By Haley Moris
Introduction
Elizabeth* is a close friend I have known since the beginning of high school. While interviewing her as part of the FACTS elective in fertility awareness, I had the opportunity to meet her 2-week-old baby boy! It is a surreal experience seeing your childhood friend become a mother, and I have loved walking through several phases of life with her.
Before getting married, Elizabeth and her husband met with a fertility coach trained in the Marquette Model. For faith-based reasons, they wanted to learn how to use a fertility awareness-based method (FABM) to avoid pregnancy. The fertility coach provided them with a spreadsheet to chart Elizabeth’s cycles using the ClearBlue monitor, and they completed an hour-long lesson with the teacher to learn the method. On the spreadsheet, she would record the date, day of her cycle, monitor reading, and whether she and her husband had intercourse; she did not record any other signs of fertility, such as cervical fluid or basal body temperature (BBT). After the session with her fertility coach, Elizabeth was able to text her whenever she needed assistance or had questions.
The Marquette Model: The Basics
The Marquette Model uses urinary estrogen and LH metabolites tested at home to predict the beginning and end of a woman’s fertile window. [1] It was developed as a method of natural family planning (NFP) by Dr. Richard Fehring in 1998, when the ClearBlue Easy Fertility Monitor became available. [1] The method can be used in combination with cervical mucus or BBT, or women can use LH strips alone. [1] For experienced users, there is also an algorithm that can be applied to more accurately and confidently determine the fertile window. [1]
The Marquette Model can be used by couples who desire pregnancy, want to avoid pregnancy, or want to monitor their health. [1] It can also be used by women who are breastfeeding, perimenopausal, or have irregular periods. [1]
“The Marquette Model uses urinary estrogen and LH metabolites tested at home to predict the beginning and end of a woman’s fertile window.”
Using the Marquette Model: The Reality
Elizabeth and her husband were not necessarily trying to conceive when they got pregnant, but she admitted to frequently using the method incorrectly and engaging in intercourse during some of the “high” fertility readings on the monitor. She typically has longer menstrual cycles, averaging between 40 and 50 days, and she complained of long stretches of potential days of fertility. Elizabeth had also dropped her ClearBlue monitor, which caused the batteries to fall out, and she lost several months of stored data.
Overall, the couple is happy with the Marquette Model as a natural means of family planning, and they acknowledge their pregnancy was a result of their decisions as a couple, not a failure of the method. For them, an advantage of the Marquette Model is that it seems foolproof; while avoiding pregnancy, the ClearBlue monitor told them when they could engage in intercourse and when to abstain. They liked having a more objective measure of fertility versus relying on something they perceived as more subjective, such as cervical mucus patterns.
“The couple is happy with the Marquette Model as a natural means of family planning, and they acknowledge their pregnancy was a result of their decisions as a couple.”
Still, relying on technology has its downfalls, as seen by the incident when she dropped the monitor. Elizabeth noted it can also become expensive to continue to buy strips, especially for women with long cycles. They also did not enjoy having long periods of abstinence due to her long cycles. Although the Marquette Model allows for the use of an algorithm after six cycles for women with long cycles using the method to avoid long periods of abstinence pre-peak, Elizabeth had just completed six cycles using the method before they got pregnant. She appreciated that Marquette has fewer rules to follow than some of the other methods, but sometimes she would forget to test her first urine of the day.
Benefits of Using an FABM
Elizabeth felt that using an FABM strengthened her relationship with her husband and improved their communication surrounding intimacy. Even though the periods of abstinence before ovulation were often long, they were able to enjoy each other during the post-peak phase and would look forward it. She feels that giving up control and leaving her fertility in God’s hands was freeing; however, she admits giving up control is sometimes a source of stress. Despite having an unintended pregnancy, she is okay with not knowing what the future will look like, and she has surrendered herself and her life to God. She feels blessed and honored to be a mother.
“Elizabeth felt that using an FABM strengthened her relationship with her husband and improved their communication surrounding intimacy.”
Elizabeth plans to continue using the Marquette Model postpartum, and she and her husband are committed to avoiding pregnancy and using the method correctly. She met with her fertility coach to discuss the postpartum protocol for Marquette and feels confident utilizing the additional rules. She also purchased a monitor that measures quantitative levels of urinary hormone metabolites as a way to track her cycles more accurately. Elizabeth is curious to learn more about her cycle patterns and found it appealing that you do not have to use the first urine sample of the day. She is confident that with this combination of methods she will be able to space her pregnancies and achieve her family planning goals.
* Name was changed to protect the privacy of the interviewee.
REFERENCES
[1] Marquette University. (n.d.). Institute for Natural Family Planning Model. Retrieved October 6, 2024, from https://www.marquette.edu/nursing/institute-natural-family-planning/model.php
ABOUT THE AUTHOR
Dr. Haley Moris, DO, MPH is a PGY-1 Family Medicine resident at TIGMER in Laredo, Texas. She attended Baylor University for her undergraduate and UNTHSC Texas College of Osteopathic Medicine for medical school and her Master of Public Health. She was a FACTS ambassador in medical school and took the FACTS elective during her 4th year, which inspired her to eventually pursue further training in FABMs and their medical applications for treating infertility. Upon graduation from residency, she hopes to attend an FM/OB fellowship and incorporate FABMs into her future practice.
