Your BBT (Basal Body Temperature) rises as a result of progesterone.
9. If an egg is fertilized, the corpus luteum's life is extended by the presence of the pregnancy hormone
(hcG) and it keeps on producing progesterone and some estrogen and the development of the
endometrium continues. As the pregnancy progresses, hormone production is taken over by the
placenta.
10. If there is no pregnancy, the corpus luteum dies, progesterone levels fall and a new cycle begins.

Your Hormones are Driving Your Fertility Signs 6

Your Hormones and Your Fertility Signals
Each of the fertility signals that you observe when you chart your fertility corresponds to a hormonal process
and the presence of hormones in your bloodstream. Estrogen and Progesterone are particularly important and
both provide signals that you can easily observe. Estrogen dominates during your pre−ovulatory or follicular
phase and progesterone takes over after ovulation, during your luteal phase and also during pregnancy should
conception occur. Your cervical fluid and cervical position provide clues about estrogen, as do saliva
micrscopes and fertility monitors, while your BBT, or Basal Body Temperature, tells you about your
progesterone. Ovulation Prediction Kits and some types of fertility monitors tell you about the presence of LH
(Luteinizing Hormone), the last hormone to peak before ovulation.

Estrogen and Your Fertility Signs

Estrogen actually refers to a group of hormones that stimulate growth and strengthen tissues. Estrogen is
needed to build up the lining of the uterus so that it may nourish and sustain the fertilized egg. When we are
talking about fertility, the kind of estrogen we are referring to is called estradial. This estrogen is produced by
the developing ovarian follicles and later, in increasing amounts, by the dominant follicle before it is released
at ovulation. The hormone estrogen has many roles:

• Estrogen signals the release of the hormone LH (Luteinizing hormone) which is needed to trigger
ovulation.
• Estrogen is needed to build up the endometrium (the lining of the uterus) so that a fertilized egg can
find nourishment and implant.
• Estrogen produces cervical fluid which is necessary for the sperm to travel to the fallopian tube where
the egg may be fertilized.
• Estrogen causes the cervix to soften and open so that the sperm may enter and reach the fallopian tube
for fertilization

Some signs of increased estrogen that you can easily observe on your own are the presence, quantity and
consistency of cervical fluid and the position and texture of your cervix. These signs offer some of the best
indicators of your fertility status. How to observe and record them so that you can best assess your fertility
and time intercourse are discussed in greater detail in a later chapter.

Estrogen and Cervical Fluid

The easiest way to know about the presence and quantity of estrogen in your bloodstream (and hence gain
clues about your fertility status) is to examine your cervical fluid throughout your cycle. Your cervical fluid
observations offer a primary fertility sign. This small observation can tell you volumes about what is going on
with your fertility.

Increased estrogen as your body prepares for ovulation causes the cervix to produce fluid which becomes
increasingly wet and slippery as you approach ovulation. The fluid slides from the cervix into the vagina
where it can be observed.

Your cervical fluid varies throughout your cycle. Its presence and quality is determined by the amount of
estrogen in your bloodstream. Most of the time, the vagina is quite acidic and is even hostile to sperm. Around
the time of ovulation, however, it becomes more alkaline and provides nourishment for the sperm and allows

Your Hormones and Your Fertility Signals 7

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them to move. At this time, the cervical fluid resembles semen, or eggwhite, and allows the sperm to thrive
for the few days around ovulation when a woman is most [Link] this kind of cervical fluid is present,
sperm can be nourished inside the cervix where they can wait for the egg to be released.

While your cervical fluid pattern may vary from cycle to cycle and it may vary from woman to woman, a
typical cervical fluid pattern looks like this:

1. Immediately following menstruation there is usually a dry vaginal sensation and there is little or no
cervical fluid.
2. After a few days of dryness, there is normally a cervical fluid that is best described as "sticky" or
"pasty", but not wet. While this kind of cervical fluid is not conducive to sperm survival these days
may be considered as "possibly fertile" if found before ovulation.
3. Following these "sticky" days, women generally notice a cervical fluid that is best described as
"creamy" and generally feels cold. It has the look and feel of lotion or cream. At this point the vagina
may feel wet and this indicates possible increased fertility.
4. The most fertile cervical fluid now follows. This most fertile fluid looks like raw eggwhite. It is
slippery and may be stretched several inches. It is usually clear and may be very watery. The vagina
feels wet and lubricated. These days are considered most fertile. This is the fluid that is the most
friendly and receptive to sperm. It looks a lot like semen and like semen, can act as a transport for
sperm.
5. After ovulation, fertile fluid dries up very quickly and the vagina remains dry until the next cycle.
Some women may notice small amounts of more fertile fluid after ovulation as the corpus luteum
produces small amounts of estrogen, but you are not at all fertile after ovulation has been confirmed.

Estrogen and Cervical Position and Texture

Your cervical position offers an optional or secondary fertility sign. Like your cervical fluid, your cervix
position also responds to the presence of estrogen. Early in your cycle, during and just after menstruation and
prior to peak fertility when your estrogen level is low, your cervix is low, hard, firm and closed and easy to
feel with your fingers. Your cervix lifts and straightens and becomes softer, higher and more open as your
fertility (and the presence of estrogen) increases. These cervical changes make the cervix more receptive to

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sperm and allow them to enter and travel into the fallopian tubes where an egg may be fertilized. After
ovulation, your cervix again becomes more closed and firm and lower. Though this fertility sign is considered
optional, checking your cervical position can provide useful information about your state of fertility. The
changes in the cervix can be used to double−check observations made through checking BBT and cervical
fluid.

Estrogen and Devices

Several devices have been developed to monitor your fertility throughout your cycle. Many of these devices,
such as saliva microscopes and some fertility monitors also measure the presence of estrogen in your body.
Saliva microscopes show increased "ferning" patterns as estrogen increases. Devices that measure hormones
in your urine will tell you that your fertility is high when high levels of estrogen are detected. These devices
have been developed to indicate your proximity to ovulation by measuring the quantity and presence of
estrogen (and in some cases other hormones as well). While they are not essential if you are able to observe
your cervical fluid pattern, they can complement your own observations. The fertility signals offered by such
devices are secondary fertility signals and can be useful to cross−check and confirm the signals from your
primary fertility signs.

Observations and devices that show increased estrogen are not able to confirm ovulation. They tell you that
ovulation is approaching and that you may be in a fertile phase. These signs are very helpful for timing
intercourse. To know that you have ovulated though, you need to also track your temperature, the sign that
indicates increased progesterone.

Progesterone and Your Fertility Signs

While estrogen dominates the first phase of your cycle, progesterone dominates your second or luteal phase of
your cycle. Before ovulation, progesterone is present only in small amounts. After ovulation, progesterone,
produced by the corpus luteum, is present in higher amounts. Progesterone plays the following roles:

• Progesterone makes the lining of your uterus soft and spongy so that a fertilized egg can latch onto it
and implant.
• Progesterone is needed to support and sustain pregnancy.

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• Progesterone causes your Basal Body Temperature (BBT) to rise after ovulation so that it is
measurable with a BBT thermometer.
• Progesterone causes your BBT to stay elevated throughout pregnancy.

Basal Body Temperature (BBT) and Progesterone

Your BBT, or basal body temperature, is your body temperature at rest as measured in the morning after at
least three hours of sleep and before you get up, with a special BBT thermometer that you can buy at your
drugstore. (When you buy it, make sure it is labeled specifically as a BBT, Basal, or Fertility thermometer).

Before ovulation, basal temperatures are relatively low. After ovulation, your basal body temperature rises
sufficiently that you can see the difference between your pre−ovulation and post−ovulation temperatures
when they are plotted on a graph. A graph that shows ovulation as detected by BBT will have a biphasic
pattern. That means it will show lower temperatures before ovulation, a rise, and then higher temperatures
after ovulation.

Ovulation usually occurs on the last day of lower temperatures.

Your BBT is your fertility sign that relates to the hormone progesterone. This is the only sign that can confirm
that ovulation actually happened, while all the other signs (except some that may be done in your doctor's
office) only tell you that ovulation may be approaching. This is also the sign that will best help you to
pinpoint the day that ovulation occurred since progesterone and hence your temperature increase quite
dramatically just after ovulation has taken place.

Before ovulation, there is only a small amount of progesterone present in your body and your basal body
temperatures (your resting temperatures) are in the lower range. After ovulation, when there is increased
progesterone secreted from the corpus luteum, temperatures become elevated. The temperature elevation that
occurs after ovulation is sufficient to be measured with a BBT thermometer and viewed on a BBT graph when

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a few simple conditions are met (how−to observe your signs is discussed later).

The rise in temperature is usually about 0.4 degrees Fahrenheit or 0.2 degrees Celsius, but the rise may be as
slight as 0.2 degrees Fahrenheit or 0.1 degrees Celsius or even less in some cases. The actual temperatures are
less important than noting a biphasic pattern showing two levels of temperatures.

