Can Tracking Cervical Mucus Help You Conceive? (Episode 451)

Full Transcript: Episode 451

This is the Fertility Friday Podcast, episode number 451.

Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Training Workbook. I’m a certified Fertility Awareness Educator and Holistic Reproductive Health Practitioner with over 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormone health, and optimizing the menstrual cycle without hormones. I have been consistently outspoken about hormonal birth control over the past two decades and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices and I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys and a brand new baby girl. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with me today.

Today, I’m sharing a brand new episode in a brand new series, my FAMM Research Series. And my intention with this series is to share research with you. If you have been listening to this podcast for a while or if you’ve read The Fifth Vital Sign or just in general followed my work on social media, Instagram, then you’ll know that I’m often with my head in the books reading research studies. And I feel like this new series is a great opportunity to share some of that research with you. It’s something that my practitioners are obsessed with, I can say, my practitioners in the program, in the FAMM program, we are always delving into the research, looking at what the research says to guide our protocols and to provide that rationale and basis for the various approaches that we take with clients.

And so I’m thrilled to bring this series to you. And it’s a series similar to my Pill Reality Series or the FAMM Reality Series, where it’s not necessarily going to follow that I’m going to have a certain number of episodes after this one, then it’ll be over. But in a sense, I’ll just throw in these episodes, collect them as part of the series as time goes on. So, you know, every month or two, there’ll be a couple of episodes within the series that I’ll be sharing with you. So hopefully, you enjoy these episodes. I think the majority of you will because I do know that the heavy research base to my work is one of the things that I get a lot of feedback on, a lot of positive feedback on, and I know a lot of you appreciate taking the time to do so. The various studies that I go through in the series, I’ll be linking to those abstracts in the show notes page, of course, so you’ll be able to go back and have a look at them if you’re wanting to delve in further.

So the topic of today’s episode is improving your chances of conception with cervical mucus. And so I thought this would be a very fitting episode to be the inaugural episode of the FAMM Research Series, given the importance of cervical fluid in terms of the method itself. Cervical fluid is one of the integral central parts of fertility awareness as a concept, whether you’re using it to avoid pregnancy or to conceive, or even just to gain a better insight into what’s happening hormonally. So with that said, let’s go ahead and jump into the first session of the FAMM Research Series, improving your chances of conception with cervical mucus.

All right, so the study that we are going to be delving into today, it’s called “Cervical Mucus Secretions on the Day of Intercourse: An Accurate Marker of Highly Fertile Days.” And so, like I said at the top of the episode, I’ll be linking the abstract to this episode so you can find it in the show notes page for fertilityfriday.com/451 and we’re just going to delve into what this study talks about.

And so to give you a general overview, basically what the researchers did is they took a group of 193 healthy Italian women who were trained in the Billings Method of Ovulation, or the Billings Ovulation Method. And for those of you that are not familiar with a variety of different types of fertility awareness-based methods, the Billings Ovulation Method is a mucus-only method. And the way that the method, it’s a little bit different, and it’s more based on observation, sensation. It’s not an external wiping method, but either way, you’re still very adequately trained to identify the various changes in cervical mucus and to identify the difference between different types so that you can identify days of fertility. So it is useful just to keep in mind that the participants of the study, they are trained to look at their mucus in specific ways and they are able to then distinguish between different types of mucus throughout the cycle quite reliably.

Women were recruited into the study over a period of several years and thousands of cycles were reported and recorded over the time of the study period. So very interesting. And to boil it down to what the researchers were looking to find, they were specifically wanting to study how effective tracking cervical mucus changes would be in terms of supporting women to conceive. So how effective identifying fertile-quality mucus would be in helping women to identify their fertile window and improve their chances of conception. That’s essentially the point of the study.

And so very relevant to us because on the podcast, we’ve talked so much about mucus. And if you’ve been tracking your cycles yourself or if you’ve been interested or nerding out on this topic, then you’ve likely talked a lot about mucus and learned a little bit about mucus and all that kind of stuff. So it is really interesting when we find studies that are specifically looking at these topics and asking these questions and giving us the science to back our observations — what we’re doing when we’re checking what’s coming out of our vaginas and sitting in our underwear and whatnot.

