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Billings Ovulation Method. Natural Fertility Regulation. Billings Ovulation Method. A natural way to: Achieve Pregnancy Postpone Pregnancy Monitor Reproductive Health. Billings Ovulation Method. easy to learn simple to use no drugs or devices no side effects - PowerPoint PPT Presentation
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Billings Ovulation Billings Ovulation MethodMethod
Natural Fertility RegulationNatural Fertility Regulation
Billings Ovulation Billings Ovulation MethodMethod
A natural way to:
Achieve Pregnancy
Postpone Pregnancy
Monitor Reproductive Health
Billings Ovulation Billings Ovulation MethodMethod
easy to learn
simple to use
no drugs or devices
no side effects
reliable
morally acceptable to all cultures
Male FertilityMale Fertility
Sperm production begins at puberty
Production of sperm continues throughout life
Female FertilityFemale Fertility
Begins from puberty
Cyclic – potentially fertile for approx 5-7 days
Finishes at menopause
++
== Couple FertilityCouple Fertility
THE FEMALE REPRODUCTIVE ORGANSTHE FEMALE REPRODUCTIVE ORGANS
THE OVARIES – whose function is the cyclic maturation of ova (eggs), produce hormones oestrogen and progesterone
FALLOPIAN TUBES – tubes through which sperm cells are assisted in their passage from the uterus to the ovum (egg)
FALLOPIAN TUBES – the fertilized ovum (embryo) is actively transported to the body of the uterus
THE UTERUS - the organ of the female in which the embryo implants and develops
ENDOMETRIUM – the inner lining of the uterus which is shed at menstruation
THE CERVIX – the neck of the uterus which bears the mucus-producing crypts
THE VULVA – the external parts of the female genital organs. It is the sensing organ for cervical mucus
THE VAGINA – the birth canal, the passage through which the baby is deliveredThe lining of the vagina has no glands
POCKETS OF SHAW – after ovulation, under hormonal control, mucus is dried as it passes through the vagina
Keeping a RecordKeeping 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
The woman will both feel and see the bleed as it arrives at the vulva
• ••
• •
wet wet wet sticky dry
• • • • • •• •
Sensation/Appearance of discharge
Menstruation, indicated by a red stamp or the symbol
Following menstruation cervix occluded with thick, dense plug of mucus
Plug prevents passage of sperm into cervix and protects body from infection
Sperm cells kept out in vagina quickly become incapable of fertilizing ovum and destroyed by surrounding cells
The ovaries are quiescent
Nothing leaving the cervix, vulva feels dry
• ••
• •
wet wet wet sticky dry dry dry dry dry dry
• • • • • •• •
| | | | |
DRY - nothing is felt, nothing is seen
Recorded with a plain green stamp or the symbol |
BASIC INFERTILE PATTERN (BIP)BASIC INFERTILE PATTERN (BIP)
UNCHANGING PATTERN - DRYUNCHANGING PATTERN - DRY
Discharge remains same day after day, cycle after cycle
Small fragments breaking off lower part of plug results in discharge
BASIC INFERTILE PATTERN (BIP) BASIC INFERTILE PATTERN (BIP)
UNCHANGING PATTERN - DISCHARGEUNCHANGING PATTERN - DISCHARGE
• ••
• •
wet wet stickydry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • •• •• • O O O
• ••
• •
wet wet wet stickydry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • • •• •• • = = = = =
• ••
• •
wet wet wetdry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • •• •• • = = = =
Basic Infertile Pattern of mucus remains the same day after day, cycle after cycle.
Initially recorded with white baby stamp or the symbol O
Then recorded with yellow stamp or the symbol = when pattern is seen to be unchanging
• ••
• •
wet wet stickydry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • •• •• • O O O
• ••
• •
wet wet wet stickydry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • • •• •• • = = = = =
• ••
• •
wet wet wetdry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • •• •• • = = = =
Basic Infertile Pattern of mucus remains the same day after day, cycle after cycle.
Three cycles are studied in order to identify correctly the point of change of sensation or appearance of the mucus or both
• ••
• •
wet wet stickydry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • •• •• • O O O
• ••
• •
wet wet wet stickydry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • • •• •• • = = = = =
• ••
• •
wet wet wetdry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
• • •• •• • = = = =
Basic infertile pattern of mucus remains the same day after day, cycle after cycle.