If there is no pregnancy, then your temperature will stay elevated for 10−16 days, until the corpus luteum
regresses. At this time, progesterone levels drop dramatically and you get your period. Your temperature
normally drops at this time as well, though it is not unusual to have erratic or high temperatures during your
period.

While measuring your BBT can help to pinpoint or confirm ovulation, it is important to observe this sign in
conjuction with other signs as well, particularly your cervical fluid. Observing multiple signs allows for
cross−checking in the case that one sign is ambiguous or affected by other factors.

Luteinizing Hormone (LH) and Your Fertility Signs

Ovulation Prediction Kits (OPK)

Luteinizing hormone (LH) is the last hormone to peak before ovulation and is the hormone responsible for
triggering the rupture of the ovarian sac that releases the egg for ovulation. This hormone can be measured by
ovulation prediction kits (OPKs) that use chemicals to identify its presence in your urine.

The presence of increased amounts of LH in your urine, as detected by OPKs, usually means that you will
ovulate within 12−24 hours but this can vary slightly depending on your own hormonal profile. LH is not
released all at once, but rather it rises and falls for about 24−48 hours. The LH rise usually begins in the early
morning while you are sleeping and it takes 4−6 hours for it to appear in your urine after that. For this reason,
first morning urine may not give the best result. Testing mid−day is usually recommended. It is important to
follow the instructions of your OPK for maximum results.

Luteinizing hormone is the last hormone to peak before ovulation. For this reason, many women like
ovulation prediction kits, though they are not able to confirm or pinpoint ovulation precisely. Because you
may already be fertile before your OPK turns positive, it is important not to rely exclusively on OPKs for
timing intercourse and identifying your most fertile time. You may like to use them, however, to cross−check
your other fertility signs and to offer additional clues about impending ovulation. They may be especially
useful if you have ambiguous charts, irregular cycles or multiple patches of fertile cervical fluid before
ovulation.

Luteinizing Hormone (LH) and Your Fertility Signs 11

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You now know the role the hormones play in governing the events of your fertility cycle. When you observe
your fertility signs, you will have a greater awareness of what they mean to your fertility status. Read on to
learn how to best observe and record your fertility signs.

Luteinizing Hormone (LH) and Your Fertility Signs 12

How to Observe and Record Your Fertility Signs

Your Fertility Signs

Your primary fertility signs are your cervical fluid and your basal body temperature (BBT). These are the ones
that are essential to check when you are charting your fertility. Other fertility signs that can also shed light on
your fertility status and your fertility pattern are cervical position, ovulation predictor kits (OPKs), ferning
devices and fertility monitors. These are considered secondary fertility signs and are useful for
cross−checking your primary fertility signs, though they are not usually essential. Other personal observations
of your own body that you may come to notice over a few cycles can also offer added insight.

Cervical Fluid

Cervical fluid is produced by your cervix as you approach ovulation due to increased estrogen. It flows from
the cervix into the vagina where it can easily be observed. Your cervical fluid changes throughout your cycle,
increasing in quantity and becoming more clear and stretchy as you get closer to ovulation. Noticing and
recording these changes will help you better time intercourse and recognize your own fertility pattern.

In the most common pattern, cervical fluid starts out dry after your period and then gets sticky, then creamy,
then wet and watery, becoming most like eggwhite as you get closer to ovulation. You may get different types
of cervical fluid on the same day. Always record your most fertile cervical fluid to make sure that you do not
miss a potentially fertile day.

How to check for cervical fluid externally

Avoid checking your cervical fluid just before or after intercourse as arousal and seminal fluids will skew
your observations. The best way to check your cervical fluid is to make observations when you go to the
bathroom. After you wipe, you can wipe outside your vagina a second time and note what, if anything, you
find on the bathroom tissue. This will soon become second nature and you will find yourself noticing your
cervical fluid every time you go to the [Link] can also use your clean fingers to check and you may
also notice some cervical fluid in your underwear.

Things to notice when checking your cervical fluid

• Does the vagina feel wet or dry?

• Is there any fluid on the tissue?
• How does it look?
• What color is it?
• What consistency is it?
• How much is there?
• How does it feel when you touch it?
• Can you stretch it between your thumb and index finger?

If you are having trouble finding cervical fluid, doing kegel exercises (tensing and relaxing the muscles that

How to Observe and Record Your Fertility Signs 13

 Fertility Friend Handbook
control the flow of urine) helps to push cervical fluid to the vaginal opening and makes observation easier.
(Avoid doing kegels immediately after intercourse though as this could push the semen and therefore the
sperm away from the cervix, which is exactly where you want them to be). Exercise and bowel movements
also push cervical fluid to the vaginal opening making observation easier. You may find that the best time to
check your cervical fluid is after a bowel movement. If you are still having trouble finding cervical fluid, you
may consider checking it internally. This can be helpful if you have decreased estrogen as caused by
breastfeeding or perimenopause or if cervical fluid seems scant. If you are easily able to check your cervical
fluid externally, it is best to do it that way consistently and not check internally at all. As with all aspects of
charting, consistency is key.

Checking your cervical fluid internally

If you check your cervical fluid by internal observation, only the method for gathering the fluid is different.
Otherwise, follow the same steps and observations as for external observation. To collect cervical fluid
internally follow these steps:

1. Insert two fingers in your vagina until you can feel your cervix.
2. One finger should be on each side of the cervix.
3. Press gently against your cervix.
4. Collect the fluid by moving your fingers to the opening of the cervix.
5. Remove your fingers and pull them apart slowly.
6. Make your observations as outlined for external fluid observation.

How to record your cervical fluid

No matter how you observe your cervical fluid (with your hands, toilet tissue, or in your underwear, or
internally if necessary) the way to record it will be the same. Always record your most fertile type of cervical
fluid, even if you noticed more than one type of cervical fluid in a given day or even if it is scant. This is so
you will not miss a potentially fertile day and so that you have a consistent way of keeping track of your
cervical fluid from cycle to cycle.

Below are the types of cervical fluid to record in Fertility Friend. Not everyone experiences every type of
cervical fluid. Just record the types you do get. You may also have some cervical fluid that does not seem to
"fit" perfectly into any category. In this case, record it in the most fertile category that best seems to fit. For
example, if you notice in a day that you have cervical fluid that seems to fit somewhere in between creamy
and eggwhite, record it as eggwhite. Likewise, if you get both creamy and eggwhite fluid in the same day,
record eggwhite on your chart.

• Dry: Record your cervical fluid as "dry" if you have no cervical fluid present at all; if you notice no
cervical fluid in your underwear; and if the outside of your vagina feels dry. You can expect to see dry
days both before ovulation after your period and after ovulation. Record "dry" if you are not able to
gather or see any cervical fluid, even if your vagina feels slightly moist inside.
• Sticky: Record your cervical fluid as "sticky" if it is glue−like, gummy, stiff or crumbly and if it
breaks easily and quickly and if it is not easily stretched. It will probably be yellowish or white, but
could also be cloudy/clear. You may or may not see some sticky cervical fluid before and after
ovulation.

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 Fertility Friend Handbook
• Creamy: Record your cervical fluid as "creamy" if it is like hand lotion, white or yellow or
cloudy/clear, like milk or cream, mayonnaise or like a flour/water solution. It may stretch slightly but
not very much and break easily.
• Watery: Enter "watery" if your cervical fluid is clear and most resembles water. It may be stretchy
also. This cervical fluid is considered fertile and this may be your most fertile cervical fluid or you
may get it before you get eggwhite cervical fluid or you may not get this type of fluid at all.
• Eggwhite: This is your most fertile cervical fluid. Record "eggwhite" if your cervical fluid looks at all
like real eggwhite, is stretchy and clear, or clear tinged with white, or even clear tinged with pink. It
also resembles semen (and has a lot of the same physical properties to allow the sperm to travel and
be nourished). You should be able to stretch it between your thumb and index finger.
• Spotting: Record "spotting" when you have any pink or dark red/brown spots that leave a small mark
on your underwear or pantyliner or that you only see when you wipe. If it does not require a pad or
tampon, record it as spotting rather than menses. You may see spotting before or after your period,
around the time of ovulation or around the time of implantation if you conceive. Do not start a new
chart until you have red flow.
• Menses: When you record "menses" you can choose light, normal and heavy. Always start a new
chart on your first day of menses. That is the first day that you have red blood flow that requires a pad
or tampon. This is cycle day one. Fertility Friend will automatically start a new chart for you when
you enter menses.

Note: To see the abbreviations that represent each cervical fluid entry in Fertility Friend, see the chart legend
beside your chart graph.

Factors that can influence your cervical fluid pattern

Certain factors may influence the quality and quantity of cervical fluid that you produce and could thus impact
the interpretation of your chart. Some factors may be a result of hormonal factors, while others may be related
to lifestyle or medications. If any of these applies to your case, make sure to record it in the notes section of
the data entry field in Fertility Friend so that you can recognize why a particular entry may seem unusual or
different. You also have the option of displaying those days on your chart with a special square (rather than a
circle) so that you can see with a quick glance those days where special circumstances may apply. (See the
setting section).