To give you the conclusion and the results right off the bat and then we’ll delve into what it means in some of the nitty gritty details. Basically what the researchers found was that when women were trained to rate their cervical mucus from basically dry to peak-quality mucus, which is the clear stretchy stuff, the probability of conception was highly correlated with the appearance of the most fertile-quality cervical fluid. And so I’ll just quickly read from the abstract here. The probability of conception ranged from basically negligible for days with no noticeable mucus to about 30% for days with the most fertile-type mucus detected by the women.

So there was a direct correlation between the chances of conception and the woman identifying and then timing sex on days where she identified the fertile-quality cervical mucus, the peak-type mucus. In the language that I use and that I teach, we call that peak-type mucus — the clear, stretchy, lubricative type cervical fluid.

So what does the study tell us? I’m going to go through some interesting points that the researchers found. I’m going to share some of my thoughts on it and kind of bring it all together. But in the most basic terms, the study tells us that women can tell the difference between their cervical secretions and that there’s a very high correlation between what we’re observing in our cervical mucus and what’s happening in our body around the time of ovulation.

And so what I always stress when talking about fertility awareness is that fertility awareness actually doesn’t help us to predict ovulation in the sense that we can’t ahead of time say, okay, I know definitely I’m going to ovulate on this day of the cycle. That’s not the point of fertility awareness tracking, but what this whole observational routine does show us and tell us and inform us about is at what point of the cycle are we fertile? At what point of the cycle can we conceive? So when we’re tracking cervical fluid, it’s telling us the fertile window. It’s telling us that these days are the days of fertility. These are the days where if you have sex, it’s possible to conceive. And these are the days that it’s not. So it’s something to get your head around because it’s not predicting ovulation. But it’s telling us that these are the events that tend to happen as you approach ovulation. And so these are the days where conception is possible.

So it’s pretty basic. But on the other hand, I get so many questions from clients and DMs and all those kinds of things. So on the one hand, it’s really simple to understand and on the other hand, you may have questions about how it all works. But the bottom line is that women can be trained to identify their fertile window based on their cervical mucus.

And so to break it down a little bit, the women in the study were taught to rate their mucus on a scale of one to four. And I’m just taking a peek at some of the data here. And basically, the numbers one and two: so one was no sensation of cervical fluid or a dry sensation. So basically, one was no noticeable mucus. Two was they called it slightly moist. So there still wasn’t any noticeable substantial or noticeable mucus, but there was some sort of shift in terms of her observation where it wasn’t completely dry, but there was a bit of a moist sensation. Now, again, the Billings Ovulation Method is different to the wiping method. So for anyone of my clients or practitioners or anyone who’s been following more closely with the information that we discussed in The Fifth Vital Sign, my understanding of the Billings Method is that it’s more sensation in the general sense, where if you’re walking around throughout the day, you may pay attention to how you feel, if it feels wet as you’re walking around during the day, and it’s not necessarily based on observations in terms of wiping and looking. So when it says no sensation, it means that you walk around, you feel dry. When it says slightly moist, you feel a little bit moist, right? So it’s a little bit of a different methodology just to keep that in mind.

The three on the scale of one to four was a damp sensation. So now you’re feeling a little bit more of something there. And the appearance, it says the creamy, whitish, yellowish, sticky, stringy mucus. Four is what I would refer to as peak mucus, so from the perspective of the way that I’m trained and the language that I use, it sounds like three would be more of a non-peak based on the appearance, and four would be peak. Non-peak is more of the lotion-y type, and then peak is more of the clear, stretchy, raw egg-white type. So it says wet, slippery sensation, clear, stringy, or stretchy, fluid, watery mucus, and it also says blood trails.

So basically we have this very simple classification system where women are rating from nothing really there to this clear stretchy mucus and they’re basing their actions on that. In this research study, the women were tracking their cervical mucus every day and they were tracking their intercourse. And so the researchers were then able to see when they were having sex based on what type of mucus they were having and who conceived and when and who was more likely to conceive based on what mucus observations they were having. And in case you’re wondering, the women that were chosen for this research study were specifically chosen because they were not avoiding pregnancy. So the women who were part of the study were either actively trying to conceive, planning to conceive in the future, but either way, they were not using contraception. That was one of the requirements of the participants in the study. So basically, a cohort of women who are cycling, they’re not on contraceptives, and they’re not using any type of birth control, and they’re having sex, noting it down, tracking the mucus and seeing how it plays out in terms of the probability of conception based on the mucus that they are reporting.

