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Up to 30% of couples who are evaluated by Fertility Care Centers are diagnosed with “Unexplained Infertility”. They are often told that their best (and sometimes their "only") option is Artificial Reproductive Technology (ART) which includes but is not limited to InVitro Fertilization (IVF).
I have great news for you! There is no such diagnosis as “Unexplained Infertility" among NaPro providers. NaProTechnology will offer you an alternative choice to IVF..... a "Natural Procreative" alternative!
NaPro is more effective than ART in assisting couples to achieve a pregnancy, touting an impressive 80% success rate demonstrated in over 35 yrs of research done at the St. Paul VI Institute. In many common Infertility cases, the success rate will be between 66 and 75% using NaPro as compared to only 7.5% to 61% using ART (depending on the specific type of procedure employed). See the CDC website and choose the procedure you would like to know about.
You may also wish to view a few good NaPro research articles showing our impressive pregnancy outcomes here: Tham, E., Stanford et al, and Collins, et al.
More importantly, NaProTechnology is morally acceptable and will never result in your embryo/babies being discarded or frozen. We strongly believe couples are deeply wounded by ART, though not always consciously. Lastly, the NaPro diagnostic work up and treatment protocols are much less expensive and absolutely safe for your baby. You may wish to view a recent research article demonstrating some of the harmful effects that ART can produce in your child here: Luke, et al.
Infertility: defined as the woman's inability to achieve a pregnancy after 12 months of regular, unprotected sexual intercourse. NaPro defines Infertility as the inability to achieve a pregnancy after 6 months of timed intercourse using the Creighton Model System of charting (CrMS).
Primary Infertility: the woman has never achieved a pregnancy.
Secondary Infertility: the woman has achieved a pregnancy in the past, but she is unable to achieve a pregnancy now.
Recurrent Pregnancy Loss (RPL) (recurrent miscarriage) is defined as two or more pregnancy losses at less than 20 weeks gestation.
Chemical Pregnancy: the woman achieved a pregnancy, but the baby was lost (miscarriage) very early, typically at less than 4-6 wks.
There are many causes of infertility and RPL. NaPro providers will do a thorough work up to look for all of them.
Uterine Structural Causes:
Thrombophilias: (thrombo = clot; philia = favor)
Immunological Diseases: (Auto-Immune Disorders)
Endocrine Diseases:
Genetic factors:
Male Infertility
Click the image to the right to join Sharon Best, PA-C as she summarizes the NaPro diagnostic evaluation and different treatment management plans for patients struggling with Infertility & Recurrent Pregnancy Loss. She will explain the similarities and differences a patient might experience who is being treated by a NaPro-trained provider as compared to what a woman might experience who is being treated by a mainstream medicine Reproductive Endocrinologist. The lecture will discuss NaPro's nuanced hormone panel assessments, types of Luteal Phase Deficiencies, Ovulation Disorder and how NaPro providers will perform follicle tracking to make accurate diagnoses for our patients. The etiology of Infertility & Recurrent Pregnancy Loss is always multi-factorial, and women are often told their conditions are "unexplained". Thus, their only option is IVF. NaPro providers are experts in finding the root causes for our patients' diagnoses and treating them. Sharon cites 41 publications throughout this lecture.
Your appointments at MyCatholicDoctor with me will be one FULL HOUR in length. Generally speaking, NaPro appts will follow a typical protocol as outlined below. However, every individual is different and your situation may warrant a more expeditious process. Please know, the Creighton Model System (CrMS) is very important. Your CrMS chart will help direct me to what diagnostic tests and imaging tests should be done and what treatment plan would be most appropriate.
First Appt: I will take a comprehensive medical history and provide you with education about normal healthy reproduction and oftentimes about a condition I suspect you may have after we have talked a while.
I will order a pelvic ultrasound which I will ask you to schedule on day 5 of your next menstrual cycle. I will order a series of laboratory tests. Click the "laboratory tests" button below to learn more.
You will be asked to begin charting your menstrual cycles using the Creighton Model System (CrMS). Please choose a Fertility Care Practitioner (FCP) by clicking the "Fertility Care Practitioners webpage" button below to learn more about scheduling an Introductory Session to get started.
You will also be asked to begin taking a Prenatal vitamin if you have not already begun. After much thought and research, KLAIRE Labs Prenatal & Nursing Formula is my preferred prenatal vitamin. However, If you prefer to take the synthetic "Folic Acid" rather than the active metabolite (Metafolin, also called L-5 methyltetrahydrofolate), I would recommend Nature Made Prenatal + Folic Acid + DHA. Lastly, I do always recommend quality supplements and some of the larger conglomerate corporations my not be able to quality control their products well. Thus, there will always be unethical people who sell fraudulent products. For this reason, I will often create a FullScripts account for my patients, and recommend they purchase through this site. Once I create an account for you, you will be able to see my custom made NaPro "multi-patient" plan, which includes all of my preferred brands of supplements you may be offered.
Please consider joining me as I pray for you here.
Second Appt: You will be asked to return to the office in 2 mos for a follow-up appointment to review the results of your imaging and laboratory tests. Together we will also review your Creighton Model System (CrMS ) chart to look for specific biomarkers which will help me make a diagnosis.
Please upload an image of your CrMS chart two days prior to all follow up visits and send to me via the portal.
Please add the length of your post-peak phase and your mucus cycle score (MCS) to the R-hand margin of the chart. Your Fertility Care Practitioner (FCP) will calculate your MCS for you.