In most cases the effects are not great enough to seriously hamper your charting efforts or skew the analysis
enough to dramatically alter your results. Nonetheless, the following factors may impact cervical fluid
patterns and should be noted when possible:

• medications such as antihistamines and diuretics

• fertility medications, such as clomid (ask your doctor)
• tranquilizers
• antibiotics
• expectorants (ask your doctor before using an expectorant to increase cervical fluid)
• herbs (ask your doctor before taking herbs while trying to conceive)
• vitamins
• vaginal infection or sexually transmitted disease (ask your doctor if you think this is a possibility)
• illness
• delayed ovulation (can cause multiple cervical fluid patches)
• douching (not recommended unless advised by your doctor)
• being overweight (can cause increased cervical fluid)
• arousal fluid (can be mistaken for eggwhite cervical fluid)

Factors that can influence your cervical fluid pattern 15

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• semen residue (can be mistaken for eggwhite cervical fluid)
• lubricants (not recommended when trying to conceive as they can be hostile to sperm)
• breastfeeding
• decreased ovarian function
• just stopping birth control pills

If you notice anything that concerns you about your cervical fluid (like if it is smelly or is causing you
discomfort or itchiness or if you are bleeding or spotting when you do not expect to), call your doctor.

More about Cervical Fluid

Intercourse Timing and Cervical Fluid:

Your cervical fluid is probably your best sign to indicate when to start having baby making intercourse since it
offers a sign that ovulation is approaching. Your chances of conception are best when you have intercourse
just before ovulation. You should begin to have intercourse every other day or every 36 hours from the time
you first observe fertile cervical fluid or even before if you do not get fertile cervical fluid for at least a few
days before ovulation. If you know or suspect you know the day you will ovulate based on past BBT charts,
Fertility Friend's analysis or from an ovulation predictor kit, change your intercourse pattern to every day
from the day before ovulation until ovulation is confirmed by a few sustained elevated temperatures. Ideally,
you want to have healthy sperm waiting in fertile cervical fluid when your egg is released. The best thing to
do is to look at the Fertility Analyzer in Fertility Friend which will take into account all of your fertility signs
from both your current and past cycles if applicable.

Multiple Eggwhite Cervical Fluid Patches:

Several patches of eggwhite fluid with no clear thermal shift probably means that you are having an
anovulatory cycle. You can have fertile−like cervical fluid and still not ovulate. If you have several cycles that
show this pattern, you should ask your doctor to look at why you might not be ovulating. If you have several
patches of eggwhite cervical fluid and a temperature rise, then your ovulation was probably delayed due to
some external reason. One of the factors that can affect cervical fluid (mentioned above) may apply. In any
case, you should still have intercourse every other day when you see eggwhite cervical fluid to make sure not
to miss an opportunity.

No Eggwhite Cervical Fluid:

If you do not see any fertile looking cervical fluid, the first thing to do is to make sure about how you are
checking your cervical fluid, especially if you are new to charting. See the guidelines above. If you are sure
you are checking your cervical fluid properly, the next thing you want to do is check if you are ovulating by
seeing if your temperatures show a clear thermal shift. A lack of cervical fluid along with no temperature rise,
or with erratic temperatures may indicate that you are not ovulating. If you are not ovulating for a few cycles,
you need to talk to your doctor. If you are ovulating, then cervical fluid production may be affected by one of
the factors mentioned above. You may want to check your cervical fluid internally at your cervix. You will
also want to find out what your own most fertile cervical fluid looks like and treat this as eggwhite fluid. It is
important that you have intercourse as close to ovulation as possible as your partner's sperm may not be able

More about Cervical Fluid 16

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to thrive while waiting for the egg to be released.

Fertile Cervical Fluid after Ovulation:

Some cervical fluid after ovulation is possible because the corpus luteum, though its main function is to
produce progesterone, produces estrogen in small amounts and this may cause you to see some cervical fluid.
If your chart does not show clearly that you already ovulated, do not stop having intercourse. If your
temperatures show clearly that you ovulated, then you are likely no longer fertile. It is also not uncommon to
confuse semen and eggwhite or watery cervical fluid.

Cervical Fluid and Semen:

If you find that you have more watery or eggwhite days than you would expect and that these often follow
days or nights that you had intercourse, then you may be mistaking seminal and cervical fluid. They are quite
similar but you will find that fertile cervical fluid (eggwhite) is clear and stretchy and shiny. It will stretch a
couple of inches without breaking. Semen may be more whitish and will break when pulled. If you are in
doubt and it is near your fertile time, always record eggwhite cervical fluid, even if it may be obscured by
seminal fluid so that you do not miss a potentially fertile time and so that Fertility Friend will give you its
most accurate analysis.

Basal Body Temperature (BBT)

Your BBT, your body temperature at rest, is a critical fertility sign because it is the only sign that will tell you
definitively that you ovulated. It also is the only sign that will let you pinpoint (to as close a degree as
possible) when ovulation occurred. All your other signs tell you only that ovulation is approaching. Charting
your BBT will also tell you how long your luteal phase is so you will know when to test for pregnancy, when
you may be pregnant and also if it is sufficiently long to allow for a pregnancy to occur. It is best to use your
cervical fluid and other signs in conjunction with charting your BBT to get the most out of charting and to get
the most out of Fertility Friend's analysis tools. The cervical fluid data along with your BBT data can offer
you amazing insight into your fertility pattern.

After ovulation, the corpus luteum (the remains of the follicle that released an egg at ovulation) produces
progesterone. Progesterone causes an increase in your body temperature that is observable when you measure
your BBT with a special BBT thermometer just upon waking in the morning.

How to take and record your BBT

It is important to use a special Basal Body Temperature thermometer rather than a fever thermometer. Both
digital and mercury thermometers will be effective, however, we recommend using a digital BBT
thermometer. A digital BBT thermometer will give a quicker reading, will beep when it is finished recording
the temperature, and is easier to read. This can make a difference when you are bleary−eyed first thing in the
morning. Both will store your reading, though it is best to enter your temperature in Fertility Friend or record
it on your bedside notepad as soon as possible. It is best if you can establish a routine where you enter your
data at the same time every day just to establish the habit so you will not forget. Missing data, especially
temperature data can skew the interpretation of your chart. Make sure you are using a BBT thermometer. A
fever thermometer or an ear thermometer will not be effective. You can find a BBT thermometer at most
pharmacies. Fertility Friend accepts readings in both Fahrenheit and Celsius.

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Some important guidelines to follow when taking your BBT

Your temperature data will be most reliable if you follow these guidelines. Not following these guidelines
may make your chart difficult to read and may make detecting ovulation more difficult as well. It is essential
that you use a special BBT thermometer and that you take your temperature in the morning right after waking.
Please note that these are ideal guidelines. We recognize that the realities of your life may make meeting these
ideals difficult or impossible at times. Fertility Friend is able to detect ovulation and make its analysis even
under less than ideal conditions. The closer you can get to the ideal, the more accurate and reliable your
ovulation detection, analysis and interpretation will be.

• Take your temperature before rising in the morning as any activity can raise your BBT.
• If you use a mercury thermometer, shake it down the previous night. (Or ask your partner to do it)
• Take your temperature at the same time every morning.
• Take your temperature after at least 3 consecutive hours of sleep.
• Keep your thermometer accessible from your bed so you do not have to get up to get it.
• Use the same thermometer throughout your cycle if possible. If it breaks or the battery dies and you
use a new one, make a note of it on your charts.
• Keep a spare thermometer in case one breaks (especially if you are using a glass thermometer).
• Temperatures can be taken orally or vaginally but must be taken in the same place throughout the
cycle since the temperatures of the different parts may vary. Most women prefer to take their
temperatures orally and this is usually fine, though some women find that they get a clearer reading
by temping vaginally.
• Record your temperature soon after you take it (or ask your partner to) since most thermometers only
store a reading until the next use. If you have to do something else or want to stay in bed, you can
record it later, but we recommend recording it right away when possible to avoid forgetting. Fertility
Friend includes a printable bedside notepad in case you are not able to log in right away.
• If you must use a heating pad or electric blanket, keep it at the same setting throughout your cycle.
Make a note of its use.
• Take your temperature before doing anything else including eating, drinking or going to the
bathroom. If circumstances arise that prevent you from taking your temperature right away, take it as
soon as you are able and make a note of the circumstances.
• If you have special circumstances on a temporary or an ongoing basis and you are unable to follow all
of the above guidelines, keep temping anyway following the guidelines as closely as possible. Make a
note of your special circumstances in the notes section of your chart and/or in your charting profile
and Fertility Friend and our team will do our best to interpret your chart. There is still a good chance
that you will be able to chart and see your fertility pattern.
• Enter your temperature and always record the time you took it in the data entry page on Fertility
Friend. The time you took your temperature is also important for the analysis.

