Title: Billings Ovulation Method
1Billings Ovulation Method
- Natural Fertility Regulation
2Billings Ovulation Method
- A natural way to
- Achieve Pregnancy
- Postpone Pregnancy
- Monitor Reproductive Health
3Billings Ovulation Method
- easy to learn
- simple to use
- no drugs or devices
- no side effects
- reliable
- morally acceptable to all cultures
4Male Fertility Sperm production begins at
puberty Production of sperm continues throughout
life
Female Fertility Begins from puberty Cyclic
potentially fertile for approx 5-7 days Finishes
at menopause
Couple Fertility
5THE FEMALE REPRODUCTIVE ORGANS
6THE OVARIES whose function is the cyclic
maturation of ova (eggs), produce hormones
oestrogen and progesterone
7FALLOPIAN TUBES tubes through which sperm cells
are assisted in their passage from the uterus to
the ovum (egg)
8FALLOPIAN TUBES the fertilized ovum (embryo)
is actively transported to the body of the uterus
9THE UTERUS - the organ of the female in which the
embryo implants and develops
10ENDOMETRIUM the inner lining of the uterus
which is shed at menstruation
11THE CERVIX the neck of the uterus which bears
the mucus-producing crypts
12THE VULVA the external parts of the female
genital organs. It is the sensing organ for
cervical mucus
13THE VAGINA the birth canal, the passage through
which the baby is deliveredThe lining of the
vagina has no glands
14POCKETS OF SHAW after ovulation, under hormonal
control, mucus is dried as it passes through the
vagina
15Keeping a Record
- Observations made at the vulva as the woman goes
about her normal daily activities No internal
examination - Most fertile characteristic of day recorded each
evening - One or two words recorded to describe sensation
and appearance Coloured stamps or symbols used
on chart
16The woman will both feel and see the bleed as it
arrives at the vulva
17Sensation/Appearance of discharge
Menstruation, indicated by a red stamp or the
symbol ?
18Following menstruation cervix occluded with
thick, dense plug of mucus
19Plug prevents passage of sperm into cervix and
protects body from infection Sperm cells kept out
in vagina quickly become incapable of fertilizing
ovum and destroyed by surrounding cells
20The ovaries are quiescent Nothing leaving the
cervix, vulva feels dry
21BASIC INFERTILE PATTERN (BIP) UNCHANGING PATTERN
- DRY
DRY - nothing is felt, nothing is seen Recorded
with a plain green stamp or the symbol
22BASIC INFERTILE PATTERN (BIP) UNCHANGING
PATTERN - DISCHARGE
Discharge remains same day after day, cycle after
cycle Small fragments breaking off lower part of
plug results in discharge
23Basic Infertile Pattern of mucus remains the same
day after day, cycle after cycle.
Initially recorded with white baby stamp or the
symbol O Then recorded with yellow stamp or the
symbol when pattern is seen to be unchanging
24Basic Infertile Pattern of mucus remains the same
day after day, cycle after cycle.
Three cycles are studied in order to identify
correctly the point of change of sensation or
appearance of the mucus or both
25Basic infertile pattern of mucus remains the same
day after day, cycle after cycle.
There is no entry of sperm into the cervix
because of the plug of mucus This unchanging
pattern of infertility is common for many women
26Ovaries are active and are producing
oestrogen Cervix is stimulated fluid mucus is
produced,this frees the plug, sperm can now
enter cervix
27Change in sensation no longer dry Recorded with
white baby stamp or symbol O
28Change in vulval sensation or appearance of mucus
Ovaries are active and are producing
oestrogen Cervix is stimulated fluid mucus is
produced,this frees the plug, sperm can now
enter cervix
29CHANGING PATTERN OF FERTILITY
Changing pattern of fertility Ovaries producing
greater amounts of oestrogen Mucus progressively
changing to a wet, slippery sensation Clear
strings of mucus may be noticed
30CHANGING PATTERN OF FERTILITY
Maximum amount of mucus may diminish Slippery
sensation may continue for a day or two Last day
of slippery sensation the most fertile day of the
cycle - PEAK OF FERTILITY Very close to the time
of ovulation
31THE PEAK
- the last day of the slippery sensation
- associated with increased sensitivity and
with swelling of the vulva
32THE PEAK
The ovary is now producing progesterone,preparing
follicle to shed ovum (ovulation)
33RECOGNISING THE PEAK
Peak is recognised on the day of change No longer
any lubricative sensation at the vulva Peak is
marked with a cross on the record
34Ovulation occurs on Peak day or days 1 or 2 after
Peak The ovum can live for up to 24 hours
35DAY 1 to 3 PAST PEAK
Cervix gradually closes with thick plug of
mucus Small channels remain through which sperm
can travel
36DAY 1 to 3 PAST PEAK
The three days following the Peak are markedwith
a numbered green or yellow baby stamp ora
numbered symbol or
37THE LUTEAL PHASE
From the fourth day past Peak, cervix is
closed Sperm cannot enter If not fertilized, the
egg will have disintegrated
38THE LUTEAL PHASE
Plain yellow or green stamps are now used or the
symbols for discharge or for dry
39MENSTRUATION
Occurs 11-16 days after ovulation Plug has left
the cervix allowing flow of blood Start of next
cycle
40Billings Ovulation Method
4 Rules
3 Early Day Rules Peak Rule
41Early Day Rule 1
Avoid intercourse on days of heavy bleeding
during menstruation.