There is no entry of sperm into the cervix because of the plug of mucus
This unchanging pattern of infertility is common for many women
Ovaries are active and are producing oestrogen
Cervix is stimulated – fluid mucus is produced,this frees the plug, sperm can now enter cervix
oestrogen
• ••
• •
wet wet wet sticky dry dry dry dry dry drysticky
cloudy
• • • • • •• • | | | | | O
Change in sensation – no longer dry
Recorded with white baby stamp or symbol O
Ovaries are active and are producing oestrogen
Cervix is stimulated – fluid mucus is produced,this frees the plug, sperm can now enter cervix
• ••
• •
wet wet wetdry
slight mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
dryslight
mucus
moistcloudy
• • •• •• • = = = = O
Change in vulval sensation or appearance of mucus
• ••
• •
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery
• • • • • •• • | | | | | O O O O O O
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
CHANGING PATTERN OF FERTILITYCHANGING PATTERN OF FERTILITY
• ••
• •
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery
• • • • • •• • | | | | | O O O O O O
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
CHANGING PATTERN OF FERTILITYCHANGING PATTERN OF FERTILITY
THE PEAKTHE PEAK
• the last day of the slippery sensation
• associated with increased sensitivity and with swelling of the vulva
THE PEAKTHE PEAK
The ovary is now producing progesterone,preparing follicle to shed ovum (ovulation)
progesterone
oestrogen
• ••
• •
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery dry
• • • •• •• •
| | | | | O O O O O O I
• ••
• • X 1
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery dry
• • • •• •• •
| | | | | O O O O O O Ix 1
RECOGNISING THE PEAKRECOGNISING 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
Ovulation occurs on Peak day or days 1 or 2 after Peak
The ovum can live for up to 24 hours
DAY 1 to 3 PAST PEAKDAY 1 to 3 PAST PEAK
Cervix gradually closes with thick plug of mucus
Small channels remain through which sperm can travel
• ••
• • X 1
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery dry
• • • •• •• •
| | | | | O O O O O O Ix 1
The three days following the Peak are markedwith a numbered green or yellow baby stamp ora numbered symbol | or =
DAY 1 to 3 PAST PEAKDAY 1 to 3 PAST PEAK
• ••
• • X 1 2 3
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery dry sticky sticky
• • • •• •• •
| | | | | O O O O O O I = =x 1 2 3
THE LUTEAL PHASETHE LUTEAL PHASE
From the fourth day past Peak, cervix is closed
Sperm cannot enter
If not fertilized, the egg will have disintegrated
• ••
• • X 1 2 3
wet wet wet sticky dry dry dry dry dry drysticky
cloudywet
clearslippery
clear
slippery
clearstrings
slippery slippery dry sticky sticky sticky drydry
cloudydry
cloudydry
cloudydry
moistcloudy
dry dry dry dry
• • • •• •• •
| | | | | O O O O O O I = = = | = = = | = | | | |x 1 2 3
THE LUTEAL PHASETHE LUTEAL PHASE
Plain yellow or green stamps are now used or the symbols = for discharge or | for dry
Occurs 11-16 days after ovulation
Plug has left the cervix allowing flow of blood
Start of next cycle
MENSTRUATIONMENSTRUATION
Billings Ovulation Method
3 Early Day Rules
Peak Rule
4 Rules
Early Day Rule 1
Avoid intercourse on days of heavy bleeding during menstruation.
Early Day Rule 1
Reason:
Ovulation might occur quite early in the cycle and menstrual bleeding could obscure mucus
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
X 1 2 3
Date ____/____/___
• • • •••
0••
0••
0x
|1
|2
|3
| | | | | | | |
Description of Mucus: Sensation/ Appearance
Wet Wet Wet Wet
spotting
slippery
spotting
slippery
stretchy
spotting
slippery
clear
Peak
sw ollen
v ulv a
dry dry dry dry dry dry dry dry dry dry dry
Early Day Rule 1
Ovulation can occur as early as day 5 Menstrual bleeding would obscure beginning of fertile phase
Early Day Rule 2
Alternate evenings are available for intercourse when these days have been recognised as infertile. (Basic Infertile Pattern)
Early Day Rule 2
Reason:
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.
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.