And so, unsurprisingly, the women who had sex on their days of peak mucus, the clear stretchy stuff, had the highest probability of conception. And the researchers kind of talked a little bit about why that might be. And so this brings us into what this all means from a hormonal standpoint and understanding the cycle a little bit on a deeper level.

So most of you are familiar with just the general idea of what’s happening in the cycle. And so one of the ways that I often talk about what’s happening in the cycle is from that lens of what’s happening hormonally. So in the most basic sense, if we divide the cycle in half, we can have the pre-ovulatory phase — so what happens before ovulation — we can have the post-ovulatory phase — what happens after ovulation. And so when we’re in the pre-ovulatory phase, so before ovulation, as we’re approaching ovulation, we’re having a variety of follicles develop in the ovaries. One is inevitably chosen, that becomes the dominant. And as this process is happening, as the egg is essentially being prepared for ovulation, the ovary is producing estrogen. It’s part of the developmental process of the follicle.

And so when we’re in the pre-ovulatory phase, it is the estrogen that is being released that is triggering the cervix, the cervical crypts to make cervical mucus. So when we’re tracking cervical mucus, we’re tracking our mucus, what we’re actually seeing in a healthy normal cycle. So I just have to stress that because when we’re looking at mucus methods and looking at mucus as a reflection of what’s happening hormonally, this is most reliably done in women who have healthy mucus production and fairly normal cycles. And we’ll talk a little bit more about some of the situations that differ and different strategies for women who don’t necessarily have the ability to rely on their mucus. So just keep that in mind.

But in a healthy cycle with normal mucus production, what we’re seeing when we’re tracking mucus is a reflection of what’s happening hormonally. So when we’re seeing that shift from basically dry, not really seeing anything, to starting to see some potentially lotion-y type mucus and going all the way up to the clear stretchy as they classified it as a 4 on their scale, what we’re seeing is a reflection of the rising estrogen levels. And in general, then when you get closer to ovulation, so what happens hormonally is that the estrogen levels continue to rise until they hit a peak. And it’s that peak of estrogen that actually triggers ovulation. So it makes sense then that it corresponds that when you’re seeing the highest quality of mucus, the peak-type mucus in the greatest quantities, that’s often correlating right very obviously, with those high estrogen levels that happen right before ovulation.

So we could talk about the mucus in two distinct ways. We could say that, okay, well, when we have that significant quantity of peak-type, clear stretchy cervical mucus, that means that we’re closest to ovulation anyway, estrogen is the highest, ovulation’s imminent, so we’re actually timing it at the right time. And so, outside of the properties of mucus, which is a whole other rabbit hole in how mucus changes the pH of the vagina and keeps sperm alive and filters out abnormal sperm and all that great stuff that I talk about extensively in Chapter 3 of The Fifth Vital Sign — outside of the quality of the mucus to help fertility, it plays a key role in just straight timing.

So when we have that peak-quality mucus, if you’re tracking your cycle and you’ve done it for a little while, you’ve started to notice, very likely, assuming your mucus is fairly normal and assuming that you’re able to observe your mucus, if you are tracking, you’ll notice that you see, even if you’re not 100% clear on what you’re seeing, you’ll see patterns where you don’t really have a lot or you don’t have any. And then at a certain point of your cycle towards ovulation, that’s when you have most and it’s most obvious and you might notice a change in your libido or other changes as well and then it goes away. And so even just that very basic change that you see cycle after cycle after cycle, it’s related to that hormonal shift.

So if you didn’t know anything else other than to, if you’re trying to conceive, to have sex when you see that clear stretchy mucus — if you didn’t know anything else, that would significantly increase your chances of conception. And one of the reasons is because it helps you get the timing right. One of the things that this study shows us is that the actual mucus itself is just as good of a marker of timing sex, if not better than a lot of the devices and various things that we use, including ovulation strips. And if you’re using an app that has predictive settings and all that kind of stuff, the mucus reliably outperforms that in women with healthy cycles according to the study. So lots of interesting stuff there.