During this appointment, you may be asked to begin some supplements and/or medications. We will also discuss drawing a full set of hormone panels. We will make a decision if you should have a peri-ovulatory estradiol panel, a post-Peak estradiol & progesterone panel, or both panels.
Hormone Panels:
Many patients will be asked to consider working with a dietitian or a nutritionist to help optimize your reproductive health. Oftentimes I may also recommend a mental health appointment to help with anxiety, depression and/or disordered eating habits.
Third Appt: You will return to the office in 2 mos to review the results of your hormone panels as well as the biomarkers on your CrMS chart. Most often at this time I will have made one or more more diagnoses to identify the root cause of your symptoms. Together we will discuss a treatment plan, which will be implemented.
Follow Up Appts: You will return to the office every 2 months. During this time, I will conduct a comprehensive medical interview to ensure your symptoms have resolved, and to ensure you are responding well and not having any negative responses to the management plan. Depending on the individual patient and your individual diagnosis, I may need to monitor your progress with serial laboratory tests and/or serial imaging.
After 6 -9 months: If medical management has not been successful AND we have not identified yet any other root cause for your problem, you may wish to move forward with a diagnostic laparoscopy. However, this would be your personal decision after we discussed benefits vs risks for your individual case. All surgeries present risks, which can sometimes be serious. Oftentimes, we will have identified additional medical conditions which are treatable with supplements and/or medications. On occasion, I may come to know a surgical evaluation will be of benefit to you earlier on in this process, and an expedited surgical referral will have been recommended. NaPro surgeons typically book out 5 mos to 18 mos. At any time, if you feel you would like an expedited surgical referral, please feel free to discuss this with me.
Please review my laparoscopy page. You will notice NaPro surgeries are done very differently as compared to laparoscopies done by mainstream medicine surgeons. We use a near contact approach and a near adhesion-free technique", which has been described as pelvic surgery of the pelvis.
At any point in time, if a diagnosis has been made, treatment initiated, and/or you are satisfied with the medical management we have implemented, you can schedule annual or biannual visits, per your choice.
For patients who have a diagnosis of Infertility or Recurrent Pregnancy Loss, we will pay attention to two very specific biomarkers: a) TEBB "Tail End Brown Bleeding (brown spotting at the end of your period) and b) a persistent "2W" mucus pattern in the post-Peak phase. Either biomarker may indicate a condition called Chronic Endometritis (C.E.) If you have either biomarker, we would discuss an option to schedule an endometrial biopsy, which can done in a local GYN office or preferably with a NaPro surgeon trained to recognize subtle signs of CE in the endometrium. The endometrial tissue should be sent for examination to look for signs of inflammation. A specific stain called a "CD138" must be ordered with this biopsy to correctly make the diagnosis of CE. About 78% of women treated for for CE with the appropriate antibiotic for 14-21 days are able to achieve a healthy pregnancy.
On occasion, if the woman's TEBB does not abate with progesterone replacement and she has had RPL, we could have a discussion about "empiric treatment for CE". This means, I will offer a course of doxycycline or clarithromycin be taken for 14 days to both the woman, which can sometimes resolve the chronic endometritis and allow the woman to achieve a pregnancy. Empiric Treatment will be done on a case by case basis. We do have data to show efficacy.
If you are interested in reading a few research articles discussing Chronic Endometritis click hereand here.
I will be asking you to tell me very specifically how much you are bleeding. An example of a "detailed flow" is: M, M, H, L, L, VL/B
TAMPON or PADS:
MENSTRUAL CUP MEASUREMENTS
**The Diva Cup comes in 20, 30 and 32 ml cups 32 being the largest but other cups may vary. 1 ml = roughly 1 cc
Other important information about your flow:
To view research publications for my specific NaPro Treatments for Infertility & RPL, click the "Pharmacological Treatments" button ABOVE
To view research publications to support continued Progesterone Pregnancy Support, click the button BELOW, and scroll towards the bottom of the page.
Dr. Anne Nolte is the co-founder and Executive Director of the
The National Gianna Center for Women’s Health and Fertility, of which there are now nine Gianna Center Medical ClinicsDr. Nolte currently sees patients in New York City Watch this excellent 15-minute video. Dr. Nolte addresses how NaPro Technology is superior treatment for infertility at she presents a very succinct overview of general NaPro services, This video was created by Saint Peter's Healthcare System. which was ranked by Newsweek as one of the best hospitals in the US for maternity care in 2022. To learn more about St Peter's click here.
Dr. Catherine Keefe, MD is a NaPro trained ObGyn surgeon who sees patients at National Center for Women’s Health - St. Paul VI Institute in Omaha, NE. Sharon was privileged to be able to work and train with Dr. Keefe for one week directly after she completed her NaPro Training in Omaha. In this video, Dr. Keefe shares true stories of women who were told the only way they could achieve a healthy pregnancy was via IVF. The women underwent the NaPro diagnostic work-up, as described below, and were successful in achieving a normal health pregnancies.
UPMC Divine Mercy Womens Health
225 Grandview Avenue, St 302, Camp Hill, PA 17011
Instagram page: NaPro-Fertility-surgeon
The course includes 8 sections covered in 3 hrs.
Click the image to the left to be directed to:
https://www.rrmacademy.org/challenge-page/masterclass-in-endometriosis-and-surgery
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