Catholic World News News Feature
Infertility Treatment, Catholic Style December 05, 2001
By Lesley Payne
Promoters of natural family planning (NFP) often complain that the method’s phenomenal effectiveness, safety, and marriage-building benefits are among of the world’s best-kept secrets. Certainly drug companies, prescription-pushing physicians, medical schools, and other beneficiaries of the booming business in artificial contraceptives are silent about NFP.
Not surprisingly, new NFP-inspired treatments for infertility, which some doctors claim are three times more effective than the high-tech solutions offered by the booming infertility specialty—are likewise being ignored.
Mainstream infertility treatments include many procedures that are morally unacceptable to Catholics. With in vitro fertilization a number of embryos are implanted in the woman’s uterus, with most (or all) of them destined to die. High doses of fertility drugs like Clomid and Pergonal often result in four, five, or more babies being conceived, with the couple pressured to undergo "selective reduction"--to abort all but one or two of the babies. Other standard infertility procedures violate the Church’s teaching that the unitive and procreative aspects of marital sexuality can never be separated. For example, where defects in the husband’s sperm motility or the wife’s cervical mucus are suspected, the recommended treatment is usually intrauterine insemination, in which the physician injects a sample of the husband’s semen, illicitly obtained, directly into the wife’s uterus.
The underlying assumption of such anti-life infertility treatments is that the woman’s body must be bombarded with drugs and battered with machinery to force it to produce the desired product. This clumsy approach has proven to be both inefficient and costly. Most infertility specialists, having no knowledge of the methods of charting a woman’s monthly cycle—methods which have been greatly refined by NFP practitioners--can only guess when a woman is likely to be ovulating, or when she should be given a fertility drug to induce ovulation more efficiently.
LEARNING BY OBSERVING
All of the available NFP methods can help couples who are attempting to achieve a pregnancy. But Dr. Thomas Hilgers, of the Pope Paul VI Institute for the Study of Human Reproduction in Omaha, Nebraska, has taken one step further. He has put his 20 years of research into the development of the Creighton NFP model to work in what he calls "NaPro Technology," which can also be used to treat infertility and other female reproductive disorders.
Couples who use the Creighton NFP model carefully track changes in the woman’s cervical mucus (other NFP methods also track temperature changes and other signs of ovulation), and chart their observations, using special notation and forms developed by the Creighton method. According to Dr. Martha Garza, a reproductive endocrinologist in San Antonio, Texas, research has shown that the mucus changes observed correspond exactly with the changing levels of estrogen and progesterone that cause a woman to ovulate and menstruate. A Creighton-trained physician, she says, can track hormone levels and identify any hormone deficiencies which would cause infertility or miscarriages, simply by evaluating a woman’s NFP charts. The only way for mainstream infertility specialists to obtain such detailed information would be to take blood hormone levels every day in the patient’s cycle. But that process would be prohibitively expensive. Instead, Dr. Garza says, the standard practice is to obtain hormone levels at several points during the cycle, and then use those samples as the basis for an educated guess as to which day the woman is "supposed" to ovulate.
Many of the hormone deficiencies which can be diagnosed through the Creighton method respond remarkably to another treatment developed by Dr. Hilgers: cooperative progesterone replacement therapy (CPRT), in which progesterone administered on the days following ovulation, according to a carefully planned schedule.
Dr. Hilgers has also discovered that other causes of infertility, such as endometriosis and polycystic ovary disease, can also be diagnosed from a woman’s NFP charts, allowing the physician to go right to surgery, rather than wasting time experimenting with other treatments. The Pope Paul VI Institute has even developed a device for collecting sperm samples during intercourse—a process which, unlike the standard practice, does not violate Church teaching.
Dr. Kathleen Raviele, an obstetrician/gynecologist in Atlanta, Georgia, notes that when ovulation does not occur naturally, it is permissible to induce the process by using drugs like Clomid. But there are some drawbacks to Clomid, she notes, such its potential to cause problems with cervical mucus (which can be counteracted with antibiotics, she notes) and—far more serious--the risk of causing multiple pregnancies. Unfortunately, many of the doctors who treat infertile couples are willing to risk multiple pregnancies, since they are fully prepared to abort any "extra" fetuses. As a result these are quick to administer Clomid, even when there might be a simpler medical solution to the problem.
