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Infertility: The IVF Alternative

Infertility is a symptom of underlying disease.  The diseases that cause infertility have a “two-pronged” effect.  They not only hinder the functioning of fertility, but they also cause both short and long-term health problems.  The persistent unwillingness to address infertility problems from this point of view or perspective is one of the major flaws in the current approach to the treatment of infertility.

More effective than IVF

Tubal Occlusion.....................1.4 times better
Endometriosis.......................2.2 times better
Polysystic Ovaries.................2.7 times better
Anovulation..........................3.2 times better
 

Until 1978, most of the effort in medicine in evaluating and treating women with infertility was placed in trying to identify and treat the underlying causes.  In 1978, in vitrofertilization produced a paradigm shift.  It led to a “skipping over” the causes and this continues up to the present time to be the foundational management approach.  In essence, this is a symptomatic or Band-Aid approach to treatment, not one that gets to the root causes.  When the artificial reproductive technologies began to take hold, now over 30 years ago, diagnostic laparoscopy was in its infancy.  Hormone assessment, while available, was not readily accessible.  Modern Ultrasound technology was not yet available.  Selective hysterosalpingography had not yet been developed and the fallopian tubes could not be catheterized. T

he Creighton Model FertilityCare™ System began its first Allied Health Education Program for FertilityCare™ Practitioners (FCP) in 1978.  This means of objectively monitoring the biomarkers of the menstrual and fertility cycle was only in its beginning stages.  With the availability of the CrMS, observations of mucus patterns during the course of the menstrual and fertility cycle could be observed for the very first time.  In fact, information obtained by women charting their cycles in this fashion is unique and can only be obtained in this fashion.  In Figure 40-2, a normal cycle with a normal mucus pattern, Peak Day and post-Peak phase is illustrated.  In addition, the estrogen levels (black bars) and progesterone levels (red bars) are also shown to demonstrate the correlation to underlying hormonal events. 

igure 1. A normal CrMS chart with daily levels of E2 and progesterone. The hormonal profiles are normal. The mucus cycle is normal.

In the next cycle, a completely dry cycle is observed.  No mucus is observed during the cycle.  These dry cycle patterns occur in about 15 percent of all women with regular cycles and infertility.  Looking at the underlying hormonal correlations (Figure 2), one can see that the estrogen and progesterone levels are significantly decreased compared to the levels observed in the normal cycle (Figure 1).  This suggests that the dry cycles – the absence of mucus – are a reflection of underlying hormonal abnormalities.  We now know that this is an exhibition of abnormal development of the follicle with a subsequent abnormal corpus luteum.  This is also associated with abnormal ovulation events. 

Figure 2. An infertility patient with a dry cycle and daily levels of E2 and progesterone. Both the preovulatory and the postovulatory profiles are very decreased revealing very poor ovarian function.

The Goals of NaProTECHNOLOGY in Infertility
 

NaProTECHNOLOGY approach to the infertile couple has the following goals:

  1. It works towards assessing the underlying causes of the reproductive abnormality.
  2. It allows for the treatment of these underlying causes.
  3. It assists the couple in achieving pregnancy while maintaining the natural acts of procreation.
  4. If the treatment program is unsuccessful, research into the unknown causes is undertaken.
  5. If medically unsuccessful, the program will assist with successful family building by being supportive of adoption.

Several examples of successful outcomes in patients with infertility are shown in the next series of charts.

Case No. 1:  In this patient with dry cycles and seven years of infertility, Vitamin B6 was recommended on day 1 as a mucus enhancing supplement.  In the last cycle, limited mucus was observed and pregnancy achieved without any additional assistance except fertility-focused intercourse.

 [Case No. 1. In this patient with dry cycles and seven years of infertility, vitamin B6 was recommended as a mucus-enhancing supplement. In the last cycle, limited mucus was observed and pregnancy achieved without any additional assistance except fertility focused intercourse.]

Case No. 2:  The limited mucus cycles, endometriosis, ovarian dysfunction and a husband with a low sperm count were identified in this patient who had failed two previous IVF procedures.  In spite of these abnormalities, with proper NaProTECHNOLOGY treatment, she achieved a pregnancy and had a normal healthy baby.

Case No. 2. Limited mucus cycles, endometriosis, ovarian dysfunction and a husband with a very low sperm count were identified in this patient who failed two previous IVF procedures. In spite of these abnormalities with proper NaProTECHNOLOGY treatment, she achieved a pregnancy and had a normal healthy baby.

Effectiveness For Infertility Treatment

Using a NaProTECHNOLOGY approach for the treatment of infertility can be highly effective and even more effective than current approaches to infertility.  In Figure 3, a life table comparison of the effectiveness of NaProTECHNOLOGY (in blue) with a similar non-NaProTECHNOLOGY approach taken at Johns Hopkins University is shown.  The success rates are clearly better using the NaProTECHNOLOGY approach.

[Figure 3. Cumulative pregnancy rate of patients with endometriosis treated with NaProTECHNOLOGY compared to conservative surgery only. Patients with normospermic husbands only (From: Pope Paul VI Institute research, 2004 and Rock JA, Guzick DS, Sengos C, et al: The Conservative Surgical Treatment of Endometriosis: Evaluation of Pregnancy Success with Respect to the Extent of Disease as Categorized Using Contemporary Classification Systems. Fertil Steril 35:131-137, 1981).]

A similar study showing a comparison of a NaProTECHNOLOGY approach to the treatment of women who have polycystic ovarian disease and comparing it to the work at Johns Hopkins University also shows a significant improvement (Figure 4).

[Figure 4. Cumulative pregnancy rate for patients with polycystic ovarian disease treated with NaProTECHNOLOGY compared to surgical wedge resection only. (From: Pope Paul VI Institute research, 2004 and Adashi EY, Rock JA, Guzick D, et al: Fertility Following Bilateral Ovarian Wedge Resection: A Critical Analysis of 90 Consecutive Cases of the Polycystic Ovary Syndrome. Fertil Steril 36:320-325, 1981).]