And hopefully the background information is helpful as well. But to pull it back to the main point I wanted to make is that the timing is key and the mucus really helps us to identify and get that timing right. And then a secondary and very important factor of cervical mucus is that it is key to fertility in the sense that it is associated with keeping sperm alive for up to five days and providing that ideal home away from home, ideal environment for sperm to thrive during your menstrual cycle, during that fertile window, so that the sperm is ready and waiting for when ovulation takes place. So two very important aspects of cervical fluid.

So essentially the study confirms what many of us already know about cervical mucus. It really highlights and shows us and gives us the scientific data to back up that cervical mucus is a reliable way to identify our fertile window, to help to time sex accordingly, because it is associated with the hormonal shifts that we’re seeing in the menstrual cycle. It also shows us that women can be taught to reliably understand, interpret, and identify the changes in their cervical mucus secretions. And although there’s always a learning curve to learning something new, there’s no evidence to suggest that women have a difficult time learning this basic information. We could talk about different methods and the different nuances to that. But the basic understanding of cervical mucus, the difference between different types that we produce and identifying the days where we see that kind of fertile-quality cervical mucus in highest quantities, that is something that women can do reliably with instruction.

So for any of you who’ve ever been told that it’s like too complicated, too difficult, all that kind of stuff and fertility awareness is just such a waste of time or it doesn’t do anything, it doesn’t help — I know some of you may have heard similar sentiments from your doctor. Well, this research study and many others, but today we’re talking about this one, this research study certainly refutes that.

And so one other thing I thought was interesting is what the researchers said about cervical mucus and what they suggested in terms of its ability to help to time sex effectively, and even potentially to time other procedures, like IUI or other assisted reproductive technology. So I just want to go through what it says. I might read a little and paraphrase a little. But basically the researchers towards the end of the study gave some clinical guidelines. And they’re basically saying that in a clinical setting when women are going for, let’s say IUI, intrauterine insemination — and so that’s when women are at times given potentially a trigger shot to make them ovulate, but either way they’re inseminating or putting the washed sperm directly into the uterus. And the researchers actually suggest that because the cervical mucus observations are so effective at identifying the most receptive time in the woman’s cycle — so because the results showed that if women timed sex based on their cervical mucus in the highest category, so on the scale of one to four when they identified the mucus as a four, there was a significantly higher chance of conception compared to any other time of the cycle.

And so the researchers are actually suggesting that this could be a viable option for timing intrauterine insemination, timing IUIs. And they said here, the advantages of this approach over ovulation detection kits include lower cost. So they’re saying you don’t have to buy a bunch of equipment and all that kind of stuff because you could just have her check her mucus. And it says greater efficacy in that most fertile-type mucus symptoms typically begin early in the fertile interval and occur during the most fertile days, while ovulation detection kits typically miss the most fertile days. So they’re also saying that there’s a validity in this method because you get a couple days of advance warning.

I’ve talked about this. I’ll link one of my kind of popular episodes on this topic of ovulation predictor kits. And one of my points related to relying on ovulation predictor kits is that when you track mucus, you’re going to get mucus for a healthy typical cycle for several days before that strip turns positive. So the ovulation predictor strips are testing for a hormone called luteinizing hormone, or LH for short. And basically, as you’re approaching ovulation, we talked about how the estrogen is rising. And once that estrogen hits its peak, that is what sends that message back to our pituitary to release that LH. And so basically what you have is the ovary preparing for ovulation. And once we get that LH surge, LH is what triggers ovulation. It triggers the ovary to release the egg. And so because of that, we get that positive LH test typically about 36 hours before ovulation. And so you’re getting that about a day and a half before you actually ovulate. If you’ve tracked your cycle for any period of time, you typically don’t get a day and a half of cervical fluid. You typically get cervical fluid in a healthy cycle for several days, maybe five or six days in a healthy cycle.

