Overview of NFP Methods

Which Method is Best?

You may be tempted to ask yourself, "Which method is the best?" The answer is that no method is the "best" for everyone. Because each of the methods is vastly different and each woman's body and personality are vastly different, it is impossible to direct everyone into the same method. There are basic criteria that you can consider when choosing a method of NFP. The most important considerations are whether or not the woman has any underlying medical conditions and also her (and her husband's) lifestyle and personality. Some methods will not work (or be less effective) if a woman has specific underlying medical conditions or if she has lifestyle/personality considerations. The most common example of a medical situation is that of Polycystic Ovarian Syndrome (PCOS). Women with this condition often have excess amounts of the hormone estrogen in their bodies and limited amounts of progesterone in their bodies. If a woman with this condition uses the Sympto-Thermal or Marquette Methods, then the method could fail to show any change in fertility. If the woman is using Sympto-Thermal then she could have continuous mucus and no Basal Body Temperature shift. This will make it appear as though she is always fertile (which she is not). If a woman with this condition uses the Marquette Method, then the urine sticks and mucus observations could show continuous fertility (which is impossible). Another common situation can be found in women who have depression and/or anxiety. Methods like Billings and Creighton have a more demanding observational routine than a method like Marquette (monitor only instructions). These women could find themselves overwhelmed or unable to stick to the observational routine necessary to ensure high efficacy which can cause further depression or anxiety. While it is not always the case that a woman with PCOS would have difficulty in using Sympto-Thermal or Marquette methods, or that a woman with depression/anxiety could face challenges charting with Billings or Creighton methods, these are factors that the woman/couple needs to be made aware of before taking on the time and/or cost associated with learning one of these methods. Couples who find themselves in methods that do not "work" the way they were told it would work tend to have a great deal of frustration, anxiety and eventually come to believe that NFP doesn't work at all when, in reality, they may just be using a method that doesn't work for them. Couples deserve to have information like this as part of their discernment. Some couples may choose to try one of these methods despite the fact that it may not work as well, but it is important that they have the information as part of that discernment. There are other examples like this that can be applied to other methods so it is important that if a woman/couple has underlying mental health, gynecological or thyroid issues or an autoimmune disorder, someone is available to guide them through these challenges. Please contact Jenny Ingles for help with this.

The second point that must be considered is the reason the woman/couple wants to use NFP, even if that reason is going to change in the future.  If there are no underlying medical conditions and the couple is just looking to discern family size, then any method they choose will likely work.  However, if the woman has serious medical conditions in which pregnancy could result in death, then choosing a method with a higher effectiveness rate at avoiding pregnancy may be more prudent. If they are facing infertility, then the only method that has been studied and is effective at treating infertility other than PCOS is the Creighton Model. If they are looking for the "easiest" method to use, then more questions are needed because what is "easy" for one woman to track is not "easy" for another. For example, some women find it very easy to take their temperature at roughly the same time each day while women with erratic work schedules may find that impossible.

The third point that must be considered is how strongly the couple can adhere to what is required to use the method.  For example, the Creighton Method requires an observational routine that some women simply will not participate in. The Sympto-Thermal Method requires that the woman wake up at roughly the same time every day to check her temperature and some women are not willing to do that on weekends or holidays. These are points that the couple needs to discern for themselves.

This overview is designed to help answer some of these basic questions. The methods are in alphabetical order and are bullet-pointed for easy assessment. At the bottom of the page, there is a chart with the methods lined up side-by-side for quick comparison. If you need further assistance, contact Jenny Ingles to assess your specific situation.

But before jumping into method specifics, the following aspects are important to note:

• All the presented below:
  • are 99% Effective in avoiding pregnancy (Theoretical Use)
  • Have an App
  • Can be learned Online (Virtually or Self-Paced)
• Mucus is classified as standardized when it is defined in a manner where the viscosity, clarity and lubricative qualities can be quantified for diagnostic and therapeutic use. 
• "Treatment of infertility" means that the method, itself, has protocols that have been studied and the method teachers are trained to implement outside of the need to see a doctor. Each of the methods can be used by a doctor (who is trained to do so) to help diagnose infertility. Just because a method cannot treat infertility, does not mean the method isn't helpful in discovering the underlying cause of infertility.

