Book Review: TAKING CHARGE OF YOUR FERTILITY by Toni Weschler

​My path to becoming a birth worker started with Clomid.

Clomid is an ovulation-stimulating drug. After a year of trying for a baby, normal test results, and a diagnosis of “unexplained infertility,” my OB prescribed Clomid to increase our chance of becoming pregnant.

The good news? It worked! The second month of taking Clomid, I conceived two babies—my wonderful twin daughters. My husband and I were ecstatic that our dream of becoming parents was coming true! I love these sweet girls and their twin bond and am so grateful they came to our family when they did.

The bad news? This approach to fertility treatment did nothing to help my confidence or trust in my body. After a few blood tests that ultimately didn’t turn up any real reasons for infertility, my doctors stop trying to find a “why” and just moved ahead with a “Band-Aid” approach. I was already regularly ovulating each month, but my OBs figured that if I ovulated more eggs, there’d be a higher chance of me getting pregnant each cycle. They weren’t wrong.

But I started my pregnancy feeling broken and confused. And I’m confident this affected the choices I made during their birth.

After my twins were born and we were ready to start trying for another baby, I really wanted to figure out why it had been so hard for us to conceive. Turns out, trying to get pregnant the second time wasn’t really any easier.

But I had a thirst to try to figure out why. One day, I was reading an email newsletter and saw that a local fertility educator was hosting a free one-hour workshop on fertility awareness. I really had no idea what that meant, but I knew I wanted to be more aware of my fertility, so I went to the workshop.

It was eye-opening. The teacher talked about all of the signs our bodies give us to indicate how fertile we are at different phases of the menstrual cycle. I had heard about temperature charting—and had it dismissed offhand in a doctor’s appointment as something that didn’t actually work! But I had no clue about the other cues she was talking about: cervical position, firmness, openness, fluid, vaginal wetness, and more! I got my hands on a copy of Toni Weschler’s Taking Charge of Your Fertility and dove in.

TAKING CHARGE OF YOUR FERTILITY: AN OVERVIEW

Taking Charge of Your Fertility is a comprehensive book that describes fertility signs, how to identify them in your own body, and how to use this knowledge to either avoid or achieve pregnancy and be informed and empowered about your own body. The book begins with a review of the current common options for birth control and bodily awareness that are offered for women: the long list of birth control options and their accompanying side effects do nothing to help us take charge of our own fertility, and they leave us with a long list of negative side effects!

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​The Menstrual Cycle

​Weschler then offers a detailed overview of female and male internal and external reproductive anatomy. With that groundwork laid, she describes the menstrual cycle in detail, including the hormones that trigger each phase.

In the first portion of the menstrual cycle, Follicle Stimulating Hormone encourages the maturation of 15 to 20 eggs in each ovary. The follicles that hold each egg produce estrogen as the eggs continue to mature. Eventually, when your body reaches an estrogen threshold, the most dominant follicle that cycle releases an egg, and the others disintegrate. This can happen anywhere from day 8 to day 21 or later in your cycle. As your estrogen levels peak, this also triggers a surge of Luteinizing Hormone (LH), which causes the mature egg to pass through the ovarian wall. This is called ovulation. After ovulation, fimbria (little fingers at the end of the fallopian tubes) gather the egg and carry it from the pelvic cavity into the fallopian tubes. The follicle that released the egg becomes the corpus luteum and releases progesterone for 12-16 days. This hormone stops the other follicles from releasing their eggs, induces thickening of the endometrium (inner lining of the uterus), and triggers a shift in basal body temperature, cervical fluid, and cervical position. If the egg becomes fertilized and burrows into the endometrium (lining of the uterus), your body starts producing HCG, which signals for the corpus luteum to continuing releasing progesterone so that the uterine lining doesn’t disintegrate and shed itself during menstruation, as it does in cycles that don’t result in pregnancy.

If you’re like me, after getting to this point in the book, you’ve probably learned 10 times what you’ve ever been taught about anatomy, fertility, and menstruation. And we’ve only covered the first tenth of the content of Taking Charge of Your Fertility! (I won’t go into as much detail about the content of the rest of the book in this blog post.)

The Three Primary Fertility Signs

After gaining a firm understanding of your anatomy and menstrual cycle, you’re ready to learn about how you can take charge of your fertility, by learning about, identifying, and charting the three primary fertility signs: cervical fluid, basal body temperature (or waking temperature), and cervical position.

There’s so much more detail for each of these signs than I’ll be able to give here (which is why Toni Weschler wrote a 400 + page book about it!), but let me give you a quick overview.

Cervical Fluid: Your cervical fluid, which presents itself to you as vaginal discharge, changes consistency throughout your cycle. The consistency of your cervical fluid is a big clue as to whether you’re in the fertile portion of your cycle. Everyone’s fluid is slightly different, and it may take you a while to identify your pattern at what influences it, but here’s the general pattern: at the beginning of your cycle, you have menstrual discharge. When that ends, you may have a few days of vaginal dryness, and then you’ll likely start to have some secretions that are sticky. With this type of discharge, you’re potentially fertile, but it’s unlikely that sperm would survive in this type of fluid.  