Dr. Raviele says:
In most infertility clinics they don’t even bother to diagnose the problem. Not enough attention is paid to cervical mucus, which is a big factor. They bypass it, going straight to intrauterine insemination and in vitro fertilization, which are morally unacceptable. They don’t do much for treating tubal patency, but bypass this and go right to in vitro. They don’t treat the disease.
CASE STUDIES
"We had been trying to get pregnant for two years before we met Dr. Hilgers," says Jeff Taylor of Papillon, Nebraska. "Within six months of seeing him, we were pregnant." He recounts an all-too-typical story: With our old doctor in North Carolina, we were being led toward Clomid and Pergonal, but we decided that was not the course we wanted to take--especially after the doctor so cavalierly told us multiple pregnancies could occur and they would have to go in and selectively abort some of the children. That doctor wanted us to start fertility drugs right away, without doing a laparoscopy [a surgical procedure to look inside the pelvic cavity]. Suzanne’s mother had had a hysterectomy early in life, so we knew there was a chance something was wrong.
Suzanne Taylor tried one cycle of Clomid, but suffered uncomfortable side-effects. Next the doctor offered Pergonal injections. But the cost would have been $1,500 per cycle—a cost not covered by the Taylors’ medical plan. And since they would again have faced the risk of multiple pregnancies, the couple decided against Pergonal. "We began praying more fervently about this," says Jeff. "But we thought maybe we wouldn’t be able to have children--that maybe God wanted us to adopt."
During 1997, the Taylors were living near Omaha while Jeff conducted on a temporary project for his company. Suzanne, volunteering at a Christian school (the Taylors are Evangelical Christians), mentioned her infertility problem to the school’s administrator, who told her about the Pope Paul VI Institute. Recalls Jeff:
If that’s not God working! Not being Catholic, if we had just seen "Pope Paul VI Institute" in the phone book we would have said, "Oh that’s just for Catholics," and we would not have called.
In August of 1997, the couple attended Creighton training and began charting Suzanne’s cycle. In October they met with Dr. Hilgers. In a physical examination he detected evidence of endometriosis—an excessive growth of tissue blocking the uterus--and an ovarian ultrasound test uncovered polycystic ovary syndrome. On laparoscopy, Dr. Hilgers found one of Suzanne’s fallopian tubes to be blocked . He unblocked it, but the endometriosis was too severe to be treated in that surgery. "Her endometriosis was so bad," says Jeff, "it didn’t take a rocket scientist to tell that, no matter how much medication they gave her in North Carolina, this girl wasn’t going to get pregnant, and if she did, the chance of an ectopic pregnancy was extremely high."
In January of 1998, Dr. Hilgers performed microlaser surgery to vaporize the endometriosis implants, and performed wedge resections of both ovaries to treat the polycystic ovary disease. Jeff notes that all of this was paid for by their health insurance, since it was to treat an underlying disease, rather than simply to remedy infertility.
The Taylors conceived on the second cycle after the surgery. Hormone tests showed low progesterone levels, so Suzanne received supplemental progesterone for ten weeks. Their daughter, Erin, was born December 7, 1998. When Jeff’s company’s project was finished, the Taylors chose to remain in Omaha, with Jeff taking a job as business manager for the Paul VI Institute. Jeff notes that, in the course of his new job, he often speaks at local parishes, promoting NFP.
Mary Jean Bagileo has been teaching the Creighton method since 1995. Her husband, Nick, is Family Life Director for the Diocese of Oklahoma City. After her first child was born, Mary Jean suffered a series of miscarriages. "I found out from my chart was what wrong," she says, "and took it to a Creighton physician." Mary Jean herself could explain what the chart showed:
The post-peak phase [after ovulation is identified, until the beginning of menses] should be 9 to 17 days on average, in order to allow implantation to occur after conception. Because I was charting, I was able to tell that most of the time my post-peak phase was 4 to 6 days. In theory, implantation occurs 6 to 9 days after conception. If your post-peak phase doesn’t last long enough for implantation to occur, everything will be flushed out with menses. My post-peak phase was so short that if I was conceiving, I would have been having early miscarriages.
