National PCOS Awareness Month
Getting to the Root to Restore Fertility
By: Kayla Fussy, MD
Director’s Note: As we conclude Polycystic Ovary Syndrome (PCOS) Awareness Month, we are featuring an interview with Jennifer,* both a patient user and instructor with the Creighton Model. Dr. Kayla Fussy, a former FACTS elective participant, was impressed to hear firsthand from Jennifer just how effective fertility awareness-based methods (FABMs) can be in the restoration of fertility once underlying causes such as PCOS are identified. Not only was Jennifer able to utilize FABMs to plan her family, but her success story also highlights the myriad applications of FABMs for medical management.
Jennifer* is a 31-year-old woman who has been charting with the Creighton Model of natural family planning (NFP) for over seven years. She and her husband have three children, ages 1, 3, and 5. She was first exposed to Creighton while growing up, as many of her family and friends were familiar with it. In college, per the recommendation of a family member, she began casually charting with the Creighton Model because she was concerned about potential thyroid issues. The Creighton Model is a natural or fertility awareness-based method (FABM) that uses cervical mucus as a biomarker to identify the fertile and infertile times in a woman’s cycle. Couples can use it to help achieve or avoid pregnancy, and it may also lend insight into female reproductive health.
“The Creighton Model is a natural or fertility awareness-based method (FABM) that uses cervical mucus as a biomarker to identify the fertile and infertile times in a woman’s cycle.”
When Jennifer became engaged after graduating from college, she and her fiancé attended a Creighton Model introductory session. The couple chose Creighton due to Jennifer’s familiarity with the method and the accessibility of an introductory class. Although she is quite comfortable with the method now, in hindsight, Jennifer reflects that their initial exposure to the Creighton method was inadequate for accurate use of the method. They did not have follow-ups after their first meeting and were not given sufficient instruction in identifying different types of cervical mucus. Although they charted during their long-distance engagement, she and her husband still felt confused about charting after getting married.
Once married, Jennifer and her husband decided they wanted to try to have a baby right away. However, Jennifer was surprised when several cycles had gone by and she had not yet become pregnant. She also noticed her cycles were about 40 to 50 days long. After a few months, she and her husband began working with a clinician trained in FABMs. Lab work indicated signs of polycystic ovary syndrome (PCOS) and low progesterone, and she was prescribed myoinositol and progesterone supplements. Following several additional cycles without achieving pregnancy, her clinician added clomid for ovulation induction. After the second round of clomid, she became pregnant with their first child. She continued intramuscular progesterone injections throughout her pregnancy, utilizing the NaProTechnology protocol for progesterone support in pregnancy. She carried her pregnancy to term and delivered a healthy baby.
Jennifer has since had two subsequent healthy pregnancies, both conceived within a few cycles of fertility-focused intercourse while charting. She continued to take progesterone throughout both pregnancies, and she also takes post-peak progesterone and myoinositol during her regular cycles. She is grateful for the role that the Creighton Model played in identifying the root cause of her initial cycle issues and subsequent medical treatments. Her overall health has improved and she also recognizes how Creighton has increased communication and self-control within her marriage. She and her husband are grateful for their children and that Creighton offered a natural, restorative approach to their initial fertility issues.
“She is grateful for the role that the Creighton Model played in identifying the root cause of her initial cycle issues and subsequent medical treatments. Her overall health has improved.”
After the birth of her first child, Jennifer sought out additional education on how to use the Creighton Model to space out subsequent pregnancies. She noted a lack of available instructors in her area and decided to take a further step to become a Creighton instructor herself. She has now been an instructor for over four years. Becoming a Creighton teacher exposed her to the surprising misconceptions many people have about the female cycle, such as thinking a woman can get pregnant any day of the cycle. She feels empowered by her ability to correct these misconceptions, especially when she can help women and couples identify biomarkers suggestive of medical issues and refer them to a medical professional for further workup and diagnosis.
Jennifer strongly encourages medical students and other health professionals to learn more about FABMs to meet the great need for clinicians trained in these methods. She wishes more doctors knew about these methods and accepted them as a legitimate medical option both for family planning and as a valuable diagnostic tool to identify medical problems.
“So much information can be gleaned from a [woman’s] chart,” she notes.
My conversation with Jennifer taught me two key lessons: First, I learned the critical importance of adequate instruction and follow-up for user confidence in FABMs — even when trying to conceive. Much emphasis is placed on correct use to avoid pregnancy, but Jennifer’s experience indicates how accurate charting can aid a couple desiring to achieve pregnancy. Furthermore, a woman’s chart can be used by trained practitioners to diagnose underlying health conditions. Charting accurately and with confidence is important for women and couples to maximize the benefits of these methods.
“I learned the critical importance of adequate instruction and follow-up for user confidence in FABMs — even when trying to conceive.”
Second, Jennifer’s story revealed the power of identifying and treating the root cause of women’s health issues. I was impressed by how quickly treatment of underlying conditions, such as PCOS and low progesterone, can restore fertility. Jennifer and her husband were able to conceive within a few cycles with the help of clomid for their first pregnancy and within 1 to 2 cycles in subsequent pregnancies without ovulation induction. This underscores one of my main takeaways from the FACTS elective: FABMs assist couples with their reproductive goals in a natural and effective way that can last through the reproductive years of the couple. FABMs are not a one-time fix as they have the potential to treat underlying health conditions and restore the reproductive system to its normal function.
“FABMs assist couples with their reproductive goals in a natural and effective way that can last through the reproductive years of the couple.”
I greatly enjoyed speaking with Jennifer about her perspective as both a user and an instructor. In the coming years, I look forward to using the information I have learned in the FACTS elective to help my future patients meet their health and reproductive goals.
*Names have been changed to respect the privacy of the interviewee and her family. All information is shared with permission.
ABOUT THE AUTHOR
Kayla Fussy, MD
Kayla Fussy, MD is a first-year family medicine resident at Altru Health System in Grand Forks, North Dakota. She earned her Bachelor of Science in Biology from the University of North Dakota and recently completed her Doctor of Medicine degree at the University of North Dakota School of Medicine and Health Sciences. She chose to participate in the FACTS elective as a medical student to gain insight into the various fertility awareness-based methods and how they can be applied to treat women’s health issues and infertility. She has a strong interest in women’s health and fertility awareness, and plans to support FABM users in her future practice.
