Short answer: choose Marquette if you want objective hormone readings from a urine monitor and don’t mind ongoing test-stick costs. Choose Creighton if you want a standardized mucus-charting system taught one-to-one by a trained practitioner, often linked to clinicians who use the charts in medical evaluation. Choose Billings if you want a low-cost, mucus-and-sensation method taught by trained teachers. All three can be used to try to conceive. We don’t quote success rates here, because published figures mostly measure pregnancy avoidance, depend heavily on how the method was taught and used, and don’t translate neatly to trying to conceive.
The three methods at a glance
| Marquette | Creighton Model | Billings Ovulation Method | |
|---|---|---|---|
| What you observe | Urine hormone readings (estrogen, LH; some monitors also progesterone), optionally with mucus or temperature | External cervical mucus, dryness and bleeding, charted in a standardized way | External cervical mucus and the sensation at the vulva |
| Equipment | A fertility monitor and its test sticks each cycle | A chart and stamps or app | A chart |
| Instruction | Nurse or instructor-led classes, including online options | A trained FertilityCare Practitioner, one-to-one | Trained teachers, small-group then one-to-one |
| Typical learning structure | Introductory sessions plus follow-ups | An intro session, then follow-ups every two weeks for two months, then periodically through the first year | An intro, then follow-ups every two weeks for two months, then regular reviews in the first year |
| Ongoing cost driver | Test sticks | Follow-up sessions (fees vary) | Follow-up sessions (fees vary) |
| Best fit for TTC if you’re… | Data-minded, have irregular cycles, or find mucus hard to read | Want close coaching and a chart a clinician can use | Want a simple, low-cost, observation-only method |
The instruction structures above come from current program descriptions published by an NFP office (NFP method descriptions, 2026) and Marquette University’s Institute for Natural Family Planning (Marquette). Local programs vary, so ask your instructor about their own schedule and fees.
Marquette: hormones from a monitor
Marquette University’s institute describes its model as using urine fertility biomarkers collected at home, specifically estrogen, LH and progesterone, used with cervical mucus or basal body temperature and an algorithm to identify the fertile window. Its site discusses the Clearblue Fertility Monitor. It notes that the monitor is marketed to help couples achieve pregnancy, and that the institute has developed protocols for using it both to achieve and to avoid pregnancy. It also describes Mira as a quantitative monitor that gives daily hormone levels (Marquette).
Monitor availability: monitor models and test-stick availability change. We couldn’t confirm current retail availability for every model, so check with your instructor which monitor and sticks they teach with before you buy anything. Our comparison of Mira vs the Clearblue fertility monitor covers the practical differences.
Strengths for TTC: it’s objective, it works even if your mucus is hard to observe, and it helps when cycles are irregular. Trade-offs: test sticks cost money every cycle, and you’re relying on a device.
Creighton: standardized mucus charting
Creighton Model FertilityCare teaches you to observe external mucus and patterns of dryness and bleeding using a standardized charting system. It’s taught by practitioners trained through a program developed at Creighton University and the Pope Paul VI Institute. Program descriptions list a group introductory session, then private follow-ups every two weeks for two months, then regular follow-ups through the first year. Some practitioners teach online (NFP method descriptions).
Strengths for TTC: the charts are designed to be read by trained medical consultants, which links Creighton to restorative reproductive medicine. HowToHaveABaby’s restorative reproductive medicine explainer covers that approach, including its limits. Trade-offs: it’s the most structured to learn, and follow-up fees vary.
Billings: mucus and sensation
The Billings Ovulation Method teaches you to observe external cervical mucus and the sensation at the vulva as your fertility signs. Program descriptions list an introductory presentation, then individual follow-ups every two weeks for the first two months, with regular reviews in the first year. Refresher courses are offered after life changes such as postpartum or perimenopause (NFP method descriptions).
Strengths for TTC: it’s simple, needs no equipment, and the sensation cue is useful if you see little discharge. Trade-offs: it’s observation-only, so there’s no hormone data to fall back on if your signs are ambiguous.