The Creighton physician (who worked in another city and consulted with her by phone) put Mary Jean on progesterone supplements to lengthen her post-peak phase. She quickly became pregnant. Because of still-low progesterone levels, she continued with hormone supplements to prevent a miscarriage. Then a complication arose, because her regular physician did not understand the reason for the progesterone shots. I had a local doctor who thinks I’m nuts. I told him I was getting these shots and he just looked and me and said, "Why? They’re not needed." I stayed on them, and didn’t tell him. I asked him at 10 weeks to check my progesterone level, and at that time told him I was still getting the shots. He did the test and told me the levels were high enough, and that I didn’t need the shots anymore. I assumed he knew what he was talking about and stopped the shots. Ten days later I miscarried.
Mary Jean found a new local physician, began again with the post-peak progesterone supplementation, became pregnant, and had progesterone shots for almost five months into the pregnancy. "The progesterone levels were supposed to rise in correlation with the gestation of the child," says Mary Jean, "but mine went steadily down until 14 to 15 weeks." Her daughter, Bridget, was born in March of 1998.
Heidi Giroux of Wichita, Kansas, also a Creighton instructor, used Creighton NFP when she was first married in 1995. The following year she began to try to get pregnant, but was unsuccessful for a year. "My doctor wanted to do invasive stuff right away," she says. "He told me the first step would be an endometrial biopsy and then fertility drugs. I said, ‘Whoa! How about taking some blood first?’"
Heidi, who then lived in Oklahoma City, decided to drive 2-1/2 hours to Wichita to see Dr. Lorna Svetkovich, who had trained under Dr. Hilgers "She put me on progesterone in my luteal [post-peak] phase," she reports. "Also, I was very active--running a lot--and she recommended that I stop this to try to get my body fat up. She gave recommendations for vitamins and nutrition." The Giroux’s son Stephen was born in March of 1997. Heidi is now pregnant with her second child, having had no difficulty getting pregnant the second time.
SIGNS OF PROGRESS
Still, there are some signs of progress, as physicians and patients who have begun to recognize the medical and moral problems associated with in vitro techniques begin searching for other ways to counteract infertility. Dr. Hilgers notes that there has been a sharp increase in the number of physicians requesting training and materials from the Pope Paul VI Institute, although he readily acknowledges that the medical community is far from embracing his methods. Hilgers is now writing a definitive textbook on NaPro Technology; his preliminary book on the subject, The Medical Applications of Natural Family Planning, provides an introduction to NaPro diagnostic and treatment methods for physicians. Two week-long training sessions are held at the Institute each October, with a special track for physicians. Only doctors who do not prescribe contraceptives, and who do not refer for or perform abortions or sterilizations, can become certified as NFP medical consultants. (Others can audit the course.) The Institute recently obtained approval from Creighton School of Medicine to start allowing nurse practitioners, physician’s assistants and nurse midwives to become NFP medical consultants as well.
The Pope Paul VI Institute is currently raising funds for its research, training, and outreach projects. And the Institute has lined up support from one very prominent donor. In each of the past two years, Pope John Paul II has contributed $50,000 from his own discretionary funds.
[AUTHOR ID] Lesley Payne is a free-lance journalist based in California.
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FOR MORE INFORMATION
Pope Paul VI Institute for the Study of Human Reproduction 6901 Mercy Road Omaha, NE 68106 (402) 390-6600 web site: www.popepaulvi.com
The Couple to Couple League teaches the Sympto-Thermal NFP method, and holds seminars for physicians in Cincinnati, Ohio every six months. (The next one will be held June 11-13, 1999.) Contact CCL at (513) 471-2000; web site: www.ccli.org.
Available from One More Soul: a NFP-only physicians' directory and Physicians Healed, a collection of from doctors who came to embrace the Church's teachings on life and love and stopped prescribing contraceptives. Contact One More Soul, 616 Five Oaks Avenue, Dayton, OH 45406; (800) 307-7685.
