The Marquette Method: Tech Savvy Fertility Awareness

by Sep 22, 2020

Women have used the knowledge of their natural cycles since ancient times (Kippley, 2016). Over the past century or so more attention has been given to using fertility knowledge to avoid pregnancy naturally. Many familiar natural family planning or fertility awareness-based methods were developed between the 1930s through the 1970s. Methods were refined or reworked over the years, but for a long time not much had changed.

A couple hugging

That is, until 1999 when researchers at Marquette University in Milwaukee, Wisconsin got creative with technology!

The Marquette Method uses an electronic home fertility monitor to help couples identify their fertile window. Electronic fertility monitors are usually marketed towards couples who were trying to get pregnant. The Marquette Method of natural family planning uses the same technology to help women avoid pregnancy as well! Using home hormone tests opened up a whole new way for women to understand their cycles. The Marquette Method is evidence-based, effective, and often easier to use than other fertility-based methods.

How does it work?

Imagine: you’ve been tracking your fertility signs, but you still are not confident you’ve got it right. Maybe you work at night and your temperatures are hard to capture. Maybe you just are not sure if you understand your cervical mucus well enough to find your peak day. The Marquette Method adds in straight-forward measurement of fertility hormones to help you find your fertile window. No more guessing!

The Marquette Method was originally designed to work with the ClearBlue Fertility Monitoring System. ClearBlue is designed to detect urinary estrogens and luteinizing hormone (LH). These hormones rise you when your body is preparing for ovulation (estrogen) and when you actually do ovulate (LH). The monitor reads “low,” “high,” or “peak” depending on your hormone levels. On days with a “high” and “peak” reading, sex is more likely to result in pregnancy. A “peak” reading is a highly reliable sign of ovulation. With Marquette, you have options. You can use the monitor readings alone or you can combine your monitor results with other symptoms like cervical mucus. Many people feel more confident when using the fertility monitor to identify ovulation.

With Marquette, once you get your first peak reading it will be followed by another “peak” then “high,” “low,” “low” (PPHLL). After the PPHLL pattern, it is likely that you have ovulated, and the egg has passed. Once ovulation occurs and the egg is gone, you cannot get pregnant until your next cycle. If you are trying to avoid pregnancy, you can resume intimacy the day after the PPHLL pattern is complete. You can use all days until the next cycle begins (first day of your period) with minimal chance of pregnancy! Whether or not you can use pre-ovulation “low” days for intimacy when avoiding pregnancy depends on your personal situation. Factors like your cycle length, being postpartum, or having a serious need to prevent pregnancy might change how you use the method. The Marquette Method has different algorithms you can follow based on your personal situation.

Learning the Method

The best way to learn The Marquette Method is with a trained instructor. The Marquette Method is unique because it is only taught by healthcare providers. To become a certified instructor, you must first be a registered nurse, advanced practice registered nurse, physician assistant, or physician. Instructors complete training through Marquette University and are specially prepared to help women or couples gain confidence with the method. Because your instructors are health care professionals, they also take special steps to protect your privacy. Usually, your instructor will offer support over a six-month period or more as you get used to using the method. You can talk to them about your cycle and ask questions if you have a hard time with something!

Does Marquette Method Work?

When couples use the Marquette Method exactly according to the “rules” there is a 0.6%- 2.1% unintended pregnancy rate over a 12-month period (Fehring et al. 2008). This is as good as many hormonal methods of contraception that are considered “highly reliable.” Typical use is how the general population might use the method, including when they make mistakes and times when they decide to bend the rules. With typical use for Marquette is about 88%-94% effective (Fehring & Mu, 2013). The Marquette Method also has been shown to increase satisfaction among people who use natural family planning methods to avoid pregnancy (Fehring et al., 2008).

Do I Have to Use the ClearBlue Monitor?

The original research and algorithms for the Marquette Method use the ClearBlue Fertility Monitor. Some features of the method are specific to how the ClearBlue monitor works. We do not know yet how well other new fertility monitors might work with the same method rules or if the rules might have to be adapted. A recent study compared Wondflo urine LH hormone test sticks to the electronic hormone monitor using the same Marquette algorithms (Barron et al., 2018). Findings showed women did not have to be using the ClearBlue monitor. They could use urine test sticks with good results as well. Even though this study sample was small, it suggests that other home fertility hormone monitors could be used successfully with Marquette. More research is needed to help us understand how different urine hormone monitors can be used to support natural family planning.

Drawbacks of Marquette Method

  • Monitors and test sticks can be expensive (about $200 to start, $27-$40 per month)
  • Getting professional instruction and support adds to cost
  • It takes several months to learn the method. You may have to abstain more at first.
  • Sometimes the monitor misses your peak depending on when your hormones change
  • ClearBlue doesn’t give a hormone level, just “low, high or peak”

Benefits to the Marquette Method

  • Increased confidence that you’ve found your peak day
  • Monitor readings are easier to understand than body signs or self-read urine tests
  • Highly effective when you follow the rules of the method
  • Special algorithms to fit your life circumstances, like when you are post-partum
  • Instructors are also medical professionals with a deep understanding of fertility
  • Online communities exist for ongoing peer-support

To learn more about the Marquette Method visit The University of Marquette Institute of Natural Family Planning.

This article is for informative purposes only and is not medical advice. Please talk to your primary care provider if you have specific medical needs.

Written by Lucy McNamee, RNC-OB
References

Barron, M. L., Vanderkolk, K., & Raviele, K. (2018). Finding the fertile phase: Low cost luteinizing hormone sticks versus electronic fertility monitoring. Wolters Kluwer Health Inc., 43(3), 153–157.

Fehring, R. J., & Mu, Q. (2013). Cohort efficacy study of natural family planning among   perimenopause age women. Journal of Obstetric Gynecologic & Neonatal Nursing, 43(3), 351-358. doi:10.1111/1552-6909.12307

Fehring, R. J., Schneider, M., & Barron, M. L. (2008). Efficacy of the Marquette Method of natural family planning. The American Journal of Maternal/Child Nursing, 33(6), 348–354. https://doi.org/10.1097/01.NMC.0000341254.80426.32

Fehring, R. J., Schneider, M., Raviele, K., & Barron, M. L. (2007). Efficacy of cervical mucus observations plus electronic hormonal fertility monitoring as a method of natural family planning. Journal of Obstetric, Gynecologic & Neonatal Nursing, 36(2), 152–160. https://doi.org/10.1111/j.1552-6909.2007.000129.x

Kippley, J. F. (2016). A Short History of Natural Family Planning. http://www.nfpandmore.org/A%20Short%20History%20of%20Natural%20Family%20Planning%20.pdf#:~:text=Call%20it%20the%20first%20form%20of%20systematic%20natural,farm%20animals%20might%20be%20duplicated%20in%20%20humans.

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