Pregnancy & NaProTECHNOLOGY

There are many causes of infertility, recurrent miscarriage and pregnancy problems.  Most often the problem is multifactorial. A woman may have a structural problem with the uterus, fallopian tubes or ovaries, an organic problem such as: uterine fibroids, endometriosis or pelvic adhesions and/or an ovulation disorder. 

Your appointments at Natural Women's Health 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 Charting 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, order a baseline ultrasound and check blood levels for FSH/LH and estrogen, which must be timed to day 3-5 of your next menstrual cycle. You will be asked to begin charting your menstrual cycles using the Creighton Model System. Please choose a Fertility Care Practitioner by clicking the button below and begin to chart your menstrual cycle using the Creighton Model. 

If you have a pre-existing diagnosis of Infertility and/or if you have a history of failed IVF/IUI treatments, I may refer you to a NaPro surgeon to schedule an initial evaluation (NaPro surgeons typically book 6 months out from initial inquiry). Oftentimes, patients have very subtle endometriosis or uterine or pelvic adhesions (scar tissue) that can easily be removed during a laparoscopic surgery permitting a pregnancy to be achieved. 

I will offer you NaPro "medical management" for the next 6 months. If you successfully achieve a pregnancy, the surgeon's appt can be easily cancelled. However, if we are unsuccessful, you will be seen by the surgeon as soon as it has been determined medical management is unlikely going to be helpful.  

Second Appt: You will be asked to return for a follow-up appointment with me after you have charted two full menstrual cycles. Together we will review your Creighton Model Chart, a GYN physical examination will be preformed, and additional laboratory tests & imaging studies may be ordered, which will be specifically timed to your Creighton model chart. We will look for certain "biomarkers" in your menstrual cycle to help guide your medical management. 

For instance, 2-3 days of "tail end brown bleeding at the end of your period and/or a persistent "2W" mucus pattern may indicate a condition called chronic endometritis. We would discuss an option to schedule an endometrial biopsy, which could done in the office, and the tissue would be sent for examination to look for signs of inflammation. A specific stain called a "CD138" must be ordered with this biopsy in order to correctly make this diagnosis. Oftentimes after a three-week course of antibiotics, the woman will be able to achieve a pregnancy. 

Third Appt:  You will return to the office two weeks later to review the results of your laboratory and imaging studies. Depending on your results, you may be asked to undergo additional testing, start medications and/or perhaps make an appointment with another specialist such as a dietician or a counselor. 

Follow Up Appts:  You will return to the office every two months to monitor and/or make adjustments to your medications and treatment plan. 

After 6 months, if medical management has been unsuccessful you will be referred to Dr. Naomi Whittaker, MD who is a NaPro surgeon. You will undergo an evaluation. Dr. Whittaker will review your Creighton Model Charting as well as the medical management you have received. Together you will formulate a surgical treatment plan.