Factors that can influence your BBT

As with your cervical fluid, there are certain factors that can influence your basal body temperature. These
should be noted in the notes section of Fertility Friend. Again, as with the factors that influence cervical fluid,
these factors will usually not make charting and chart analysis impossible, especially if they occur only rarely,
though it may be more challenging. In most cases, even when these factors apply on an ongoing basis, they
will not skew your data so much that reading the chart is impossible. It is important to make a note of the
factors, however to help with the interpretation of the chart. The following factors may influence your BBT:

Some important guidelines to follow when taking your BBT 18

 Fertility Friend Handbook
• fever
• illness and infections (even those that do not produce a fever)
• cold, sore throat
• drugs and medications
• alcohol (especially in large quantities, though all alcohol consumption should be recorded)
• smoking (if you smoke, you should consider quitting before you are even pregnant)
• emotional stress
• physical stress
• excitement
• sleep disturbances (insomnia, night−waking, upsetting dreams, poor sleep)
• change in waking time
• jet lag
• travel
• change of climate
• use of electric blanket
• change of room temperature
• discontinuing birth control pills
• breastfeeding

We recommend entering your temperature data as early as you can in the morning before you get caught up in
the routine of your day. It is much easier to remember when it is a habit and your thermometer will likely only
store your reading for one day. If you are unable to log into Fertility Friend right away, record your
observations on paper until you are able to log in. A printable bed side notepad is provided for this purpose. If
you have questions about your BBT pattern or are wondering about your specific circumstances, you can
write to the Fertility Friend Team at any time for advice, encouragement or an evaluation of your chart.

More about BBT

Different Waking Times

One or two temperatures taken at different times during your cycle should not have too much impact on your
chart especially if they are not close to ovulation time. Normally there is no need to adjust your temperature.
If you want to use the temperature adjuster once or twice when it is not too close to ovulation, that should not
pose a significant problem. More than a couple of temperatures taken at different times, however, can
adversely effect the interpretation of your chart. You should try to avoid using the temperature adjuster if
possible since adjusted temperatures are not nearly as accurate as those you record daily at the same time. You
may find it useful to set an alarm so that you can take your temperature at the same time every day. You can
just take your temperature and go right back to sleep if you do not have to get up right away. If your partner
gets up at the same time every day, you can ask to be briefly woken up so you can take your temperature.
Your BBT thermometer will store the reading for you until you can record it.

Night Waking

If you have to get up in the night and it is unavoidable, like having to take care of a small child, or if you have
to go to the bathroom, just do the best you can. Take your temperature as close as you can to the same time
each morning and choose a time that is likely to be when you have had the most sleep. For example, if your

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toddler wakes up every morning at 6 am, then take your temperature at that time, even if you go back to sleep.
Try to avoid taking your temperature in the middle of the night, though, even if you seem to always get up at
the same time in the middle of the night. Temperatures taken in the morning show a clearer biphasic curve and
the time is more predictable.

Multiple Temperature Readings

Taking your temperature more than once can cause unnecessary confusion. We really recommend that you
only take your temperature once and go with that one. If you wake up in the middle of the night or earlier than
your usual wake up time and you know you are going back to sleep, resist the urge to take your temperature.
If you do take your temperature twice (or more) then choose the temperature that was taken closest to the time
you usually take it. The only good reason for taking your temperature more than once is if you wake up early
and you do not know if you will be able to get back to sleep. If you did not go back to sleep, choose the
temperature right after you woke up. If you have two temperatures taken before and after your regular wake
up time and you slept before both of them, then you can use the temperature adjuster to give you an adjusted
temperature. Try to avoid this though, as relying too heavily on it can adversely effect the interpretation of
your chart.

Shift Work

It is not impossible to take your BBT if you work shifts, but it will be more challenging. Take your
temperature at the time you wake up when you are most likely to have had the most sleep. Be as consistent as
you can. On your days off, take your temperature after you wake up as well, even if it is at a different time.
Make a note on your chart of changes in your waking schedule. You may take your temperature in the
afternoon before you go to work if that is your usual waking time and the time after which you are most likely
to have had the most sleep. It is not useful to take your temperature when you are already awake and active.

Travel

If you travel within your own time zone, just keep on taking your temperature at the same time. You may
notice a slight fluctuation if the climate is warmer/colder but this should not have a huge impact on your chart.
Make a note in the notes section that you were traveling so you can explain unusual temperature patterns. If
you are traveling to a different time zone, the disturbance is usually only limited to the day of travel and the
day after. Keep taking your temperature as before, using the same time in the local time. We recommend not
adjusting any temperatures, but again, make a note of the circumstances. Unless you are traveling right around
the time of ovulation, you should still be able to discern your pattern. When BBT is less reliable because of
such a special circumstance, pay extra close attention to your other fertility signs to avoid missing a potential
fertile opportunity.

Daylight Saving Time

The effect of Daylight Saving Time (DST) on your temperature is usually limited to the day of the change
because you adjust quite quickly. In addition, the exact effect depends strongly on your own metabolism.
Some people will see no effect at all while others will see a slight change (increase or decrease). Because in
general having one temperature slightly off will not change your chart interpretation, Fertility Friend's
recommendation is to record your temperature as usual without correcting it in any manner. We recommend
that you keep taking the temp at the same time. If you took it at 6 in the morning before the change, then take

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it at 6 in the morning after the change.

Erratic Temperatures

If your temperatures are erratic, the first thing you should do is review the guidelines about taking your BBT
and make sure you are using a special basal body temperature thermometer. If you are following the
guidelines (taking your temperature at the same time each morning, before getting up and using a BBT
thermometer) and still have erratic temperatures, the first thing to do is review your data to see what could be
disturbing the temperature. You may also consider changing your thermometer or replacing the battery in your
thermometer to see if this helps. You may also want to talk to a Fertility Friend guide to get her opinion about
what could be causing the erratic temperatures. If you have several cycles that are erratic and you are taking
and recording your BBT properly, and you are unable to see an ovulation pattern, you should talk to your
healthcare provider.

"Flat" Temperatures

If your temperatures seem to be around the same level all the time, the culprit is usually your thermometer.
Even when you are taking your temperature at the same time, following all the guidelines, there is usually
some fluctuation in temperatures. Your first step is to check your thermometer's battery or get a new
thermometer. If your temperatures are still flat, and/or show no sign of a biphasic (ovulatory) pattern when
you would expect them to, this is something to ask your doctor about if it happens for a few cycles.

Timing Intercourse using BBT

By the time you see a rise in temperature, you have probably already ovulated and it may be too late to time
intercourse for conception purposes. You should still have intercourse though until ovulation is confirmed by
a sustained rise in temperatures. You can predict ovulation, however, based on when you ovulated in previous
cycles as pinpointed with your BBT and other fertility signs. The best thing to do is to follow the Fertility
Analyzer in Fertility Friend which takes into account all signs and previous cycles as well.

You now have enough information to begin charting your fertility signs and let Fertility Friend do its analysis.
If you choose to record and observe secondary fertility signs, read the rest of this section for a brief how−to.

Changes in the Position and Firmness of your Cervix

Your cervical position is an optional, secondary fertility sign.

It may take a few cycles to notice the changes your cervix experiences throughout your fertility cycle. It is a
good idea to check when you know you are fertile as indicated by your cervical fluid and then again when you
know you are not fertile (as indicated by your thermal shift in your luteal phase) when you are getting started.
With this correlation, you will feel more easily the differences between your fertile and non−fertile times.

When you are approaching ovulation, your cervix will be high and soft (and you may notice that it feels more
open also). When you are no longer fertile, your cervix will feel lower, more firm and you may notice that it is
more closed. If you are not comfortable checking your cervix or you find the changes difficult to observe, and
you are able to observe your cervical fluid easily, checking your cervix is not absolutely essential. If you are
comfortable checking your cervix and are able to identify changes, you will benefit from the additional

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information that will help cross−check your other signs.

Checking your Cervix

If you choose to check your cervical position as an indicator of fertility here are some guidelines:

• To avoid the possibility of infection, always check the cervix with clean hands.
• Check the cervix once a day after menses. You only need to check once a day, unlike cervical fluid
which you may check several times a day.
• Check your cervix at the same time every day as it may change throughout the day.
• Use the same position for checking your cervix throughout the cycle as changing positions will
change your observation of cervical height.
• Squatting or placing one foot on a stool (or toilet seat) are good positions.
• Relax. (You will be able to more easily relax as you gain more experience).
• Insert one or two fingers into the vagina. At the back of the vagina, you should be able to feel your
cervix. If you feel something at the back of your vagina that stops your fingers, then you have found
your cervix. If you apply gentle pressure you will notice that it feels smooth, round and firmer that the
surrounding vaginal tissues.
• Feel your cervix and make the following observations:
♦ Is the cervix high or low? (it is more difficult to reach it is high)
♦ Does the cervix feel soft or firm?
♦ Does the cervix feel open or closed? (Women who have already had children may notice that
the cervix always feels slightly open).
♦ Does the cervix feel wet or dry?
♦ Do you feel any bumps on your cervix? (If you feel bumps that do not seem to be related to
your fertility pattern, talk to your doctor right away)
• Record observations.