Additional information about ovarian function, which could potentially help with diagnostics. If you’re dealing with a woman who’s seeking IUI treatment, then they’re saying that tracking this extra information could potentially help identify other factors that could be contributing to her fertility challenges. So that was what the researchers had to say about using cervical mucus to identify the fertile window. And they were talking about the potential for it to be used even in a clinical setting to inform the timing of IUI procedures. So that’s certainly something to think about.

So basically then the study is telling us that not only is mucus an effective way of identifying the fertile window, but it is as effective, if not more effective than the typical ways that we do that. So for example, the ovulation strips, and it should be considered a viable alternative.

So I have a couple of thoughts then to wrap up today’s conversation about this research study on cervical mucus. Just to kind of reiterate, when you’re tracking your cycle, there’s lots of different ways to chart mucus. And if you’re familiar with Taking Charge of Your Fertility, typically we’re looking at sticky, creamy, egg white, wet. If you’re looking at some of the other fertility awareness-based methods, then we get into peak, non-peak. There’s basically different words for the same observations. But when we’re tracking the mucus that we can see and observe, typically it falls into two categories. We kind of have the lotion-y stuff, and then we have the clear stretchy stuff. And so with just that basic knowledge, even just from listening to today’s podcast, you have enough information to actually just kind of take a look at what’s going on down there and identify whether or not it’s that clear stretchy. So even the basic scale that they provided in the study, any woman can take that information if they’re trying to conceive and pay attention to when they start to see the clear stretchy stuff and have sex on those days. It’s just that simple. There’s no trick to it.

With that said though, there are situations where it may not be as straightforward, only because not all women have a very clear pattern of cervical mucus, and that could be for a couple of different reasons. A couple of other things I just wanted to say before I get into that because it’s its own thing. Peak mucus, then, is associated with peak estrogen levels, and so it is helpful to know that mucus isn’t just this random thing that’s going on, it’s highly correlated with our hormonal cycle. And what we’re seeing in terms of cervical mucus in a healthy cycle is we’re seeing, in many ways, a direct reflection of what’s happening hormonally. So that is something to consider.

So getting into then some of the caveats. So this study really did appear to study women who had pretty typical mucus patterns who were actually seeing cervical mucus on a cyclical basis. And it is important to point out that not every woman sees that mucus reliably. And it could be for a variety of different reasons. Many of the women in the study had had children already, postpartum, and those types of things. And so some of the women at least in the study may have been at different stages.

So a lot of the clients that I work with, and a lot of the women that I see in my practice, a lot of the women that my practitioners work with in their practicum, have a recent or at least sort of recent birth control history. So there are a number of factors that affect cervical mucus production. And one of those factors certainly is hormonal birth control use. So hormonal birth control is known to suppress mucus production, even if it’s temporarily. When you’re on hormonal birth control, if you’ve ever used hormonal contraceptives, you may have noticed or may not have noticed that you don’t make mucus when you’re on contraception. And even if you see some sort of discharge, you’re not seeing clear, stretchy cervical mucus. And the reason for that is because that’s one of the main modes of action. One of the ways that hormonal contraceptives work.

And so this is across the board — if it’s a hormonal birth control, whether it’s the pill, the patch, the ring, the shot, or the progestin-releasing IUD, one of the main modes of action for these contraceptives is to suppress mucus production. So typically then what’s happening in your cervix is that your cervix is plugged with a thick mucus plug and you’re not actually making any clear stretchy cervical mucus. So research has been done to show that over time, the time being on the birth control pills specifically or the different hormonal methods, because you’re not making that mucus, it can actually suppress and have a negative effect on your cervical crypts.

So many women come off of birth control after being on for a long time, often in the research studies two years or more is considered long-term. But certainly I work with many women who’ve used birth control for 10 years or more, 15 years, sometimes 20 years even. But when you’re on birth control for a longer time, some women come off of it and find that they don’t necessarily have a whole lot of mucus. And it can range. So I’ve had clients who come off and for several months they see none at all, even if they’re ovulating. And so we call those dry cycles. And I think just to put that out there, even for women who I’ve worked with who’ve had those dry cycles, they’re not dry forever. There’s typically several months, let’s say two to three months in these cases, where they’re not seeing anything at all, even if they’re ovulating. But then eventually, the mucus production does return to some degree.

