Science of Fertility

For most of her reproductive life, a woman will experience fertile ovulatory cycles. However, all women will experience infertile variants of the ovulatory cycle, particularly during breastfeeding, approach of menarche and menopause, periods of stress, andduring and after hormonal contraception. The hormone patterns and therefore the symptoms in these infertile cycles differ from the fertile ovulatory cycle. Recognizing these variants is particularly important for pregnancy achievement.

Ovulation -the release of an ovum by the ovary and therefore the only timeduring the cycle when the ovum is exposed for fertilization–is the central event ofthe fertile ovarian cycle. It determines the time when pregnancy can occur from an actof intercourse which is the period of 3-4 days (rarely 5-6 days depending on thecervical mucus) before ovulation determined by the fertilizing life span of the spermand up to 24 hours after ovulation determined by the fertilizable life span of the ovum.Outside this time period a woman cannot conceive from an act of intercourse nomatter how hard she tries. Even within this time period, pregnancy from an act ofintercourse is not a certainty, the chances vary depending on the couple and the timingof intercourse in relation to ovulation. Maximum fertility is reached during the periodof 24 hours before ovulation and several hours afterwards. If the chances of pregnancy at this time are 70% per cycle, it takes two cycles for 90% of couples havingintercourse on the most fertile day to achieve pregnancy. If the chances at the beginning of the fertile period are 10% per cycle, it takes 24 cycles for 90% of coupleshaving intercourse at this time to achieve pregnancy

Natural fertility regulation (NFR) methods could provide family planning (avoiding or achieving pregnancy) naturally through conforming to the women’s reproductive cycle without the use of drugs or devices. NFR originated about 60 years ago from the rhythmic method, but this method was not scientifically based. Its deadly shortcoming is the prediction of the coming events on the basis of the past rhythm is therefore destined to be inaccurate with a failure rate of more than 20%. A milestone in the NFR study is the discovery of the intrinsic relationship between the cervical mucus, the hormonal balance and the fertility status of women by the Billings group. It was shown that the changes in the cervical mucus correlated with the sex hormone levels in the women, thus the fertile status could be determined by observing the characteristics of the cervical mucus at the vulva. In this way the Billings Ovulation Method (BOM) overcomes the fatal weakness of early natural family planning methods in predicting the current events on the basis of past happening, and lays the foundation of scientific NFR research.

Rock solid science starts with rock solid scientists who have a strong desire to seek answers, reasons and explanations not just for their subject of interest but for many things that surround them. The scientists involved in the development of the Billings Ovulation Method® were Drs John and Evelyn Billings and Professors Emeritus James Brown and Erik Odeblad. What started as a collaboration between scientists became a life-long friendship.

This paper is a tribute to outstanding research about the Billings Ovulation Method®: it is a fact that Billings Ovulation Method® has been subjected to more scientific research of the highest standard than any other method of regulating fertility, natural or otherwise, and it is now essential knowledge for the medical profession.

The late respected director Anna Cappella was a tireless and passionate supporter of the Billings Ovulation Method®, as well as a friend and collaborator of Drs John and Evelyn Billings: the Centre on Natural Fertility Regulation (NFR) was born, from their partnership, at the Catholic University of the Sacred Heart in Rome, where couples have searched and found qualified professional advice on this Natural Method and a careful approach to the values of the person, respectful of the ethical issues related to the answers and reasons of the Magisterium with regard to sexuality and fertility.

Fertility is a transient biological state that depends on the fertility potential of the couple. During a women’s lifetime, the ovary will go through different states of hormonal secretion and ovulation. The concept of the ovarian cycle as a continuum considers that all types of ovarian activity encountered during the reproductive life are normal responses to different environmental conditions in order to ensure the health of the mother and child.

In the 30 years fertile life of women, only a few days in each cycle are fertile and the rest of the time is infertile. People of insight have long considered making use of this natural phenomenon to regulate fertility. Early methods of natural family planning (rhythm, basal body temperature, symptothermal, etc.) are unsatisfactory for fertility regulation and the Chinese people did not accept them. In the early 60’s, Drs. J.J. and E.L. Billings and their colleagues discovered the interrelationship between the cervical mucus and the cyclic changes in the ovarian hormones and fertility and alleged the use of mucus symptom as the main index of ovulation and fertility applicable to all phases of female reproductive life. This is a milestone in the study of natural family planning.

An introduction to, and some new, anatomical and physiological aspects of the cervix and vagina are presented, and also an explanation of the biosynthesis and molecular structure of mucus.

The history of my discoveries of the different types of cervical mucus is given. In considering my microbiological investigations I suspected the existence of different types of crypts and cervical mucus and in 1959 I proved the existence of these different types.

The life of a new organism of the human species starts at the moment of fertilization. This is when the sperm and oocyte plasma membranes fuse. The ovarian continuum begins at fertilization, when the zygote starts its development.

Until now, a biological dogma has been that all sex differences in the brain arise from differences in the gonadal secretions. It has recently been demonstrated that the whole genome of males and females seems to be different; not only are the sexual chromosomes different, but also autosomes have a major role in sexual differentiation. For our purposes this will be very important to keep in mind, because during this lecture I would like to invite you to look at ourselves the way we were created. I would also like to invite you to look at the many instances by which this creation can be distorted.

The title of this presentation contains two words which we must discuss a little, namely Fertility and Awareness. In the present context the word Fertility means the capacity to produce offspring. This capacity is, as we know, different for women and men. In a broad sense women have a cyclically varying fertility from puberty to menopause, while men are fertile from puberty onwards for the rest of their lives. The Fertility which is the subject for this presentation is mainly the normal cyclically varying capacity to conceive in women. To be fertile a woman has to have a mature egg cell available for conception and implantation, and hopefully carry the offspring until delivery. The other word, Awareness, means that a woman can know when she possesses this capacity. Human beings have existed for a long time, andwe may speculate that perhaps people have once had some natural feelings about the fertile periods in women. We know nothing about this in prehistoric and early historical time, and when people started to write in early times, this was probably restrictedto men only. Who has heard about a woman Hippocrata or a woman Aristotela?