After a few days (it’s different for everyone and can vary from cycle to cycle), your cervical fluid will likely become more wet and creamy or slippery. You’re more fertile when your cervical fluid is creamy.

Then, your cervical fluid starts to resemble eggwhites: it stretches and is clear, and creates a lubricative vaginal sensation. This eggwhite-quality cervical fluid indicates that you’re in the most fertile part of your cycle. If you’re hoping to get pregnant, take advantage of this time! If you’d rather not, use barrier method birth control or abstain from intercourse during any pre-ovulatory days with cervical fluid of any consistency.

After ovulation, as estrogen levels drop, cervical fluid tends to dry up quickly, and progesterone kicks in as the primary hormone of your menstrual cycle.

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Basal Body Temperature (Waking Temperature): As hormones rise and fall during your cycle, your basal body temperature shifts in response. During the first part of your cycle, pre-ovulation, your temperature will be lower, around 97.0 to 97.7 degrees Fahrenheit. After you ovulate and progesterone is the primary hormone of your cycle, your temperatures will shift and remain higher throughout your cycle, with an average basal body temperature of about 97.8 degrees.

Tracking basal body temperature is pretty easy, but there are a few things that make it even easier—nearly effortless! In order to ensure that your temperature is accurate, you’ll need to use a thermometer that is accurate to the tenths place. Choosing one that is specifically marketed as a “basal body thermometer” will ensure this accuracy. Typically, you must also take your temperature at about the same time every day, before getting out of bed, and after three hours of uninterrupted sleep. As a mom and doula, I know that regularly aligning those three requirements can be tricky! Personally, I’ve opted to use TempDrop, a wearable thermometer that has uses an algorithm to account for sleep disturbances or inconsistencies. I just put on the armband when I go to bed, take it off when I wake up, and sync it to the app on my phone, which uploads my temperature data to a graph on the app and makes it easy to see when I’ve ovulated and my temperature has risen! If you opt for a different thermometer, there are several other apps that will chart your temperatures for you, such as Femometer, CycleProGo, and many others. They also offer places to write notes and keep track of your cervical fluid quality and cervix position, firmness, and openness, as well as any other notes that may impact your fertility (illness, stress, etc.). I started charting my cycle years ago with pen and paper, and let me tell you, these apps are game changers!

Cervical Position: Weschler describes cervical position as an optional sign gives more information about how fertile you are at different signs of your cycle. To remember the cervix’s position during fertile times, Weschler introduces the acronym SHOW. When you’re in a fertile phase of your cycle, your cervix becomes Soft, High, Open, and Wet. (You can imagine that this would create an ideal environment for sperm to pass through to achieve pregnancy!)

Applying Your Fertility Knowledge
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After describing each of these signs, Weschler gives detailed instructions on how to observe each of them within your own body, and how to chart or keep track of them. As you put these principles into practice, you’ll be able to gain valuable information about your own body and use this information to help you achieve or avoid pregnancy. Throughout the rest of the book, Weschler describes various circumstances during which you may not ovulate (adolescence, breastfeeding, PCOS, etc.). She gives information about how to use fertility awareness to avoid pregnancy and to help become pregnant. Beyond avoiding or achieving pregnancy, she discusses how an increased awareness of your fertility is helpful in staying informed about your gynecological health, appreciating your sexuality, navigating PMS and menopause, and enhancing your sense of self-esteem and self-efficacy. In short, fertility awareness is useful throughout your life!

After the primary content of the book, Toni closes with tons of helpful appendices, ranging in topic from using fertility awareness while breastfeeding, troubleshooting hard-to-read basal body temp charts, how to research fertility clinics, and much more!

Last Thoughts

This blog post has been a (comparatively) brief overview of how to better understand your body’s fertility cues, which you can use to avoid or achieve pregnancy. But it’s not comprehensive! I hope you feel empowered by the information you’ve read here, and that you’re motivated to go and learn more! Especially if you’re using fertility awareness to avoid pregnancy, I highly recommend that you get your hands on a copy of Taking Charge of Your Fertility and get familiar with all of the details that I didn’t go into here! (I have multiple copies in my Lending Library!) I also recommend that you take several months, off of hormonal birth control, to get familiar with your body and your fertility signs. If it’s not something you’ve been used to paying attention to, it can take some time to read your body’s cues. So use a barrier method of birth control while you’re learning!

If you’re using this information to become pregnant, you’ll still learn a lot from reading Taking Charge of Your Fertility. The things you’ll learn will help you navigate fertility challenges, time your pregnancy, and be confident in your estimated due date based on your unique cycle and day of ovulation.

Whatever your circumstance, I can’t wait for you to learn more!

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