What about sympto-thermal?
If none of these appeals, sympto-thermal methods combine cervical mucus, waking temperature and cervix changes. They’re taught by certified instructors, with online and home-study options in some programs (NFP method descriptions). Adding temperature gives you confirmation that ovulation happened, which many people trying to conceive find reassuring. Our guide to checking cervical position covers the cervix part.
What the first few months look like
Whichever method you choose, expect the first cycles to be about learning rather than perfect timing. With Creighton and Billings, you chart every day and bring your charts to each follow-up, where the instructor helps you interpret ambiguous days. With Marquette, you learn when to start test sticks, how to read the monitor and how to combine its readings with mucus or temperature. In all three, the early follow-ups are when most mistakes get corrected, so it’s worth keeping those appointments even if you think you’ve got it.
Trying to conceive doesn’t have to pause while you learn. Having sex every day or two through the days your chart looks most fertile covers the window while your skills catch up.
Can you combine methods?
Yes, and many people do. Adding OPKs or a thermometer to Creighton or Billings gives you hormone data or confirmation without changing how you chart mucus. Adding mucus observation to Marquette is already part of the model. The main thing is to tell your instructor what else you’re tracking, so they can help you interpret everything together rather than separately.
How to choose
Decision steps
Do you teach specifically for trying to conceive? What equipment will I need, and what does it cost per cycle? How many follow-ups are included? Can we meet online? How do you handle irregular cycles or PMOS (formerly PCOS)? At what point would you suggest a medical evaluation?
Many people use an app alongside any of these. Our roundup of fertility awareness method apps covers which apps support which methods. ConceiveGuide’s ovulation tracking methods compared and LifeFertile’s best fertility trackers are useful if you’re weighing devices too. For the basics of each sign, see our cervical mucus guide.
When to see a doctor: learning a method shouldn’t delay an evaluation. ASRM and ACOG recommend one after 12 months of trying under 35, after 6 months from 35 to 40, and right away over 40 or with risk factors such as irregular cycles (AAFP, citing ASRM and ACOG).
Fertility monitor test sticks
If you’re learning Marquette, check with your instructor which monitor and test sticks they teach with, and confirm the sticks match your monitor model before buying.
Check price on Amazon →Explore every way to track ovulation
Our ovulation tracking hub covers monitors, OPKs, BBT and mucus methods, with links to the detailed guides.
Visit the Ovulation Tracking Hub →Frequently Asked Questions
Which fertility awareness method is best for getting pregnant?
There's no single best one. Marquette suits people who want hormone data from a monitor, Creighton suits people who want close one-to-one coaching, and Billings suits people who want a simple, low-cost observation method.
Do I need an instructor to use these methods?
All three are designed to be taught by trained instructors or practitioners, usually with follow-ups over the first months. Learning with support makes charts much easier to interpret.
Does the Marquette Method require a Clearblue monitor?
Marquette uses urine hormone readings from a fertility monitor. Its institute discusses the Clearblue Fertility Monitor and also describes Mira as a quantitative monitor. Ask your instructor which device they teach with.
Can I use these methods with irregular cycles?
Yes, but a method with objective hormone readings, or one that adds temperature, is often easier with irregular cycles than mucus observation alone.
How effective are these methods for getting pregnant?
Published effectiveness figures mostly measure avoiding pregnancy and depend on how the method was taught and used, so we don't quote them for trying to conceive. Ask any instructor where their figures come from.
Primary sources and further reading
- Marquette University Institute for Natural Family Planning — Marquette Model overview
- Diocese of Charleston — Natural Family Planning booklet (2026), method and instruction descriptions
- American Family Physician — Infertility: Evaluation and Management (2023)
Sources checked October 12, 2026.
When It’s Time for the Next Step
If you’ve been trying for 12+ months (or 6 months over 35), it may be time to see a fertility specialist. If cost is a barrier, you can also compare clinics abroad and get a written quote before you decide.
See Your Options Abroad → This link connects you with international fertility treatment resources. We may receive referral compensation at no cost to you.