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Fertil Steril. 2015 May;103(5):1319-25.e3. doi: 10.1016/j.fertnstert.2015.01.031. Epub 2015 Feb 24.

Self-identification of the clinical fertile window and the ovulation period.

Author information

1
Service de Biostatistique, Hospices Civils de Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Evolutive, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5558, Villeurbanne, France. Electronic address: rene.ecochard@chu-lyon.fr.
2
Service de Biostatistique, Hospices Civils de Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; Equipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Evolutive, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 5558, Villeurbanne, France.
3
C. T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
4
Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada.
5
Reproductive Health Research Institute, Pontificia Universidad Católica de Chile, Santiago, Chile.

Abstract

OBJECTIVE:

To assess the sensitivity and specificity of the self-identified fertile window.

DESIGN:

Observational study.

SETTING:

Not applicable.

PATIENT(S):

A total of 107 women.

INTERVENTION(S):

Women recorded cervical mucus observation and basal body temperature daily while undergoing daily ovarian ultrasound.

MAIN OUTCOME MEASURE(S):

The biological fertile window, defined as the 6 days up to and including the day of ovulation; and the 2-day ovulation window, defined as the day before and the day of ovulation.

RESULT(S):

The self-identification of the biological fertile window by the observation of any type of cervical mucus provides 100% sensitivity but poor specificity, yielding a clinical fertile window of 11 days. However, the identification of the biological fertile window by peak mucus (defined as clear, slippery, or stretchy mucus related to estrogen) yielded 96% sensitivity and improved specificity. The appearance of the peak mucus preceded the biological fertile window in less than 10% of the cycles. Likewise, this type of mucus identified the ovulation window with 88% sensitivity.

CONCLUSION(S):

These results suggest that, when perceived accurately, more accurate clinical self-detection of the fertile window can be obtained by identification of peak mucus. This may improve efforts to focus intercourse in the fertile phase for couples with fertility concerns.

KEYWORDS:

Fertile window; cervical mucus; fertility awareness methods; menstrual cycle; ovulation

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