42Early Day Rule 1
Reason
Ovulation might occur quite early in the cycle
and menstrual bleeding could obscure mucus
43Early Day Rule 1
Ovulation can occur as early as day 5 Menstrual
bleeding would obscure beginning of fertile phase
44Early Day Rule 2
Alternate evenings are available for intercourse
when these days have been recognised as
infertile. (Basic Infertile Pattern)
45Early Day Rule 2
Reason
Seminal fluid on the day following intercourse
could obscure the mucus. It is important to allow
time for the seminal fluid to disappear and to
confirm the BIP is still present by avoiding
intercourse on consecutive evenings.
If the woman is lying down the fluid mucus that
leaves the cervix in the beginning of the fertile
phase, collects in the upper part of the vagina.
The woman needs to be in an upright position for
a few hours for this cervical mucus to make its
presence felt at the vulva.
46Early Day Rule 2
Alternate evenings are available for intercourse
when these days have been recognised as
infertile. (Basic Infertile Pattern)
47Early Day Rule 2
Alternate evenings are available for intercourse
when these days have been recognised as
infertile. (Basic Infertile Pattern)
48Early Day Rule 3
Avoid intercourse on days of discharge or
bleeding which interrupts the Basic Infertile
Pattern.
Allow 3 days of BIP afterwards before intercourse
is resumed on the fourth evening. Rule 2
continues
49Early Day Rule 3
Reason
Waiting will enable the woman to either recognise
the Peak in which case the Peak Rule is
used.
50Early Day Rule 3
Waiting will enable the woman to either recognise
the Peak in which case the Peak Rule is used, or
51Or when the change is an interruption of the BIP
caused by raised oestrogens, the hormonal level
will return to a basic low level and the woman
will recognise a return of the BIP.
She counts 3 days to enable the oestrogens to
settle at the basic low level, before resuming
intercourse applying Early Day Rule 2
52Early Day Rule 3
or when the change is an interruption of the BIP,
caused by raised oestrogens Allow 3 days of BIP
before intercourse is resumed on 4th evening
53Peak Rule
From the beginning of the 4th day past the Peak
until the end of the cycle, intercourse is
available every day at any time.
54Peak Rule
From the beginning of the 4th day past the Peak
until the end of the cycle, intercourse is
available every day at any time.
55Billings Ovulation Method
Observation of Patterns Fertility Changing,
developing pattern of variable length Infertility
Unchanging pattern
56Rules for achievement of Pregnancy
- Apply the Early Day Rules
- Postpone intercourse until the slippery
sensation occurs - Intercourse should occur over the time of
the slippery sensation and for one or two days
after
57Rules for postponement of Pregnancy
- Apply
- The Early Day Rules
- The Peak Rule
58Billings Ovulation Method
4 Rules
3 Early Day Rules Peak Rule
Can be used throughout all stages of reproductive
life
59Billings Ovulation Method
Effectiveness Recent trials have reported
effectiveness greater than 99 when the Method
guidelines were followed for avoidance of
pregnancy
Indian Council of Medical Research Task Force on
NFP (1995) Jiangsu Family Health Institute,
China (1997)
60Billings Ovulation Method
- Requirements
- Accurate Observations
- Accurate Charting
- Motivation
- Loving co-operation
61Billings Ovulation Method
- Benefits
- Accurate, scientific, simple method of
regulating fertility - Increases knowledge, understanding and of
respect for fertility - Joint responsibility
- Does no harm
- Develops couple communication and
relationships
62Billings Ovulation Method
Research began in 1953. Ongoing research has
confirmed validity of this safe, effective and
reliable method
Drs John and Evelyn Billings