The Billings Ovulation Method

• Tracks and Measures Cervical Mucus
• 93% Actual Use Effectiveness Rate in avoiding pregnancy
• 88% Actual Use Postpartum Effectiveness Rate in avoiding pregnancy
• Cervical Mucus Observations not standardized
• Can be used if the woman has PCOS
• Can be used to treat infertility in cases of PCOS
• May be less effective:
  • If the woman has certain gynecological conditions

The Boston Cross Check Method

• Basal Body Temp (BBT), Cervical Mucus, and Urinary Hormones are biomarkers tracked
• Cervical Mucus Observations not standardized
• Additional, one time cost for monitor
• Ongoing cost for monitor strips
• Does not treat infertility

The Creighton Model FertilityCare System

• Tracks and Measures Cervical Mucus
• 96.8% Actual Use Effectiveness Rate in avoiding pregnancy
• No effectivness data for Actual Use Postpartum Effectiveness Rate 
• Cervical Mucus Observations are standardized
• Spanish Instruction available in-person and virtual
• Can be used regardless of medical conditions the couple may have
• Can be used to treat certain types of infertility
  • Up to 40% Effective in treating infertility without seeing a doctor
• Employs NaPRO TECHNOLOGY for treating gynecological conditions and infertility
  • Up to 80% Effective in achieving pregnancy in infertility couples

The Marquette Method

• Hormones of Estrogen and Luteinizing Hormone are detected in urine as primary bio-marker
• Uses cervical mucus as secondary bio-marker (Optional - In addition to the hormone monitor or as a stand-alone bio-marker)
• 92-98% Actual Use Effectiveness Rate for avoiding pregnancy*
• 84 - 92% Actual Use Postpartum Effectiveness Rate for avoiding pregnancy*
• Cervical Mucus Observations not standardized
• May be less effective:
  • If the woman has PCOS, Estrogen Dominance or gynecological conditions that affect hormones
• Additional, one time cost for monitor
• Ongoing cost for monitor strips
• Does not treat infertility

*Effectiveness rates are determined by how the couple uses the method. Options are "Monitor Only", "Monitor plus Mucus" and "Mucus Only

The Sypto-Thermal Method

• Basal Body Temp (BBT) and Cervical Mucus are Primary Biomarkers
• Cervical Position as a Secondary Biomarker
• 93% Actual Use Effectiveness Rate in avoiding pregnancy
• 88% Actual Use Effectiveness Rate in avoiding pregnancy when BBT is not used
• No effectivness data for Actual Use Postpartum Effectiveness Rate 
• Method for classifying mucus is not standardized
• Spanish Instruction available in-person and virtual
• May be less effective:
  • If the woman has irregular waking/sleeping patterns
  • If the woman has PCOS, Estrogen Dominance or gynecological conditions that affect hormones
• May experience longer periods of abstinence if the woman has long cycles and continuous mucus – Seek assistance from a trained teacher to help alleviate this issue
• Does not treat infertility

The chart below is intended to help couples find an NFP method that fits their needs. If you have questions, then please contact Jenny Ingles for more information.

⁰ Effectiveness Rate of Avoiding Pregnancy

† May cause inaccuracies in Basal Body Temperature which reduces the Effectiveness Rate at avoiding pregnancy to 88%  

≠ PCOS is associated with Estrogen Dominance which may cause inaccuracies in Estrogen Hormone strips

** gynecological conditions that cannot be treated with Creighton can be treated with the assistance of a NaPRO doctor and Creighton

‡ This method can be used during Breastfeeding; however, there is no data regarding the effectiveness at avoiding pregnancy available

ʬ Teaching hours are based on how the specific method is taught and how it schedules an introdcution and follow-ups. The hours are broken up over the course of multiple sessions in all of the methods.  Some couples require more teaching hours in order to gain system mastery