Submitted by Fri 04/10/2009
Trying to get pregnant, but can’t? Or, you become pregnant, but suffer miscarriages? One in five couples in the United States experiences infertility, subfertility or recurring miscarriages. Typically these women have had their blood drawn on day 3-to-7 of the menstrual cycle to assess gonadotrophin and prolactin levels, thyroid function, hemoglobin, rubella status and testosterone levels. They have additional blood tests on day 21 or 22 of the cycle to measure progesterone levels. The men have undergone seminal fluid analyses, post-coital tests, ultrasound examinations. Then the couples are usually given a trial of clomid for six-to-nine months. If clomid doesn’t work, the couples are advised to undergo Artificial Reproductive Technology (ART). Occasionally, ovulation induction with follicular stimulating hormone (FSH) may be given for three-to-six cycles. Ultimately, however, most of these couples are ushered into the fertility doctor’s office to begin the in vitro fertilization process, a costly and invasive procedure with a success rate less than 30 percent. In their pursuit to get real answers, these couples are tremendously frustrated, discouraged, and for good reason. In fact, it can be legitimately said that obstetricians and gynecologists did a far better job caring for infertile couples in the 1950s than they do in the 21st century. In 1950 the pregnancy rate following ovarian wedge resection was 66 percent. Compare that success to today’s 23 percent success rate with IVF treatments. In a real sense, the successful treatment of infertility is sliding backwards instead of advancing. But there’s hope for this couples. NaProTechnology is a new women’s health science founded by Dr. Thomas W. Hilgers, director of the Pope Paul VI Institute for the Study of Human Reproduction and the National Center for Women’s Health in Omaha, Nebraska. NaProTechnology success rates are 1.5 to 3 times higher than IVF (23.5% vs. 38.4%-81.8%). Unlike artificial reproductive technologies which ignores the underlying causes of infertility, the focus of NaProtechnology is diagnosis and treatment, while maintaining the natural act of intercourse. Couples are asked to chart their cycles using the Creighton Model FertilityCare System (CrMS). After charting two cycles, the evaluation begins. The charts provide valuable clinical information such as identifying the timing of ovulation and determining the length of the follicular and luteal phases in a woman’s cycle. Dr. Phil C. Boyle, NFPMC Galway, relates how he uses the chart: “Couples have come to me and said, ‘My day 21 progesterone is about 30. It’s normal. I don’t have low progesterone.’ So our first evaluation will be day P+7 progesterone [based on the woman’s chart]. I tell them that they are correct! The day 21 progesterone level is fine at 30 but their P + 7 progesterone level is entirely too low. That frequently launches us into a complete hormone study. We discuss the increased incidence of miscarriage and preterm labor associated with low hormone levels and the need to supplement or repair. ” The NaProTechnology approach includes three phases:
1. Establish a diagnosis. After a woman charts two cycles, a medical consult is submitted to a physician who is trained in NaProTechnology. Typically the diagnosis will include routine FSH, LH, prolactin, rubella, B12, thyroid function as well as estradiol and progesterone and testosterone as indicated. “These results are a very satisfying thing for somebody who is experiencing difficulty, as they are finally able to get some answers and explanations,” says Dr. Boyle.
2. Targeted treatment. Generally, targeting the treatment may last about three cycles. The CrMS chart is used to determine if the treatment is successful or if further research is needed to fix the problem. If surgery is indicated, surgical NaProTechnology is offered, which is a specialized form of gynecologic surgery to reconstruct the uterus, fallopian tubes and ovaries in such a way that pelvic adhesive disease can be eliminated. “It is, in a sense, a ‘near-adhesion free’ form of surgery,” says Dr. Hilgers.
3. Begin Counting Good Cycles. “Everyone wants to get pregnant yesterday,” says Dr. Boyle. With NaProTechnology it takes about three months to evaluate the problem and three months to fix it. After that, the goal is to get 12 effective cycles, but to get 12 effective cycles could take 18 months. Dr. Boyle stresses it is important that couples keep it enjoyable. “If you’re putting life on hold waiting to get pregnant, it’s probably not going to happen. Minimize stress from work, illness, bereavement, holidays, and every place possible. Then relax and enjoy a loving environment.” Presently there are 220 physicians trained in NaProTechnology in the United States and Canada, with 52 more trained physicians practicing in other countries. To find a Creighton Model FertilityCare practitioner and NaProTechnology medical consultant closest to you, visit FertilityCare Centers of America.