NaProTechnologies and Infertility: A Reproductive Endocrinologist’s Perspective

NaPro (Natural Procreative) Technologies is a woman’s health science which has, as its main principle, the ability to work cooperatively with the woman’s menstrual and fertility cycle.  It relies on the Creighton Model Fertility Care System biomarkers to monitor objectively the occurrence of various hormonal events during the menstrual cycle.  It seeks to provide information that is valuable in both natural family planning as well as enhancing fertility by enhanced fertility awareness.

For the normally cycling woman, NaProTechnologies is an effective means of determining her fertile periods to either enhance the possibility of conceiving or to avoid pregnancy.  It can also be effective in identifying the presence of factors preventing conception, particularly if there is a problem with the ovulatory process.  The techniques for both diagnosis and treatment employed in NaProTechnologies are acceptable to a wide array of couples with varied interests.  It is considered a morally acceptable approach to both Family Planning and fertility enhancement by various religious groups, including the Catholic Church.

The fertility enhancement provided by NaProTechnologies serves as a good starting point for couples with straight forward and relatively uncomplicated fertility issues.  However, the overall fertility rates are not comparable to those that will be obtained by a Reproductive Endocrinologist who specializes in non-IVF fertility care.  This is due to both the dramatic difference of background and training of a Reproductive Endocrinologist (REI) and the scientific technology available only through an REI.

Reproductive Endocrinologists are physicians (MD/DO) who have completed four years of medical school, four years of residency in Obstetrics and Gynecology and two or three years of fellowship in Reproductive Endocrinology and Infertility.  All 11 years are a highly intense training period.

NaProTechnologies draws practitioners from a variety of backgrounds including physicians (usually not Ob/Gyns), nurse midwives, advanced practice nurses, physician’s assistants, general nurses and pharmacists.  They then undergo a 13-month training course that contains only two sessions lasting 7 to 9 days each of “total immersion” courses.  The remainder of the education is completed by long-distance supervision.

A significant discrepancy also exists in the technologies available to patients under the care of a Reproductive Endocrinologist.  Due to their greater training and experience, more advanced services are available through an REI.  The REI will have on-site ultrasound, including saline infusion sonography and sonohysterography.  A complete line of safe ovulation induction treatments, including use of the injectable gonadotropin medications, will be available.  Advanced fertility surgery from hysteroscopy (including myomectomies and intra-uterine adhesiolysis), Fallopian tube catheterization (to open up blocked Fallopian tubes) through laparoscopic laser surgery (with or without the DaVinci Robot) to treat endometriosis, pelvic adhesive disease and uterine fibroids is available when needed.  Even microsurgical reversal of blocked Fallopian tubes, including previous tubal ligation, is available.

This much greater array of medical and surgical fertility treatments available through a Reproductive Endocrinologist who specializes in non-IVF infertility care is a natural follow up for couples who have not achieved a pregnancy through NaProTechnologies and do not want to either proceed to IVF or abandon their pursuit of children.  Very frequently, the family that they seek is closer than they realize.

If you have pursued NaProTechnologies without success, strongly consider consultation with a fellowship trained Reproductive Endocrinologist who does not focus their fertility care on IVF.  This individual can help you to both further understand why you have not been  achieving a healthy pregnancy and help you build your family through diagnostic and treatment modalities that are aligned with the fertility guidelines of the Catholic Church.  If the physician does not perform IVF, then their entire focus will be on you achieving pregnancy using these advanced fertility methods without pressure to enter into IVF. 

Any concerns you may have with the course of your care should be frankly discussed with the physician .  One should find a caring environment where both the patients and the physician understand and comfortably accept treatment while at the same time administering cutting edge medical care for infertility. 

If your fertility issues have been unsuccessfully treated in NaProTechnologies, then seek out the more advanced care of a non-IVF fertility care Reproductive Endocrinologist. 

Gerald V. Burke, M.D.