The headlines were foreboding indeed: “Why the rhythm method doesn’t work,” read one. “Ovulation: shock discovery,” said another. “Ovulation study rewrites science books,” said a third.
At the heart of them all was a study from the University of Saskatchewan that left headline writers dusting off cliches about the rhythm method and natural family planning experts shaking their heads in disbelief.
“Their discoveries are not new,” said Doreen Beagan, a long-time teacher of the Billings method of NFP and a board member of the national NFP organization WOOMB.
Newspapers breathlessly announced last week the “discovery” that women may be capable of ovulating several times a month, in apparent contradiction to the accepted wisdom that women release one egg per month.
The study, published recently in the journal Fertility and Sterility, reported that of 63 women studied for one month, ultrasound tests showed that in almost all of the women, follicle development occurred in waves two or three times during the cycle, meaning an egg was ready to be released. Follicles are the cells and fluid that surround eggs as they start to develop.
Beagan said NFP teachers and experts have long known (and taken into account) that the body can make several attempts to ovulate before ovulation actually occurs. An attempt at ovulation, she said, is just that: an attempt. “NFP researchers, teachers, and users recognize the signs of an attempt, as well as the signs of an actual ovulation … and indeed the signs of a cycle running out with no ovulation at all,” said Beagan.
Dr. James Brown of WOOMB said in a statement that the existence of “waves of anovulatory ovarian activity as described by the Saskatchewan study” has been known for decades and that natural family planning rules have been developed to allow for it.
A woman using NFP is taught to observe the physical signs of her body associated with such waves, and learns to distinguish it from true ovulation, he said. “This distinction is important because confusion between the two events could lead to mistakes in timing ovulation, and this applies both to the avoidance and achievement of pregnancy,” since many couples use NFP to enhance their chances of conceiving.
Dr. Brown said he welcomes further research on the subject, but the study’s findings are “grossly in error” when they indicate that fertile ovulations can occur more than once on different days during the menstrual cycle.
From observing millions of women using NFP and studying approximately 10,000 ovarian cycles in a large spectrum of women (the Saskatchewan study was based on a study involving 63 women), Dr. Brown said, “We can state that once ovulation has occurred, another ovulation cannot occur” in the interval before the woman’s next period.
Even the Saskatchewan study, he said, indicated that all the women released only one egg during the study cycle and the only two who appeared to ovulate more than once had abnormal (infertile) cycles.
Natural family planning methods that make use of a woman’s natural cycles, unlike methods of contraception, are approved by the Catholic church for couples who, for good reason, have chosen to avoid pregnancy. Most news accounts of the study also took the opportunity to toss jibes about the unreliability of “so-called natural family planning methods.”
Typical was Bruce Murphy, a biologist studying reproduction at the University of Montreal, who said, “It really gives us a new idea about how the menstrual system works. It may explain why my mother had four kids using the rhythm method.”
Unquestioning journalists not only didn’t challenge the reference to a means of birth control that has been outdated for decades, they also were happy to provide space for quips about people who use NFP. “We all know people trying to use natural family planning, and we have a word for those people. We call them parents,” Dr. Roger Pierson, director of the reproductive biology research unit of the University of Saskatchewan, joked.
The report’s emphasis on the assumed possibility of more than one ovulation on different days during a woman’s cycle “reflects the unwarranted hostility of the authors, the Journal, and the current official opinion to natural family planning,” said Dr. Brown. Indeed, several observers said the report indicated a preconceived bias toward assisted-reproduction technology and contraception. The possibility that the researchers could be looking for funding for in-vitro fertilization programs was also raised.
Meanwhile, NFP proponents pointed to the fact that China has successfully used the Billings method with millions of women. Shao-Zhen Quian of the Academy of Sciences in Shanghai has called it the “simplest and most consistently effective” method, artificial or natural, of preventing births.
Sue Fryer, director of the Billings Centre in Maple Bay on Vancouver Island, said a Chinese study in which thousands of women were followed for more than a year observed a pregnancy rate of less than one per cent.
Responding to Dr. Pierson’s comment that his discovery left him “flabbergasted,” Fryer said, “What is ‘flabbergasting’ is that a doctor who heads a university reproductive biology research unit has no more knowledge of natural family planning than the rhythm method, a technique that was outdated 50 years ago!”
Coquitlam biochemist Christian Lemay said that, rather than discrediting NFP, the study actually puts the birth control pill into question, since the pill’s use is “based on an incomplete understanding of the reproductive cycle it is trying to control.”
Several people agreed the study could actually serve to promote NFP, which simply uses “available data and doesn’t try to ‘control’ anything,” said Lemay.
In Australia, the couple who developed the Billings method, John Billings and his wife Lyn, called the study “nonsense.” “It’s absolutely impossible for two ovulations, or more ovulations, to occur in a cycle on different days,” said John Billings.