So I think what I see more of the time is that we are seeing some mucus production, but maybe not necessarily large quantities of mucus. And that’s kind of more typical. But either way, that’s one of the examples of a scenario when you’re not seeing a lot of mucus, even though you’re ovulating.

There are other situations. I’ve worked with many clients who’ve had cervical dysplasia, which is abnormal cells of the cervix, at one time or another, and they may have had a procedure done to scrape those cells, whether it’s conization, LEEP, whatever the case may be. And so when I’m working with clients that have had those types of procedures done, it is not uncommon for those women to, again, have lower mucus production. And that could be because these procedures do some level of damage to the cervical crypts themselves and result in less cervical mucus production.

Also, there’s other reasons. There’s certain medications, whether it’s antihistamines or certain fertility drugs even. So fertility drugs like Clomid, for example, that are used to trigger ovulation, are also known to suppress mucus production over time. And so repeated use of these drugs can contribute to lower mucus production. So that’s just a handful of scenarios where you have a person who may be ovulating, but they’re not necessarily seeing a whole lot of mucus.

And so something that may seem counterintuitive is that pregnancy is actually possible in every cycle with ovulation. So even if you have a cycle where you’re not necessarily seeing a whole bunch of mucus, if you are ovulating in that cycle, it is still possible for you to conceive. And I have certainly seen that happen.

So going back to the study, in a healthy normal cycle, if you’re seeing mucus during that fertile window and then you’re ovulating and it’s going away, the mucus is an excellent way to identify those fertile days of your cycle. And so it is crucial in identifying that timing. If you fall into one of those categories that I was referring to and you are ovulating, but you are not seeing mucus, what happens is it doesn’t mean you’re not fertile. It doesn’t mean pregnancy is not possible, even though that may sound counterintuitive to what you’ve heard. What it means is that in your case, mucus may not be the primary way to identify fertility, but only because you have impaired mucus production.

So that’s a whole topic in itself. I’m not going to go too far into the weeds, but I just wanted to point that out to really kind of put the study into perspective. Because I know that these are the kinds of questions I get when I talk about topics like this, particularly if you yourself are listening and you’ve been tracking mucus, but you don’t feel confident that you’re seeing a whole lot or you’re having trouble noticing it and identifying it.

So in terms of timing, the quantity isn’t necessarily that important. What’s important is the shift in mucus. So I’ve worked with many women who don’t necessarily have large quantities of clear stretchy mucus, but when they’re around that time of fertility, they do notice a shift, a change. Whether it’s that they feel, similar to the Billings Ovulation Method, they feel more lubricative, they can feel like there’s something in their underwear when they’re walking around, or whether they’re actually doing the wiping method and they do notice that it’s more lubricative or slippery when they’re wiping, but they don’t necessarily see a whole lot. Those are some nuances. And if you’re having a difficult time, it’s a good idea to work with an instructor to help to give you maybe more of a personalized strategy to organize and identify your fertile window.

But either way, for most women, even if they’re not seeing hordes and hordes of mucus, they’re still able to identify those differences and still able to identify the fertile window. If you’re noticing a shift, but if you’re not seeing any, then you may want to look at different strategies. And so those strategies can include checking for cervical position instead, and also using those ovulation predictor strips to at least give you a second marker in addition to whatever mucus you’re seeing or your cervical position changes so that you can actually have two ways of identifying that window when ovulation is approaching. So hopefully that is helpful and not too confusing.

But ultimately, I just want to speak to the fact that not all women have the strongest mucus sign when they’re tracking their cycle. And just a kind of a final note with this study, because they were tracking specifically for conception, that was the focus really of this study. They were focusing on using mucus as a marker for timing and how effective it is for women to identify the differences in mucus and time sex along with their highest fertile quality cervical mucus, or peak mucus, to see how effective it was. They weren’t looking at it from a birth control angle. But if you are using fertility awareness to avoid pregnancy personally, then you can kind of flip this on its head in a way and recognize that when you’re trying to avoid pregnancy, it’s crucial to avoid unprotected sex during that fertile window.

I guess a good guideline just to keep in mind, and there’s more to it, and if you’re planning to use fertility awareness for birth control, I do recommend that you consider having at least a few sessions with an instructor because you want to make sure you choose a specific method, that you’re good with the rules, and that you understand the different scenarios that can happen to lower efficacy. But ultimately, the most basic understanding is that pregnancy is possible in any cycle with ovulation. And cervical mucus plays an essential role in that.

