Exploring the Root Cause of Infertility with NaPro​

By: Hannah Irwin, DO

Director’s Note: Dr. Hannah Irwin, a former FACTS elective student, interviewed Jenny,* a Creighton Model user who found an alternative to conventional reproductive medicine in fertility awareness-based methods (FABMs). They discuss Jenny’s introduction to FABMs and her appreciation for these methods in the midst of her infertility struggles. The interview format provides a unique opportunity to learn about the real-life impact of FABMs and the multifaceted changes they can have on a person’s life.  If you have used FABMs and would like to share your story with one of our elective students, let us know here!

Fertility awareness-based methods (FABMs) have long been utilized as a natural means of avoiding pregnancy with various advantages, including limited cost, no side effects, and no contraindications. However, their utility extends far beyond avoiding pregnancy and can be used to gain an astounding amount of information about a woman’s health and fertility. With the guidance of FABM-trained medical professionals, these methods can be utilized as a diagnostic tool by women struggling to conceive in order to identify the root of the problem. However, these methods are not well known, and it can be challenging to find a practitioner who is equipped to support women and couples in their use of cycle tracking to identify and address underlying causes of infertility.

“With the guidance of FABM-trained medical professionals, these methods can be utilized as a diagnostic tool by women struggling to conceive in order to identify the root of the problem.”

I recently had the pleasure of meeting with Jenny, a woman who had been trying unsuccessfully to become pregnant for four years before learning about FABMs. She had experienced numerous frustrations and had seen an OB/GYN who only gave her the option of doing in vitro fertilization (IVF). Jenny wanted to explore other possibilities and eventually heard about Natural Procreative Technology (NaPro) from a friend. To learn more, Jenny met with a NaPro physician and found herself drawn to the NaPro approach; she felt like she was finally investigating the cause of the problem.

Jenny’s NaPro physician encouraged her to begin charting her cycle with the Creighton Model, and she met with an instructor one-on-one to learn how to utilize the method. Creighton relies on observations of cervical mucus before and after going to the bathroom, before going to bed, and after showering to track the cycle. Any mucus observed is further examined and described by color, consistency, change, and sensation noted throughout the day. These observations are recorded at the end of the day and then brought to the physician for further interpretation.

Overall, Jenny found that learning to use the method was relatively easy, but noted that one of the biggest hurdles was remembering to check before using the bathroom. Furthermore, the amount and elasticity of cervical mucus varies, making it challenging to determine her normal mucus patterns and identify her peak day. Jenny’s cycle tracking revealed long cycles with a short luteal phase and some spotting. She was started on progesterone to augment her luteal phase, which lengthened, but she still did not become pregnant. She continued to use the Creighton Model to track her cycle but also started using LH strips to monitor for ovulation. With the LH strips, she realized that she was not ovulating despite observing cervical mucus. This was further confirmed via ultrasound.

Since December 2020, Jenny has been working with her NaPro physician to plan her cycles to optimize conditions for ovulation. Since discovering that she does not usually ovulate, she has used Letrozole to stimulate ovulation but has had some challenges with determining the optimal dosage. Despite not yet becoming pregnant, Jenny remains optimistic and seems able to find joy in the process. She believes one of the advantages of using cycle tracking is that it has afforded her a better understanding of her body and a feeling of reassurance that she is addressing the root causes of her infertility, rather than resorting immediately to IVF/ICSI.

“She believes one of the advantages of using cycle tracking is that it has afforded her a better understanding of her body and a feeling of reassurance that she is addressing the root causes of her infertility.”

Additionally, Jenny has found it empowering  to eliminate medications that she had been prescribed previously. At one point, she was started on levothyroxine, but she states that she never had a thyroid issue. It has been a relief to work with her NaPro physician and no longer use this medication. Her biggest surprise with using Creighton has been the realization that her body is not naturally doing the things she expected it to. This has been hard for her, but overall, she is very happy to have this tool available and plans to continue using it for the time being.

Jenny also feels good about the other changes that she and her husband have made in their home environment, noting that they are trying to build a toxin-free home and dietary plan. Looking back at when they first started trying to conceive seven years ago, she remarked that so much has changed: She is in an entirely different place now. Her home is more prepared for a family, and she feels healthier than ever.

“As clinicians, it is critical that we educate ourselves to then be able to point patients in the direction of FABMs to better understand their fertility.”

Jenny’s story provided so much insight into the struggles and effort of couples facing infertility. She has done so much in her life to achieve pregnancy, but it was encouraging to hear her remain optimistic after seven years of trying. As clinicians, it is critical that we educate ourselves to then be able to point patients in the direction of FABMs to better understand their fertility. Jenny reiterated her relief at finally understanding the root of her fertility issues and noted the value of FABMs in making so much underlying information readily accessible.

*Names have been changed to respect the privacy of the interviewee. All information is shared with permission.

ABOUT THE AUTHOR

Hannah Irwin, DO

Hannah Irwin, DO is a recent graduate of Arizona College of Osteopathic Medicine in Glendale, Arizona. She completed her bachelor’s degree at the University of Minnesota studying chemistry. She plans to do her residency in internal medicine and is interested in women’s health and in expanding the role of medical education in better understanding women’s physiology. She enrolled in the FACTS elective to gain a better understanding of natural family planning methods, women’s health, and fertility in order to provide future patients with a better understanding of their health and the options available to them.