•••
•• I I
X 1 2
Date ____/____/___
• • • •••
••
|
I0 |
I0 0 0 0 0 0 0
x|1
=2
Description of Mucus: Sensation/ Appearance
Wet Wet Wet Dry
spotting
Dry
spotting
dry w et
s.f.
dry w et
s.f.
no
longer
dry ,
sticky
cloudy
w et
cloudy
w et
cloudy
stringy
slippery
clear
stringy
slippery
clear
slippery
clear
Peak
sw ollen
v ulv a
dry sticky
opaque
Early Day Rule 2
Alternate evenings are available for intercourse when these days have been recognised as infertile. (Basic Infertile Pattern)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
••
•• I I I X 1 2 3 I
• • ••
••
=
I0 =
I0 =
I0 0 0 0 0
x=1
=2
=3
=
I= =
Wet Wet Wet Wet StickyCloudy
WetSF
StickyCloudy
WetSF
StickyCloudy
WetSF
DampCloudy
WetCloudyStrings
SlipperyClear
Strings
SlipperyClearSV
StickyThick
StickyLittle
DrySmear
StickyCloudy
WetCloudy
StickyCloudy
Early Day Rule 2
Alternate evenings are available for intercourse when these days have been recognised as infertile. (Basic Infertile Pattern)
Early Day Rule 3
Avoid intercourse on days of discharge or bleeding which interrupts the Basic Infertile Pattern.
Allow 3 days of BIP afterwards before intercourse is resumed on the fourth evening. Rule 2 continues
Early Day Rule 3
Reason:Waiting will enable the woman to either recognise the Peak in which case the Peak Rule is used……………….
•••
•••
X 1 2 3
• •••
••
| | | | 0 0 0 0 0 0
x
|
1
=
2
=
3
| |
Wet Dry
spotting
Dry
spotting
dry dry dry dry no
longer
dry ,
sticky
cloudy
w et
cloudy
w et
cloudy
stringy
slippery
clear
stringy
slippery
clear
slippery
clear
Peak
sw ollen
v ulv a
dry sticky
opaque
sticky
opaque
dry dry
Early Day Rule 3
Waiting will enable the woman to either recognise the Peak in which case the Peak Rule is used, or ……………………
Or 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
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
•••
•• 1 1 2 3 1 2 3
•••
••• 1 2 3
• • • •••
••
| | 0 0 0 |1
0 |1
|2
|3
| 0 |1
|2
|3
| | | | | | | • • •••
•••
|1
|2
|3
|
Wet Wet Wet w et Dry
spots
dry dry damp
y ellow
damp
y ellow
w et
thick
dry w et
clear
dry dry dry dry change
w et
clear
dry dry dry dry dry dry dry dry dry dry Wet Wet sticky
spots
sticky dry dry dry dry
Early 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
Peak 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.
X 1 2 3I I I I I
| 0 0 0 0 0 0x
|1
=2
=3
|
I=
I=
I= = = | | | |
I=
I=
dry no
longer
dry ,
sticky
cloud
y
w et
cloudy
w et
cloudy
stringy
slipperyclear
stringy
slipperyclear
slippery
clear
Peak
sw ollen
v ulv a
dry sticky
opaque
sticky
opaque
dry w et w et
cloudy
w et
cloudy
moist
cloudy
moist
cloudy
dry dry dry dry w et w et
Peak 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.
Billings Ovulation Billings Ovulation MethodMethod
Observation of PatternsObservation of Patterns
FertilityFertility
Changing, developing pattern of variable length
InfertilityInfertility
Unchanging pattern
Rules 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
Rules for postponement of Pregnancy
Apply
The Early Day Rules
The Peak Rule
Billings Ovulation Method
3 Early Day Rules
Peak Rule
4 Rules
Can be used throughout all stages of reproductive life
Billings Ovulation Billings Ovulation MethodMethod
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)
Billings Ovulation Billings Ovulation MethodMethod
RequirementsRequirements
• Accurate Observations
• Accurate Charting
• Motivation
• Loving co-operation
Billings Ovulation Billings Ovulation MethodMethod
BenefitsBenefits
• 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
Billings Ovulation Billings Ovulation MethodMethod
Research began in 1953. Ongoing research has confirmed validity of this safe, effective and reliable method
Drs John and Evelyn Billings