Recording Cervical Changes

Fertility Friend offers three fields on the data entry page that relate to cervical position. You can record the
position, firmness, and openness of your cervix.

• Position: Your cervical position may be: low, medium or high. Your cervix heightens and becomes
harder to reach as you approach your most fertile time. The important thing is to notice how it
changes throughout your cycle in relation to your fertility. Observations can be subjective so you need
to notice your own unique changes. There are really no rules to apply as you have to notice the
changes relatively as they change. This may take a few cycles to really notice.
♦ Low: Record "low" for your least fertile cervical position. This is the position where it is
easiest to feel and reach your cervix.
♦ Medium: Record "medium" for the position between your lowest and highest.
♦ High: Record "high" when your cervix is hardest to reach. You may not even be able to reach
it. You will notice that it feels more wet, soft and open at this time as well. This is your most
fertile cervical position.
• Firmness: Again, the issue is to notice the changes in the texture of your cervix relatively throughout
your cycle as it changes. Like your cervical position, it may take a few cycles to notice your own

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pattern. To get an idea of what you are looking for, check when you know you are fertile (when you
have eggwhite cervical fluid) and when you are sure you are not (after ovulation has been confirmed
by 3 high temperatures) so that you know what you are looking for. At your least fertile time, both
before and after ovulation, your cervix will feel the most hard and firm, a bit like the tip of your nose.
As you approach ovulation, your cervix will soften, feeling more like your lips. You can record the
firmness of your cervix as Firm, Medium, or Soft.
♦ Firm: Record "firm" as the most hard and firm texture you experience throughout your cycle.
Your cervix will likely also be low and quite easy to reach at this time.
♦ Medium: Record "medium" when your cervix feels between your most firm and most soft.
You may feel this just before you approach your more fertile time before ovulation and after
ovulation as well.
♦ Soft: Record "soft" when your cervix feels the most soft. It will probably feel quite wet and
high at this time as well and you may even notice that it also feels open. It may be hard to
reach. This is your most fertile cervical texture.
• Openness: Not everyone is able to observe this sign, but you may also notice that your cervix feels
more open when you are most fertile. If you are not able to observe this sign (many people are not),
simply do not use it. The firmness and position of your cervix should provide enough additional
insight into the changes in your cervix to allow you to cross−check your other signs if this is the case.
This observation can also be quite subjective because women who have already given birth may
notice that their cervix always feels slightly open. Women who have never given birth, may not notice
the change at all or may notice that the cervix only opens slightly at their most fertile time. Like your
other cervix signs, you should record how your cervix changes relatively throughout your cycle. If
you are certain that you can notice the change in the openness of your cervix you should record the
following:
♦ Closed: Record closed when your cervix feels at its most closed, least open position.
♦ Medium: Record medium when your cervix is slightly open.
♦ Open: Record open when your cervix feels at its most open position.

Devices and Tests for Measuring Fertility

There are an increasing number of products on the market designed to indicate possible fertility. They rely on
changes in hormones that can be detected in your urine or saliva. When using these kits and devices, the most
important thing is to follow the manufacturer's instructions as closely as possible. Questions that relate
specifically to a certain product are best answered by that manufacturer and most products have 1−800
numbers on the package to allow you to ask questions.

These kits and devices can give additional, secondary clues about your fertility status that can complement the
observations you make from your primary fertility signs. You may find them especially useful if you have
irregular cycles, occasional anovulatory cycles, or if you find that you are not able to get clear readings from
your cervical fluid and BBT signs. In most cases such devices are not essential, especially if you are easily
able to recognize the changes in your cervical fluid, but you may find you like to have the added information
for cross−checking.

No device or kit that you can do at home can pinpoint ovulation as well as your temperature data since only a
thermal shift shows increased progesterone which is the hormone you release after ovulation. They can be
quite useful though for timing intercourse and showing you when you have increased fertility.

Devices and Tests for Measuring Fertility 23

 Fertility Friend Handbook

Fertility Friend's analysis supports (but in no way requires) the use of OPKs, the Clearplan Fertility Monitor
and Saliva Microscopes. If the data is entered, the analysis will make use of the data. For the Clearplan
Fertility Monitor you may record Low, High or Peak. For saliva microscopes, you can record No Ferning,
Partial Ferning or Full Ferning. For OPKs, you can record positive or negative.

A few words about Ovulation Prediction Kits (OPKs)

Ovulation Prediction Kits have become quite popular and can be quite useful to help you find your fertile
time. OPKs work by measuring the presence of Luteinizing Hormone (LH) in your urine. A surge of LH
which is sent to your ovary causes your ovary to produce enzymes which in turn causes the dominant follicle
to rupture and release the egg into the Fallopian tube. This is ovulation and it is expected to occur within 24
hours of the surge of LH. An OPK is thus expected to be positive the day before you ovulate. Following a few
guidelines can help you get the most out of your OPK.

• Like any product, follow the manufacturer's instructions carefully.

• If you do not test every day from before you expect to be most fertile, you may miss the surge.
Likewise, if you test too late, you may miss the surge. Also, it may not be possible to tell if you are
about to ovulate or if you just ovulated since you will have increased LH in both cases. Usually,
though, the positive OPK means that you are about to ovulate.
• Testing daily once you have started to test is the best strategy since your first positive OPK result
probably means that you are about to ovulate and your last positive OPK, if you get more than one,
may mean that you just ovulated. Since OPK packages include only a limited number of test strips,
timing when to start testing is crucial.
• If you use OPKs, use the Fertility Friend OPK optimizer to help you choose when to start testing to
make sure you do not waste tests and so that you can get optimal results. Based on your average cycle
length and previous cycles entered in Fertility Friend, if applicable, the OPK optimizer can tell you
when to begin testing so that you will not miss your opportunity but you will not waste tests either.
• Follow the manufacturer's instructions about the time to take your OPK. First morning urine is usually
not the best for OPKs since your LH surge usually begins in early morning when you are still sleeping
and may not be apparent in your first morning urine. If you test in the early morning, you may miss
your surge entirely since LH levels may already be reduced by the next morning. Late morning or
early afternoon is usually best unless the instructions suggest otherwise.
• Record your OPK results as positive in the data entry page of Fertility Friend if the test line is as dark
as or darker than the control line. Record your results as negative if the test line is lighter than the
control line.
• Do not rely exclusively on OPK results to time intercourse as you may not see an LH surge (positive
OPK) even though you may be fertile. Your increased fertility begins before you see a positive OPK
result since sperm can live in the reproductive tract for a few days in fertile cervical fluid. Keep
having intercourse every other day before you see a positive OPK result, but switch to every day once
you see a positive result until ovulation has been confirmed by your temperature data. The Fertility
Analyzer in Fertility Friend will help you with your timing.

Other Possible Fertility Signs

Some women notice other changes that may offer another indication of increasing fertility. You may or may
not notice some of these signs. Not noticing these signs does not in any way indicate a lack of fertility. You
may also have signs of your own that you notice throughout your cycle and from cycle to cycle that are not

A few words about Ovulation Prediction Kits (OPKs) 24

 Fertility Friend Handbook
mentioned here. If this is the case you may find it useful to record these observations in your notes section.
Because these signs are not consistent, may vary from woman to woman and even from cycle to cycle for the
same woman, they are not included as fertility signs. Rather, you can check them on the checklist in the
special notes section or record them in your own notes. You can also set up your "custom signs" (see data
entry page) to include them on your chart.

