By: Olga Lacki
Editor’s Note: After years of unexplained infertility and multiple miscarriages, one couple underwent appointments, tests, and even surgery as they searched for an answer. Disheartened and ready to turn to in vitro fertilization, they stumbled upon fertility awareness-based methods (FABMs) of charting after a chance encounter with Dr. Marguerite Duane, the co-founder and executive director of the Fertility Appreciation Collaborative to Teach the Science (FACTS). Olga Lacki, a former FACTS elective student, interviewed the couple whose story demonstrates how information gleaned from a woman’s chart can be applied by an FABM-trained practitioner to avoid the anxiety and expense of unnecessary interventions.
Meet the Couple
Melissa* and her husband, Jacob,* found themselves at a crossroads. They had been trying to bring a child into the world for several years and had faced heartbreak along the way. The couple miscarried twice without any explanation. Their unexplained infertility was a source of frustration. Jacob’s sperm analyses did not present any concerns, and Melissa’s many appointments with her Ob-Gyn physician also failed to yield any answers.
Melissa’s menstrual cycle seemed normal to her. She noticed that she would menstruate for seven days, often with tail end brown spotting, but nothing about that struck her as abnormal. Rather, her biggest complaint was perineal pain. Melissa’s Ob-Gyn proposed endometriosis as a possible cause of her fertility struggles and perineal pain, referring her for laparoscopic surgery.
Results of the surgery did not reveal any endometriosis, and the couple felt dejected as they still had no answer. The memories of their miscarriages in 2011 and 2016 weighed heavily on them, but they were not ready to give up yet. As the next step, most of the couple’s medical professionals suggested that Melissa and Jacob consider in vitro fertilization (IVF). However, the price — several thousands of dollars — was daunting, and the fear of the treatment failing was even more crippling. Together, Melissa and Jacob decided to postpone IVF for the time being; Melissa had a gut feeling that it was not yet time for such drastic measures.
As destiny would have it, Melissa attended a conference where Dr. Marguerite Duane, the executive director of FACTS, was speaking. Melissa approached Dr. Duane after the talk and began to tell her about their fertility struggles. Dr. Duane listened attentively, and then asked: “Are you charting?”
Melissa began to explain that she felt pretty familiar with her cycle, but Dr. Duane repeated her question.
“No, I am not charting,” admitted Melissa.
Dr. Duane encouraged Melissa to begin charting her cycles with a fertility awareness-based method (FABM) and recommended a Creighton Model instructor. After several cycles of consistent charting and meetings with a Creighton-trained instructor, Melissa began to understand her cycle like never before. In light of Melissa’s fertility issues, the instructor promptly referred her to a local Ob-Gyn physician trained in NaProTechnology. Upon reviewing Melissa’s charts, the physician suspected a luteal phase defect. A subsequent evaluation with hormonal blood tests and an ultrasound confirmed a luteal phase defect, low estradiol, and low progesterone.
“After several cycles of consistent charting and meetings with a Creighton instructor, Melissa began to understand her cycle like never before.”
Melissa used estrogen and progesterone patches before moving onto taking hCG shots. Fearful of needles, Melissa required some convincing before beginning the hCG treatment. But after starting the shots, her hormone levels normalized. Furthermore, the tail end brown bleeding at the end of menstruation ceased, and the perineal pain improved as well. Melissa’s physician also prescribed clomiphene early in the cycle to improve ovulation. However, Melissa found herself more irritable and emotional on clomiphene and opted to switch to early cycle tamoxifen instead before her symptoms improved.
Melissa found the learning process of charting quite intuitive. At present, she sees her FABM practitioner every six months, or more frequently if she has questions. Her husband is very supportive of charting and reminds her to fill out her chart on days she forgets.
Melissa feels very blessed to have found FABMs through Dr. Duane. Had she and Jacob proceeded with IVF prior to discovering her luteal phase defect, she would have likely continued to experience miscarriages because her natural progesterone level was simply too low to maintain her cervical lining during a pregnancy. In fact, once her FABM instructor learned about her hormonal status, she expressed surprise that Melissa had been able to conceive in the first place. Understanding her menstrual cycle has given Melissa a new sense of power over her body, and she is greatly relieved to finally have an accurate diagnosis.
“Melissa feels very blessed to have found FABMs through Dr. Duane.”
It is incredible how much a woman can learn about her body through very inexpensive charting methods. Melissa underwent laparoscopic surgery and considered costly artificial reproductive technologies before she discovered the true cause of her infertility. Not only did this delay the time to diagnosis but it also caused a great deal of distress for Melissa and Jacob. This couple’s story confirms the invaluable knowledge contained within a woman’s cycle and begs the question: Why aren’t more women charting? Charting with an FABM should be the foundation upon which any additional diagnostic tests and treatments are added. In many cases, supplemental hormones targeted at key points within a women’s cycle can resolve common causes of infertility. Melissa and Jacob are a testament to the reality that knowledge of one’s cycle empowers both women and couples to truly care for their reproductive health.
“Charting with an FABM should be the foundation upon which any additional diagnostic tests and treatments are added.”
*Names were changed to protect patient privacy, and all information is published with permission.
** Your tax-deductible gift of $100 covers the cost for one person to attend a FACTS Conference, where they will learn more about FABMs, impacting the lives of people like Melissa and Jacob. Please GIVE TODAY!
ABOUT THE AUTHOR
Olga Lacki
Olga Lacki is a pediatric resident at Riley Hospital for Children at Indiana University. She attended medical school at Jagiellonian University Medical College in Krakow, Poland. She completed the FACTS Women’s Health elective in the fall of 2021.
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