Editor’s note: We are so thrilled to bring you the first installment of NaPro FAQ’s! Many thanks to Dr. Karen Poehailos and her team for putting this together for us and letting us share it with you all!
Karen D. Poehailos, MD, CFCMC
Certified FertilityCare™ Medical Consultant
NFP Coordinator, Catholic Diocese of Richmond VA and St. Thomas Aquinas University Parish, Charlottesville VA
1) What is NaPro anyway? NaPro is an abbreviation for Natural Procreative Technology, a women’s health science that monitors and maintains women’s reproductive health. NaProTECHNOLOGY®has many applications—including very effective treatments of PMS (premenstrual syndrome), chronic discharges, ovarian cysts, postpartum depression, irregular cycles, PCOS (polycystic ovarian syndrome), recurrent miscarriages and infertility. The treatments offered by NaProTECHNOLOGY® have efficacy rates that exceed the success rate of “conventional” treatments currently offered.
2) I’ve been through conventional infertility treatments. Can NaPro still help me? Yes, definitely. As opposed to usual infertility evaluation and treatment, NaPro allows the physician and patient to look for the underlying cause of the infertility. Remember, infertility is a symptom, NOT a disease. By careful cycle charting using Creighton Model FertilityCare™ System (CrMS), blood work, ultrasounds and surgical evaluation, a plan for infertility treatment based on sound scientific evidence is developed. A plan like this has a greater chance for success than the usual brief medical evaluation that rapidly is followed by a recommendation for IUI (intrauterine insemination) or IVF (in vitro fertilization.)
3) How do I access NaPro medical care? A good start is to go to www.fertilitycare.org. There you will find listings for NaPro Medical Consultants (physicians, nurse practitioners, and physician’s assistants who have completed specialized training at the Pope Paul VI Institute) as well as FertilityCare™ Practitioners (professionals trained in teaching couples how to chart the CrMS.) Whether you contact a Medical Consultant or Practitioner first, you will first need to chart using the CrMS for several cycles before the Medical Consultant can begin the evaluation.
4) What are the parts of a NaPro infertility evaluation? If you are seeking care for infertility, your evaluation will include a number of hormonal levels (there can be 10 or more blood draws in a cycle) looking at the hormones of ovulation to see if they rise appropriately. Blood will also be checked for a specialized evaluation of thyroid function . Other issues may be evaluated depending on the patient’s symptoms.
Along with the blood work, if a woman is having an evaluation for infertility, her evaluation may include a series of ultrasounds to evaluate the development of the ovarian follicle that contains the ovum (or “egg.”) She would also be recommended to have surgical evaluation. During this surgery, the Fallopian tubes (which carry the ovum to the uterus) are evaluated and treated if there are blockages, the inside of the uterus is examined with a special video camera to look for subtle abnormalities and signs of infection, and the whole pelvic area is examined very carefully for endometriosis—a common finding in women with infertility.
In addition, the couple is asked to obtain a semen sample for analysis of possible male factor infertility. This is done via an act of normal intercourse with a special perforated condom., which allows for the collection of the pre-ejaculate fluid and gives a more accurate evaluation of the seminal fluid that would be present with an act of intercourse. After all this, a treatment plan is developed which may involve cooperative hormonal therapy (hormones given at the proper point in the cycle), surgical treatment of anatomic abnormalities like endometriosis or polycystic ovaries, and antibiotics to treat underlying infection.
5) Who pays for all this? My insurance doesn’t cover infertility treatment. Great question, and one that had me wondering when I was in my NaPro Medical Consultant course. The good news is that many insurances DO cover NaPro evaluation and treatment for infertility, as well as PMS, PCOS, and irregular cycles. The key is what I mentioned earlier—infertility is a symptom, not the disease. We identify the disease state based on data from the FertilityCare™ charts and other evaluation. I have discovered that insurance does cover the costs for the labs, ultrasounds and surgery when they are targeted to the diagnosis and treatment of the actual disease state.
If a woman does not have insurance, the costs can be considerable—in the thousands. However, I’m currently working with an uninsured woman who is on a sliding scale with our local hospital for the ultrasounds and the surgery is being covered by a charity fund at another hospital. It can happen, so be open to being creative for funding. Compared to the costs of IVF with their lower success rate, it’s a good investment. And unlike IVF, NaPro works to restore a woman to health.
6) Do I have to go to Omaha for the evaluation and treatment? No. In recent years, Dr. Thomas Hilgers, the founder of NaProTECHNOLOGY®, has been training obstetrician-gynecologists how to do the specialized evaluations and treatments that he and other PPVI physicians provide in Omaha. These fellowship trained physicians are now located around the country—I’m blessed to have one an hour away. They are equipped to do the surgical evaluations and treatments—making these more accessible for those who cannot travel to Omaha. Additionally, other hospitals can provide the labs and ultrasounds needed if they demonstrate they are able to have their results compare suitably with those at PPVI Institute. Women in our area of Virginia, like some in other areas nationally, can get the full NaPro evaluation and treatment in their own “backyard”.
7) You mentioned that NaProTECHNOLOGY® has applications other than infertility. Can you give more information? Yes, NaProTECHNOLOGY® has successfully evaluated and treated chronic discharges, PMS, PCOS, pelvic pain, irregular bleeding, ovarian cysts, postpartum depression and more. The evaluation for these issues varies with the condition being treated—but with the exception of postpartum depression, always involves CrMS charting and usually bloodwork. With the data from these, a specialized treatment plan is developed using natural hormones given at the proper time in the cycle, and occasionally surgical evaluation/treatment is needed.
8) How well do these treatments work? Very well. I became a believer when a woman who had suffered debilitating PMS symptoms for years found her first relief with targeted hormonal therapy, and when a woman with a painful ovarian cyst reported relief within 30 minutes of a progesterone injection—while she and her husband were sitting on the parking lot of the local hospital ER just in case it didn’t work and she needed to be seen there. They drove home delighted to avoid the ER. (I was quite thrilled as well.) Another highlight of my first year practicing NaPro was helping a woman with a number of successive miscarriages carry her most recent pregnancy to a full-term delivery using hormonal treatment. Every NaPro Medical Consultant has similar success stories.
9) If this is so great, why aren’t there more NaPro trained doctors/NPs/PAs? First, NaPro IS that great. I had waited years for my chance to do the Medical Consultant course, and my only regret is that I didn’t do it sooner. However, NaPro training requires a great deal of time, energy, and financial expense on the part of the healthcare provider. I was blessed to have the financial support of my Diocese and Pastor, as well as a family willing to go without their wife and mother for 17 nights in Omaha in two separate stints—along with putting up with me working on exams and paperwork for a year. My office staff has also worked hard to help me provide the labs and treatments needed—which go outside the realm of “usual” family medicine.
To be a Medical Consultant, one also must certify that he/she does not provide or refer for artificial contraception, IVF, abortion, or sterilization. Sadly, not many doctors meet this criteria—but the number is growing, and I’ve been encouraged by the number of young physicians who are embracing this during their training.
Another barrier is that many healthcare providers don’t even know that NaPro exists. You can help by spreading the word to friends and encouraging your healthcare providers to look into NaPro.
10) How do I learn more? Go to www.fertilitycare.org and www.naprotechnology.com for starters. And stay tuned, my article is the first part of a three part series written by three NaPro Medical Consultants that aim to introduce you more fully to this revolution in women’s health care. Buckle up and enjoy the ride!