Some other possible fertility signs are:

• Ovulation Pain: Also known as mittelschmertz, which means "middle pain" it refers to a slight pain
that you may feel near your abdomen or ovary at the time of ovulation. It does not necessarily occur at
the exact time of ovulation and not everyone feels ovulation. As such, ovulation pain is useful to
cross−check other signs, but cannot be used to definitively confirm or pinpoint ovulation. Also, it is
very difficult to know if the pain you feel in your abdomen mid−cycle is related in any way to
ovulation or your fertility. Other pains are often mistaken for ovulation pain. It is still useful to record,
even if you are unsure if it is related to your fertility. As you become more in tune with your fertility
signs, it will become easier to recognize ovulation pain if you experience it. Women who have never
noticed ovulation pain often begin to notice it when they begin to chart their fertility signs.
• Increased Sex Drive: You may notice that your sex drive is cyclical (You may also notice that it is
not and that may be normal for you). Your sex drive may be highest at around the time before and at
ovulation. Another pattern might also be normal for you. If you notice that there is a pattern to your
sex drive, it can be helpful to record your observations to make predictions about your fertility.
• Ovulation spotting: Some women see slight spotting at the time of ovulation. This is quite rare, but
you may see that your cervical fluid is streaked with blood or has a pink tinge. If you do notice this
and it is accompanied by fertile cervical fluid (eggwhite or watery) enter the cervical fluid as
eggwhite or watery but make a note about the spotting in your notes section. If it is heavy or lasts
longer than a day, you should ask your doctor about it.
• Tender Breasts: While your experience may be different, you may notice a pattern to the sensitivity
of your breasts. They may feel more sensitive at around the time of ovulation and they may continue
to feel sensitive throughout your luteal phase. Again, if you notice that there is an observable pattern
to the sensitivity of your breasts, it is useful to record it in the checklist on the data entry page so that
you can make future predictions or notice changes from cycle to cycle. While some women say that
tender breasts are an early pregnancy symptom, there is no way to know if you are pregnant by the
sensitivity of your breasts. Breast sensitivity may be linked to increased progesterone. Progesterone is
increased both during the luteal phase of your menstrual cycle when you are not pregnant and during
pregnancy. The sensitivity of your breasts may be useful for you to cross−check other signs if you
have a consistent pattern but it is not a useful fertility sign on its own.
• Your own observations: You may notice some specific changes yourself that can offer clues about
your fertility pattern. Everyone is different, but there are clues that you may find on your own.
Changes in your complexion, your energy level, your moods, or anything else that you notice shows a
cyclical pattern can offer insight into your fertility pattern. Use the notes section, the custom signs
option, or the checklist on the data entry page to record these observations. You may be surprised to
learn that something seemingly unrelated may be related to your fertility.

A few words about Ovulation Prediction Kits (OPKs) 25

Fertility Chart Patterns

Just as we are all unique, fertility charts also show our great diversity. There is no single "one−size−fits−all"
kind of chart model into which we can all fit. Most people do not really have perfect "text−book" charts that
follow any kind of rule to the letter. There are, however, certain kinds of patterns of charts that appear
frequently that we can recognize and understand. Though your own pattern may vary slightly from those
described here and it may even vary from cycle to cycle, you will probably recognize some characteristics that
do apply to your own chart and your own situation.

We talk about patterns because we have come to notice that trends in all your fertility signs, as well as the
shape of your graph over time, from day to day and from cycle to cycle, are more important that individual
temperatures or individual fertility signs observed on any given single day. Alone, without context and
without noticing trends and patterns, your fertility signs do not offer much information. But when you are
looking at "the big picture" you can often learn a great deal about your own fertility pattern. We will talk
about Ovulation Patterns, Anovulation Patterns and Pregnancy Patterns

Ovulation Patterns

Regular (Ideal) Pattern

In an ideal charting world, ovulation patterns would universally be clearly indicated by all possible fertility
signs and they would come in the order expected and indicate ovulation for the same day. While this chart
pattern does not always prevail, this may happen, and we call this "The Regular Ovulation Pattern". If this is
not the case for you, this is usually not a reason for too much concern as the ideal is not necessarily the rule in
Charting Land. There are many other "normal" charting patterns and Fertility Friend is designed to detect
them even when they do not meet the ideal.

The regular ovulation pattern includes:

• cervical fluid becomes increasingly wet as ovulation draws nearer

• cervical fluid dries up quickly just after temperature rise
• a single patch of eggwhite cervical fluid is observed in the days just before ovulation
• a biphasic temperature shift, showing a marked increase in temperatures after ovulation
• temperature rises in a single abrupt shift that is sustained throughout the luteal phase
• cervix is high and soft and open just before temperature rise
• OPK is positive 12−36 hours before the rise
• OPK is only positive in the one or two days before ovulation
• Microscope shows full ferning in pattern similar to cervical fluid
• Fertility Monitor shows a High reading in the days leading up to ovulation and a Peak reading the day
before the rise

When all signs indicate increased fertility on the same days prior to ovulation and ovulation for a certain given
day, the detection of ovulation and the chart analysis can be quite certain. When several signs can be
correlated and cross−checked, the analysis and interpretation is more reliable. It is, however, quite possible to

Fertility Chart Patterns 26

 Fertility Friend Handbook

detect ovulation and increased fertility under less than ideal charting circumstances. The more signs that
"match" the more reliable the interpretation will be.

Chart Legend

Variations on the Ovulatory Chart Pattern

In many, if not most cases, one or more elements of the regular ovulation pattern will not be present, will be
present in a different variation, or the signs will not perfectly correlate. This is usually not a cause for concern
and your fertile time and your day of ovulation can still be determined by careful analysis. Fertility Friend is
also designed to help you find your fertile time and identify your most likely ovulation date even under less
than ideal circumstances. In some cases, the pattern may be skewed because of less than ideal data collection,
problems with manufactured devices or being unable to follow the manufacturer's instructions precisely.
Temperatures taken at different times or without enough sleep can alter the pattern, as can the subjective
nature of cervical fluid and cervical position observations. Stress, fatigue, travel and illness can also impact
your chart. Or, your own unique fertility pattern may not exactly match the ideal. This is the human element
of fertility charting and this is just part of charting while living your life. Unless you are not following the
basic guidelines of charting, this is in large part unavoidable, though as you gain experience charting your
fertility your chart will also become more reliable. Fortunately, you can usually see your fertility pattern even
when you do not match the ideal. You can still identify your fertile phase and detect ovulation with a variant
of the ideal ovulation pattern. Fertility Friend is designed to give you the best prediction of your fertility status
and ovulation based on all the data available.

Here are some ways your chart and your pattern may differ from the ideal and still show ovulation:
• Sloping rise: Temperatures may rise in a sloping rise rather than an abrupt shift. The rise may be gentle and
curved and may take three to four days to reach the elevated level that clearly shows that ovulation has
occurred.

Variations on the Ovulatory Chart Pattern 27

 Fertility Friend Handbook
• Slow rise: Similar to a sloping rise, but in even smaller increments, temperatures may rise in a slow rise
pattern rather than an abrupt shift. The slow rise may show a steady shift in small increments of one tenth
of a degree Fahrenheit over four or five days.
• Fallback rise: Temperatures may show a "fallback rise" pattern. In a fallback rise pattern the temperature
rises significantly and abruptly as you would expect, but then it drops again immediately before it rises
again and is sustained throughout the luteal phase.
• Staircase rise: Temperatures may rise in a staircase rise pattern. In a staircase pattern, the temperature will
rise, stay steady or even slightly decrease and then rise and stay steady again until reaching the elevated
level. This may occur over a period of a few days.
• Triphasic: It has been suggested that triphasic charts often turn out to show pregnancy, but just as often (if
not more so) they do not. A triphasic chart shows three levels of temperatures: pre−ovulation,
post−ovulation, and then a second rise after ovulation.
• Delayed thermal shift: Multiple patches indicating increased fertility within your cycle but the thermal shift
and ovulation may occur later than expected in a cycle that is longer than usual. A cycle like this may show
signs of increased fertility, (eggwhite cervical fluid, positive OPK, high, soft cervix, peak reading on
fertility monitor, ferning on microscope devices) both just before the rise and earlier in the cycle when
ovulation did not immediately follow.
• Short cycles: (Less than 25 days). Your chart may show increased fertility and ovulation earlier in your
cycle.
• Long cycles: (More than 32 days).Your chart may show increased fertility and ovulation later in your cycle.
• Erratic temperatures: Even if your temperatures are erratic, going up and down throughout your cycle, and
not showing a single sustained shift between pre− and post−ovulation phases, they may still indicate
ovulation and show a thermal shift that is recognizable to a trained eye or Fertility Friend's ovulation
detector, especially if there are other signs that can be correlated.
• Out of place temperatures: Both in your pre−ovulation phase and your luteal phase, you may have
temperatures that just do not seem to "fit". This is usually nothing to worry about since you are looking at
trends rather than individual temperatures. This can be a fluke or can be caused by any number of factors
that can affect your temperatures. A few out of place temperatures can usually be ignored without
impacting the interpretation of your chart, especially if they are not close to ovulation.
• High temperatures during period: It is not unusual to have high temperatures during your period due to
residual progesterone from your previous cycle. They will usually level off in time to recognize a thermal
shift in your current cycle.
• Erratic temperatures during period: Likewise, it is not unusual to have erratic, high and low, temperatures
during your period. Usually they will level off in time to recognize a thermal shift in the current cycle.
• Dip before rise: You may see a slight temperature dip before your temperature rise. If you are lucky
enough to get advanced warning of ovulation like this over several cycles, it is a good way to time
intercourse very close to ovulation. You may, however have a dip that is not followed by a sustained rise
and mistakenly assume ovulation is imminent when you see a dip. An individual dip on its own does not
tell you anything about ovulation or your fertility.
• Multiple patches of fertile cervical fluid: Since you may have increased estrogen even quite a bit before
you actually ovulate, you may get more than one patch of fertile cervical fluid in a given cycle. Though you
will only ovulate once, usually just after the last patch of fertile cervical fluid, you need to treat any
fertile−like cervical fluid as potentially fertile so you do not miss a chance for conception.
• Multiple positive OPKs: Likewise, you may have increased LH (Luteinizing Hormone, which is detected
by Ovulation Prediction Kits) even when you are not approaching ovulation. This can cause you to have
multiple positive OPKs. Again, you will probably ovulate just after the last positive OPK, but again should
treat any positive OPK reading as meaning that you may be about to ovulate.
• No eggwhite cervical fluid or no eggwhite cervical fluid before thermal shift: You may not get a patch of
fertile cervical fluid just before your thermal shift, even though the shift indicates that you ovulated. You
should try to time intercourse as close to ovulation as possible and treat the cervical fluid that you get
closest to ovulation as your most fertile cervical fluid.

