Human Life Education

Chapter Twelve: Doctor Kyusaku Ogino Discovers Scientifically Based NFP

By Fr. Anthony Zimmerman

In 1923, in the February issue of the Hokuetsu Medical Journal, Dr. Kyusaku Ogino of the Niigata University Hospital in Japan, first published the horizon-spanning theory that ovulation occurs 12-16 days before the next expected menstruation. His article is a triumph of meticulous scientific observation plus a fortunate intuition by which he could suddenly interpret the data meaningfully. His discovery, later recognized and confirmed by Dr. Hermann Knaus, has influenced human history significantly.

Before Doctor Ogino operated on his patients, he would ask them whether their cycles were regular or irregular. For his study he selected only those whose cycles were declared regular. He next asked when they expected the next menstruation. He noted that date, then operated. He took great care to not disturb the condition of the ovary and possible corpus luteum by inept handling. He needed to study their condition in their current undisturbed state. Having ascertained what he could see, he then continued with the operations. By evening candle light in his laboratory he would do more precise studies. He diagnosed on what day of the cycle an ovulation had occurred. If it had not yet occurred, he predicted when it should be due on the basis of follicular maturation. He noted all this precisely. He studied the condition of each post-ovulatory corpus luteum as well, and made copious notes. When there was also a hysterectomy, he examined the endometrium as well.

When he had 65 cases, he lined up his findings on a chart. The chart made no sense. Ovulation occurred on any and every day when the counting of the cycle days started with the first day of menstruation. Practically all scientific studies of his day were counting that way. But the chart he saw before him made no sense (see Chart A which follows).

Then came a tuition. He had noted down the exact date on which each woman expected her next menstruation. So he reversed his counting, and counted backwards from the date of the expected ovulation to the date on which he estimated ovulation had occurred, or was due to occur. Eureka! Everything fell into place. Ovulation was occurring regularly as a clock 12-16 days before the expected menstruation.

Well, almost everything. Of the 65 cycles on the chart, only two ovulations were out of place. He wrote in his article:

From the first day of the last menstruation to the 17th day preceding the expected menstruation, follicles have not yet ovulated in all cases except the 2nd and the 10th cases. (Number of cases: 21; exceptions: 2).

On days 16-12 before the expected menstruation, he found some had already ovulated, others not:

For 5 days, from the 16th to the 12th day preceding the expected menstruation, follicles have ovulated in some cases, and in other cases they have not yet ovulated. Number of cases: 13.

From day 11 before expected menstruation there were no ovulations:

From the 11th day to the beginning of the expected menstruation, I found corpora lutea in the proliferative phase in all cases. Number of cases: 31.

He then drew the conclusion, which is the base for natural family planning:

Based on the views stated above, I conclude that the period of ovulation is 5 days from the 12th to the 16th day preceding the expected menstruation. This period is the same in all cases whose menstrual period is from 23 to 45 days.

What about the two exceptions?

To my regret, as I could not examine the organization of the corpora lutea and the endometrium, I can't explain the exceptions based on a histological study. But I guess the next menstruation will come a few days earlier than the expected time in these cases. I think two exceptions in sixty-five cases can be admitted, considering the character of the expected menses" (Translation from original by Hiroshi Ogino, MD, son of Kyusaku; private correspondence).

The theory first proposed in 1923 is undisputed today. In 1924 Dr. Ogino added another 53 cases to the 65 already reviewed, and confirmed his theory (Japan Gynecological Journal, vol. 19, No. 6, 1924). He added, from studies of animals published in the literature, that sperm can survive for three days after a coitus; that sperms which survive for 4 to 8 days are exceptional cases. And from animal studies reported in the literature he assumed that the ovum will die shortly after ovulation if not fertilized. "Certainly the ova do not remain fertilizable for some days or weeks." His summary:

The period of conception in mankind consists of the ovulation period and 3 days preceding the ovulation. During 8 to 4 days preceding the ovulation, conception can take place only rarely, while no conception occurs before this period. No conception takes place a day after ovulation.

It was after Dr. Ogino published his findings in Germany in 1930 as a SONDERDRUCK AUS DEM ZENTRALBLATT FUER GYNAEKOLOGIE 1930 (Leipzig) that his theory found its way into the world medical literature. In it he set forth the Ogino theory for natural family planning:

Upon reading that article, Prof. Dr. Hermann Knaus sent him a letter of congratulations. He had arrived at similar conclusions by another route, which he published in the Muenchener Medizinische Wochenschrift of 12 July 1929, so six years after Ogino's original publication. In a note treasured by Dr. Ogino, Dr. Knaus thanked him for having made those careful studies in Japan which enabled one to identify the naturally fertile and infertile times of the cycle, and which made it possible now to choose whether to achieve or to avoid a pregnancy.

We know today that the ovulation event, governed by cyclic hormonal secretion, occurs but once during a cycle. (If there are several ovulations, they occur within 24 hours of each other.) The time of ovulation is usually 16-12 days before the expected menstruation. In the meantime a great deal more has been learned: the temperature shifts upward slightly with ovulation, leaving a pattern of low level temperature before ovulation, followed by a shift, and then a consistently high level temperature after ovulation. If there is no pregnancy, the temperature drops to announce the imminent onset of menstruation. The temperature shift has become a clear marker to identify the potentially fertile times, and the infertile times.

The cervical mucus sign, which fertile women can perceive and monitor quite easily, comes and goes with the ovulation episode. It is another sign to identify fertile and infertile times. The condition of the cervix itself is still another sign which some learn very well; it is popular with flight attendants who deal with time lags, irregular hours, and stress. Some users are perfectly happy with one sign which is for them consistent and adequate; others find greater certitude - and a shorter period of abstinence perhaps - by combining several signs for mutual confirmation. Some stick by one method, but when in doubt, seek confirmation in other signs.

At any rate, whether by electronic devices, or by simple observation, reliable NFP is now available for all in the world who seriously want to use it. Difficult cases may need special advice, care, vitamins, diet, more regular life-style, therapy, longer abstinence. Sometimes nursing mothers - if signs remain uncertain and abstinence lasts for week after week - may dialogue with husbands about what is best for the family; that is, whether to wean the baby in order to reestablish the cycle with its signs of the fertile and infertile days.

For every couple in the world, if there are fertile days, there are also infertile days of the cycle. Catholic doctors, pharmacists, nurses, health care workers of the entire world - with the fervent blessing of the Pope - are willing, we are confident, to help couples identify them. Thereafter pastors can waggle a finger at the congregation and pound on the pulpit: "Children, families: be chaste!" Couples who are faithful, who strengthen their children in the practice of rugged chastity, are the ones who will survive the AIDS epidemic, and so carry the Church and the human race into the post-AIDS future. So be it!

Next Page: Chapter 13: Ovulation: once per cycle