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A woman whose menstrual cycles ranged in length from 30 to 36 days would be estimated to be infertile for the first 11 days of her cycle (30-19=11), to be fertile on days 12–25, and to resume infertility on day 26 (36-10=26). When used to avoid pregnancy, such fertility awareness-based methods have a typical-use failure rate of 25% per year. [18]
Menstrual cycle. The menstrual cycle is on average 28 days in length. It begins with menses (day 1–7) during the follicular phase (day 1–14), followed by ovulation (day 14) and ending with the luteal phase (day 14–28). [1]
The days in which a woman is most fertile can be calculated based on the date of the last menstrual period and the length of a typical menstrual cycle. [4] The few days surrounding ovulation (from approximately days 10 to 18 of a 28-day cycle), constitute the most fertile phase.
The ovarian cycle consists of the follicular phase, ovulation, and the luteal phase; the uterine cycle consists of the menstrual, proliferative and secretory phases. Day one of the menstrual cycle is the first day of the period, which lasts for about five days. Around day fourteen, an egg is usually released from the ovary.
When a woman takes COCP, the hormones in the pills prevent both ovulation and shedding of the endometrium (menstruation). Traditionally, COCPs are packaged with 21 active (hormone-containing) pills and 7 placebo pills. During the week of placebo pills, withdrawal bleeding occurs and simulates an average 28-day menstrual cycle.
Or, a calendar rule may require calculation, for example holding that the length of the pre-ovulatory infertile phase is equal to the length of a woman's shortest cycle minus 21 days. [32] Rather than being tied to cycle length, a calendar rule may be determined from the cycle day on which a woman observes a thermal shift.