Variations on the Ovulatory Chart Pattern 28

 Fertility Friend Handbook

• Microscope or fertility monitor does not correlate: Sometimes the devices that you can purchase for
monitoring your fertility do not agree with your charting data. Fertility Friend will assess the data and
provide your most likely ovulation date and assessment of your fertility based on the data available. In most
cases, your temperature data is better able to pinpoint ovulation than any manufactured device. Devices can
be useful for indicating increased fertility before ovulation. Even if you get multiple readings that indicate
increased fertility or the data does not correlate, if you are using such devices, consider their assessments of
increased fertility so that you do not miss a potentially fertile time.
• Fertile cervical fluid after ovulation: While cervical fluid typically dries up immediately after ovulation, in
some cases it is present even after ovulation since the corpus luteum may produce sufficient estrogen to
produce some cervical fluid. If you have already ovulated and temperatures have been elevated and the
elevation is sustained, this need not be treated as fertile fluid.
• Cervical position or cervical fluid does not correlate with temperature signs: Your cervical postition or
cervical fluid may not correlate with your temperature or other data when they are cross−checked. Again,
Fertility Friend will offer the most probable assessment of your fertility and ovulation date based on the
data available.
• Temperature shift may be ambiguous: In some cases it will be clear that ovulation occurred but it will not
be possible to pinpoint definitively when with any degree of certainty. In such cases the temperature may
rise very slowly, have some dips, or some data may be missing or conflicting in such a way that makes it
impossible to tell exactly when ovulation happened. In such cases, it is important to remember why you are
charting. It is great to have accurate charting data, especially if it is taking longer than you hoped for
pregnancy to happen. But more important than having a perfect chart is timing intercourse to maximize
your chances of pregnancy. As long as you have intercourse within your fertile window, the precise date of
ovulation is not always critical.

Your own ovulation pattern may include one or more of the above special circumstances. Fertility Friend is
designed to interpret and analyze your chart and is able to recognize most ovulation patterns and pinpoint
your fertile time and ovulation accordingly. When you have special circumstances it is also a good idea to
ask for the input of a Fertility Friend guide to make the most out of your chart.

Ovulation Patterns that may require attention from your Healthcare Provider:

In some cases, you may ovulate but your chart may still be cause for concern. This list is not at all intended
to be exhaustive, nor to replace the advice of your doctor and you should always discuss any and all
medical concerns with your healthcare provider.

Some possible charting concerns to discuss with your doctor include:

• If your temperatures are consistently a great deal higher or much lower than you would expect, you
will want to talk to your healthcare provider to determine if there is an issue with your thyroid.
• If your luteal phase is consistently shorter than 10 days, this could indicate that your luteal phase is
not sufficiently long enough to sustain a pregnancy.
• If you have unexplained bleeding or spotting at any time during your cycle.
• If you consistently have well−timed intercourse and a pregnancy is not achieved after several
cycles.
• Any unexplained pain or discomfort.
• Bumps on your cervix that do not appear related to your fertility cycle.

Anovulatory Patterns
There are several potential reasons why your chart may not show ovulation. First, it is not abnormal to have

Anovulatory Patterns 29
 Fertility Friend Handbook

an occasional anovulatory cycle, even if you usually ovulate. In this case, anovulation may not be cause for
too much concern if it happens only rarely. When it happens consistently, it is reason to talk to your
healthcare provider so that together you can identify the cause and decide on a treatment if necessary.

Your chart may also not show ovulation, even if you do ovulate if you are not following the guidelines for
observing your fertility signs and charting your temperature data. For example, if you are not taking your
temperature at the same time every day, after at least a few hours of sleep and using a BBT thermometer
your chart may not show ovulation even if you do ovulate. If you have just started charting and your first
chart does not show ovulation, this also may not be cause for concern. You may just need a cycle or two
more to get the hang of charting. Before you can determine that you do not ovulate regularly you will need
to chart for a few cycles.

If are observing all your fertility signs correctly and you are taking your temperature accurately and your
charts consistently do not show ovulation, the possible reasons (not including adolescence or pregnancy)
may be: breastfeeding, just stopping hormonal birth control such as birth control pills, perimenopause,
illness, travel, too much exercise, stress, increased prolactin, polycycstic ovarian syndrome (PCOS),
significant weight loss or weight gain or possibly other conditions that can be identified with your
healthcare provider. In the case of known or suspected medical conditions, you should talk to your
healthcare provider about your best course of action.

When you do not ovulate, you may or may not menstruate. Many women assume that if they are
menstruating, then they are necessarily ovulating. This is not always true. You can still get what looks like
a period even if you are not ovulating, though your cycles will probably be less regular and may be longer.
You can still shed the lining of the endometrium which is built up through the increase of estrogen, even if
you do not ovulate and this will look like a period.

Characteristics of Anovulatory Charts:

While your own chart may vary, there are certain characteristics that are common in anovulatory charts.
They may not all be present at the same time or in each case. Most anovulatory charts:

• show no biphasic pattern, no thermal shift

• show erratic temperatures
• have large temperature fluctuations, even when temperature is taken carefully
• multiple patches of fertile cervical fluid
• long cycles (not always)
• irregular cycles (not always)
• multiple positive OPKs separated by negative ones
• signs of increased fertility but no thermal shift to confirm ovulation

Anovulatory Patterns 30
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Larger View||Chart Legend

If you chart for several cycles and ovulation cannot be detected on your chart, you should consider talking
to your healthcare provider.

Pregnancy Patterns

Pregnancy chart patterns are really a variation on the ovulation patterns since they all started out as
ovulation charts and show the diversity of ovulation patterns as well as pregnancy patterns. For many of us,
pregnancy charts are intriguing because we like to examine our charts after ovulation looking for clues that
will tell us we are pregnant or least if we have a shot at it in any given cycle. Others want to look at the
charts of those who were successful to look for hints that can help them.

The important thing to remember when you are scutinizing your own chart for signs of pregnancy is this:
there are no sure signs that will indicate pregnancy or rule it out until you can take a pregnancy test or until
you see your period. All kinds of ovulation patterns can turn into pregnacy charts as long as there is
well−timed intercourse. You do not need to show any kind of particular ovulation pattern or post−ovulation
pattern on your chart to become pregnant. Many women have no early signs that they are pregnant.

Likewise, well−timed intercourse and clear ovulation on a chart do not always result in pregnancy− even
when the chart looks promising. You have about a 20% chance each cycle depending on your age, how
long you have been trying and other circumstances.

Further, the effects of progesterone can complicate matters further when you are hoping for pregnancy.
Progesterone dominates the luteal phase of your cycle when you are not pregnant and is also present in
large amounts during pregnancy. Thus, symptoms that are typically present during the second part of your
cycle may also be present in early pregnancy. This makes distinguishing between early pregnancy
symptoms and signs that you are about to get your period nearly impossible. All this makes the waiting
time between ovulation and your period or testing time particularly agonizing. Nonetheless, there are some
characteristics that many pregnancy charts share.

Some characteristics of Pregnancy Charts:

• the intercourse pattern shows intercourse within the most fertile window, usually within a day or

Pregnancy Patterns 31
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two of ovulation
• chart clearly shows ovulation
• temperatures stay elevated beyond the normal luteal phase length
• sometimes shows a temperature dip around 7−10 days past ovulation
• sometimes shows spotting when implantation is expected to occur (7−10 days past ovulation)
• temperatures may show a triphasic pattern (temperatures rise to a third higher level that is sustained
around 7−10 days past ovulation)
• Pregnancy test is positive (of course)

Chart Legend

Trying to conceive can be an incredibly stressful and exciting time. Charting your fertility signs is one thing
you can do to put yourself in control, even if it is taking longer than you hoped or expected. As you chart
your way to conception, here are a few tips that may help:

• Have intercourse at least every other day before ovulation during your fertile phase. (Check with
your doctor first if there are any known sperm issues) .
• Have intercourse every day once you get a positive OPK result if you are using OPKs, or if you
have other advance notice that you will ovulate within 24 hours.
• Keep having intercourse every day until ovulation is confirmed by a few elevated temperatures that
are sustained.
• Avoid focusing on pinpointing ovulation. Once ovulation can be detected, it is generally too late to
conceive. Rather, look at the Fertility Analyzer that tells you that you have increased fertility and
take note of all your fertility signs.
• Try to keep your babymaking attempts enjoyable.
• Keep your sense of humor.
• Support your partner and let your partner support you.
• Talk to your friends who understand you.