As you’ve gathered from my previous brief discussion on cervical mucus, whether you have a normal mucus presentation or not, or if you have certain situations where your mucus production is limited, even if your mucus production is limited, if you’re ovulating, you can still conceive. And what the research tells us is that there is a six-day fertile window ending on the day of ovulation. And if you have unprotected sex on the five days leading up to ovulation or ovulation itself — so that’s six days in the cycle — there is a chance of pregnancy. And that’s it.

So the irony is that whether you have strong mucus production or not, if you have unprotected sex during that six-day window, there is always a chance of pregnancy. So when you’re using fertility awareness to avoid pregnancy, it is also essential for you to track your cervical mucus, to start to understand it, but to also know that when you are in the pre-ovulatory phase — so whether from the first day of your period up until you’ve confirmed ovulation — pregnancy is a possibility in any cycle that is ovulatory. And so you’re going to need to have a strategy not only to identify the fertile window, fertile days effectively, but also a strategy to manage that fertile window. Are you going to be abstaining from sex altogether? Are you going to be using a barrier? Is your partner on board? How is the communication between the two of you? And if your mucus production is not optimal, how are you going to identify those days? So many women opt to avoid unprotected sex entirely in their pre-ovulatory phase. Others use last infertile day calculation. And others follow the specific rules related to mucus for the method that they’ve chosen. And so it’s important for you to take the time to figure out what this is going to look like for you so that you can get the highest efficacy of the method.

So that brings us to the end of today’s episode. If I give a short recap, it’s basically that cervical mucus is a highly effective way to time sex when you’re trying to conceive. And research tells us that it’s very, very effective and useful, and also that women are more than capable of being trained and taught to identify the differences in their cervical mucus and use that information accordingly. Like I mentioned at the top of the episode, if you want to take a look at the study, you can find all that information at fertilityfriday.com/451. I will link the study. You can have a look at the abstract and all of the different information that we talked about today, and you’ll find more details over at the show notes page.

And I hope that you enjoyed today’s episode, the first episode in the FAMM Research Series. If you know somebody who loves to nerd out on research and you want to share this episode, the share link is fertilityfriday.com/451. And as I mentioned mid-episode, if you are really wanting to nerd out about cervical fluid, if you’re a newer listener and this topic really fascinates you, and if this episode has kind of blown your mind, like if this is more new information to you, then definitely check out my book, The Fifth Vital Sign. Chapter 3 of The Fifth Vital Sign is a cervical fluid, cervical mucus throwdown. And in there, I talk about all of those kind of nitty gritty details that you’ve never heard before. And I’ve had a lot of positive feedback from medical professionals who went through regular medical programs who are kind of wondering why they didn’t learn this level of detail about cervical mucus. So Chapter 3 of The Fifth Vital Sign is there waiting for you if you haven’t read it, or if you have the book already, you can jump in there.

And if today’s the day that you’re going to nerd out on the different types of mucus and the hormones and how it all works and especially some of those functions about how mucus supports sperm and how it affects fertility in a positive way that we did not get to get into in today’s episode, that is where you’ll want to go for more details. You can expect more of these episodes moving forward. I just think it makes so much sense because I spend so much time with my head in research papers for a variety of projects that I’m working on in the background, whether it’s more writing projects or projects related to the FAMM program, there’s just so much interesting research. And I think that this is a great opportunity to lend the validity to fertility awareness-based methods, especially for those of you who’ve ever been kind of belittled by your medical professionals. I mean, it’s sad, but I’ve spoken to so many women who’ve been discouraged when their medical professionals don’t really feel that fertility awareness is a valid method. And so it is really interesting to find out how much actual scientific data there is to back up this very interesting method, very interesting and important method, whether we’re using it for contraception, whether we’re using it for conception to optimize our chances, or just general overall health and fertility with that whole concept that the menstrual cycle is a vital sign.

So I hope that you have a wonderful week, weekend, whenever you’re listening to the show. And of course, as always, until next time, be well and happy charting.