I’m writing as a BCC instructor with some ideas for how you might manage charting in a time of Clearblue fertility monitor test stick scarcity. This is just to outline some of the options that may be available to you. Which option is best for you may depend on your cycle history, your current circumstances and seriousness of need to avoid pregnancy, and what other observational tools you can use. The Clearblue test sticks are manufactured in China. Chinese manufacturing shut down for longer than usual over the Chinese New Year, due to the COVID-19 epidemic that has become the pandemic we are currently facing. This may be the reason that test sticks are a bit harder to find than usual. Now that manufacturing is returning to normal, the main problem is due to the disruption to supply lines. That's not surprising given the novel coronavirus pandemic's effect on supply lines around the globe. The good news is that this shortage will be temporary, and Amazon will resume normal sales of the test sticks as supplies allow, as will other retailers. Do be wary of unsafe pop up sites purporting to sell the test sticks at better-than-usual current pricing. I strongly recommend the use of a fertility awareness based method instructor, so if you have an instructor, talk to them about your options within your method! They know you and your charting context and may advise you against certain approaches, or have different/better ideas about how to manage this time. This blog should not be viewed as a substitute for instruction. If you happen to be one of my own clients facing this situation, please reach out so we can discuss this and find the best way forward for you. The so-obvious-it’s-almost-not-worth-saying option is to switch to another fertility charting method, such as Billings, Creighton, FEMM, CCL, Sensiplan, etc. However, assuming you don’t want to do this, let’s get on with the ideas. Regular cycles: Most women in regular cycles will use 6-13 sticks per cycle, so if you have a box remaining it might usually last you 2-4 cycles, but you could eke it out a little more. 1. Do a chart overview of your prior 6-12 cycles. (At least six; and as many as you have up to twelve.) See the earliest peak has arrived. Start testing with the monitor on the first day it requests tests. Then switch to OPKs for subsequent days. (Follow your OPK brand’s instructions for urine collection, dipping, and reading the sticks.) When you are two days prior to your earliest peak, switch back to the monitor tests until you see peak. Begin abstaining on your algorithmic day. However, if the algorithmic beginning of fertility is after you stop using monitor tests, begin abstaining as soon as you stop testing with the monitor, as you will not be able to get the benefit of a possible high to indicate if you should begin abstaining earlier. 2. Use the monitor from the time it requests tests, until you see a high, then switch to OPKs to find the LH surge. Begin abstaining on your algorithmic day, or the first day of high, whichever comes first. 3. Use OPKs alone. If using this option, you may want to begin abstaining on day 6 if it is earlier than your algorithmic/default day. 4. Use mucus and OPKs. You can begin abstaining on day 6 if it’s earlier than your algorithmic/default day, or you can either begin abstaining on your algorithmic/default day or for first fertile mucus observation, whichever comes first. 5. Use the Clearblue Advanced Digital Ovulation tests, with a default/algorithmic abstinence day (or if you get a high on these tests before that.) 6. Use mucus rules (preferably with a cross-check that confirms ovulation.*) * All of these options can be paired with temping, or with the Proov tests to confirm ovulation. BCC encourages the use of cross checks. Postpartum/breastfeeding cycles: These cycles are often heavier on test stick use than regular cycles, as peaks are often delayed. If you’re in the first couple of postpartum cycles and are breastfeeding, be on the watch for failed ovulation attempts. 1. Start testing with the monitor on the first day it requests tests. Then switch to OPKs for subsequent days. (Follow your OPK brand’s instructions for urine collection, dipping, and reading the sticks.) In cycle #1 if you are breastfeeding, when you are at CD17, switch back to the monitor. (This will save you ten test sticks, but you may still be using a whole bunch if you don’t actually peak until, say, CD37.) In subsequent cycles, begin monitor use again informed partly by when you saw peak in prior cycles, remembering that the trend for peaks is to get earlier as cycles progress. For some women this is a slow and steady change, others may see a sudden jump forward. Your instructor could help with this. Begin abstaining on your default day. However, if you get a peak earlier than would usually be expected for the first cycles, confer with your instructor. Another more conservative option would be just to begin abstaining on CD6 for all these cycles, even if you are breastfeeding and in the first four cycles. 2. Use the monitor from the time it requests tests, until you see a high, then switch to OPKs to find the LH surge. Begin abstaining on your default day, or the first day of high, whichever comes first. 3. Use OPKs alone. If using this option, you may want to begin abstaining on day 6 if it is earlier than your default day. I personally don’t advise relying solely on whether an OPK looks low/high/peak to determine when to begin abstaining. I see too many sticks go from low-peak over the course of a day to want to rely on that for early warning, and it’s more subjective. But if you’re not very seriously TTA, it’s an option too. One of the cool things about fertility charting is that it is customizable. 4. Use mucus and OPKs. You can begin abstaining on day 6 if it’s earlier than your default day, or you can either begin abstaining on your default day or for first fertile mucus observation, whichever comes first. 5. Use the Clearblue Advanced Digital Ovulation tests, with a default/algorithmic abstinence day (or if you get a high on these tests before that.) 6. Use mucus rules (preferably with a cross-check that confirms ovulation.*) * All of these options can be paired with temping, or with the Proov tests to confirm ovulation. BCC encourages the use of cross checks. Postpartum breastfeeding cycle 0: Ah, the time when we’re usually burning through a stick a day. 1. Revert to the ol’ 20 day alternate day protocol. Remember that some monitors auto low on the twentieth test, so what you’re doing is: Testing on monitor days 6, 8, 10, 12, 14, 16, 18, 20, 22, 24. If you have the original monitor, you don’t test on day 25, but you will set it to day 5 that day. If you have the touchscreen fliptop monitor, after you have the result on day 24, you will set it to day 4. Then you test starting day 6 again. On odd days you do not test, and you abstain. You should cover those days with an OPK (following your OPK brand's instructions for collecting, dipping and reading) to ensure you don’t miss the LH surge on a day you are not testing. Note that you can test on an odd day if you are hoping to have an “extra” available day. When you get a high you can either test every day looking for a peak until it’s time to reset and then revert back to the alternate day protocol, or you can switch to OPKs to look for the LH surge until it’s time to return to monitor use for the alternate day protocol. Check in with your instructor about when to reset/revert back to monitor use if you see a high. You may not need to finish out all the tests through day 24. 2. Use the Clearblue Advanced Digital Ovulation tests, continuing to use the same holder even if you must switch to tests from a new box. When you get a high, abstain and test nine more days. Then switch to a new holder.
3. Use mucus and OPKs. This is hard because I know some of you have chosen a monitor approach precisely because you wanted to avoid using mucus! But if this is something you feel comfortable with doing, you can use mucus based rules for abstaining. For extra caution, you could use a darkening of the OPK test line (while still not positive) as an indicator to abstain as well, although we don’t know if that would actually improve efficacy at all, or unnecessarily increase abstinence. 4. Use OPKs alone, but abstain until you have monitor tests again or identify the LH surge and subsequently confirm ovulation with temps or Proov test, or see your menstrual period return when expected following the surge.