Pregnancy Patterns 32
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• Enjoy all the things in life that give you pleasure and make you strong and special.
• Talk to your friends at Fertility Friend or make new ones here.
• Ask for guidance from our guides.
• Talk to your doctor after a few cycles if you think you might need medical help.

Pregnancy Patterns 33
 A last word or just a starting point...

Trying to conceive can be frustrating and difficult when it is not achieved as quickly or as easily as you
hoped. Charting gives you control and offers you the best possible odds every cycle. The awareness that
charting brings can help you better time intercourse to conceive and will help you understand your own
unique fertility pattern.

We want to share the experience we have gained over the years we have been researching, studying and
evaluating fertility charts and talking to women who are trying to conceive.

Fertility Friend members have access to our experience via our interactive software. It is regularly
improved to reflect the results of our continued research and data collection. Fertility Friend is a
comprehensive system that is designed to help you achieve pregnancy through charting and support. We
hope that reading the Fertility Friend Handbook has given you a firm foundation for starting to chart if
you are just beginning and has added another dimension for more experienced charters.

Please feel free to contact us at anytime.

We wish you the very best!

Fertility Friend Online

[Link]

A last word or just a starting point... 34

Glossary

Anovulation
No ovulation.

Anovulatory pattern
Fertility chart that does not have an ovulation (biphasic) pattern.

Basal Body Temperature (BBT)

Your body temperature at rest as measured with a special Basal Body Temperature thermometer. A rise in
BBT occurs after ovulation making BBT the only fertility sign that is useful for pinpointing the actual day of
ovulation.

Biphasic Pattern
Chart pattern that shows ovulation by showing two levels of temperatures on a graph. Basal Body
Temperature (BBT) rises after ovulation. The pre−ovulation temperatures are slightly lower than those after
ovulation.

Cervical Fluid (CF, CM)

Also sometimes called cervical mucous, cervical fluid is produced by your cervix as you approach ovulation
due to increased estrogen.

Corpus Luteum
Literally meaning "yellow body" because of its color, the corpus luteum is what remains of the dominant
ovarian follicle that released an egg at ovulation. The corpus luteum is responsible for producing progesterone
after ovulation.

Coverline
A coverline is a visual tool used to differentiate your pre− and post−ovulation phases on your fertility chart. It
is drawn horizontally across your chart once ovulation has been detected. The way it is calculated depends on
the ovulation pattern of your chart.

Dominant Follicle
The ovarian follicle that will release an egg at ovulation. The dominant follicle is responsible for estrogen
production before ovulation.

Eggwhite Cervical Fluid

This is the most fertile kind of cervical fluid. It is stretchy and usually clear and resembles raw eggwhite. It is
sometimes called cervical mucous, ewcm, or spinnbarkheit.

Estrogen
One of the principal female sex hormones. Produced in the ovaries, estrogen dominates the first part of your
menstrual cycle, before ovulation and stimulates follicular growth. It strengthens tissues and helps to build up
the lining of the uterus and is responsible for many of your fertility signs, including cervical fluid and cervical
position.

Fallback rise
A normal ovulation pattern when your temperature rises then drops slightly immediately after ovulation and

Glossary 35
 Fertility Friend Handbook

then rises again.

Fertile phase
The period when you are most fertile (most likely to conceive) before ovulation.

Follicle Stimulating Hormone

The hormone produced by the pituitary gland that causes the growth of follicles in the ovary early in the
menstrual cycle, before ovulation.

Gonadotropin−releasing hormone (GnRH)

The hormone GnRH pulses through your bloodstream from the hypothalamus to the pituitary gland in spurts
every 60−90 minutes from menstruation until ovulation. The GnRH signals the anterior pituitary gland to
secrete FSH (Follicle Stimulating Hormone) and later LH (Luteinizing Hormone).

Hormones
Hormones are biochemical substances that are produced in one area of your body and carried in your
bloodstream to send signals that trigger responses in another part of your body.

Implantation
When the fertilized egg attaches to the lining of the uterus.

Implantation spotting
Some women experience spotting when implantation occurs.

LH Surge
A sudden and large increase in Luteinizing Hormone in response to increased levels of estrogen in the blood.
The LH surge is detected by ovulation prediction kits. Ovulation follows within about 24 hours of an LH
surge.

Luteal Phase
The second part of your menstrual cycle, after ovulation. The time between ovulation and mentruation. It is
called luteal phase because the corpus luteum governs hormone production at this time.

Luteal Phase Defect

When the luteal phase (the time between ovulation and menstruation) is too short (less than 10 days) it may
indicate that the corpus luteum is not functioning properly and may prevent implantation of a fertilized egg or
may lead to early pregnancy loss.

Luteinizing Hormone (LH)

The hormone produced in the pituitaty gland that triggers ovulation. Luteinizing hormone is the last hormone
to peak before ovulation. LH is measured by ovulation prediction kits.

Mittelschmertz
see Ovulation pain

Ovary
Produces eggs (ova) and female hormones.

Ovulation
When the ovary releases an egg.

Glossary 36
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Ovulation Pain
Slight cramping or twinges in your abdomen before, during or slightly after ovulation. This is a secondary
fertility sign and because it can happen before, during, or after ovulation and can be misidentified, it is not
reliable for pipointing ovulation. Also called mittelschmertz, or middle pain.

Ovulation Pattern
A pattern on your fertility chart that shows that you have ovulated.

Primary fertility signs

These are the fertility signs that you need to include on your chart to get an accurate assessment of your
fertility status and to make the most of fertility charting. Your primary fertility signs are your Basal Body
Temperature (BBT) and your cervical fluid.

Progesterone
Progesterone is one of the major female sex hormones. Progesterone dominates the luteal phase (the time
between ovulation and menstruation) of the menstrual cycle. Progesterone is released from the corpus luteum
after ovulation, and causes your basal body temperature to increase slightly. Progesterone helps build the
lining of the uterus so that a fertilized egg can implant.

Saliva microscope
A saliva microscope is a device that measures the level of the hormone estrogen. When there is increased
estrogen in your bloodstream (indicating increased fertility) you are able to see ferning patterns when your
saliva is observed through a microscope.

Secondary fertility signs

Fertility signs other than cervical fluid or basal body temperature (BBT) that are useful for cross−checking
your primary fertility signs and giving added insight into your cycles

Slow Rise
Normal ovulation pattern where the temperature rises slowly after ovulation.

Spinnbarkheit
See eggwhite cervical fluid

Triphasic pattern
A triphasic chart shows three levels of temperatures: pre−ovulation, post−ovulation, and then a second rise
after ovulation. Triphasic charts are occasionally an indication of pregnancy when the second rise occurs
when you would expect implantation. Triphasic charts often do not end up showing pregnancy. You can be
pregnant without a triphasic pattern and you can have a triphasic pattern without being pregnant.

Glossary 37
Common Abbreviations

2WW
Two week wait (before testing, not always 2 weeks)

AF
Aunt Flo, your period.

BD
Baby Dance. Have intercourse for conception purposes.

BFN
Big Fat Negative (pregnancy test)

BFP
Big Fat Positive (pregnancy test)

CD
Cycle Day

CL
Coverline

CM
Cervical mucous, also known as cervical fluid. It is fluid produced by your cervix as you approach ovulation
due to increased estrogen.

CP
Cervical Position

DH, DD, DS
Dear Husband, Dear Daughter, Dear Son

DPO
Days Past Ovulation

EDD
Estimated Due Date

EWCM
Eggwhite cervical mucous. See Eggwhite cervical fluid.

FSH
Follicle Stimulating Hormone

GnRH
Gonadotropin−releasing hormone

Common Abbreviations 38
 Fertility Friend Handbook

HPT
Home pregnancy test. Measures levels of the hormone hcG which are produced in pregnancy.

HcG
Hormone detected by pregnancy tests. Human Chorionic Gonadotropin.

IUI
Intra−uterine insemination

IVF
In−vitro fertilization

LH
Luteinizing Hormone

LMP
Last menstrual period. The first day of your last period.

LOL
Laughing out loud

LP
Luteal Phase

LPD
Luteal Phase Defect

M/C
Miscarriage

O
Ovulation

OPK
Ovulation Prediction Kit. OPKs measure luteinizing hormone, the last hormone to peak before ovulation.

POAS
Pee on a stick

RE
Reproductive Endocrinologist− Fertility Specialist

TTC
Trying to conceive.

Common Abbreviations 39