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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 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!
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
Sharon presented a 2-PART lecture series on Infertility & Recurrent Pregnancy Loss through MyCatholicDoctor TeleHealth platform via a live webinar on December 7, 2022, which was recorded for APP2APP Virtual Lectures, Inc
The aim of the lecture was to compare current mainstream medical literature &
guidelines to NaPro Technology protocols with regard to diagnosis and treatment of Infertility and Recurrent Pregnancy Loss.
Please feel free to watch Sharon's lecture here: APP2APP’s YouTube page.
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.
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.
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 Psychotherapist or Health Coach 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, it is likely you will need a diagnostic laparoscopy. Therefore, I will refer you to a NaPro surgeon. 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 one full year. 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 (CE). If you have either biomarker, we would discuss an option to schedule an endometrial biopsy, which can done in the office. The endometrial tissue will 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 to 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.
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:
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.
Make an Appointment with Sharon Best, PA-C at MyCatholicDoctor
Please visit the Helpful Hints 4 Patients page to book an appt and/or communicate with me as a MyCatholicDoctor patient.
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