1 NaProTECHNOLOGY & The FertilityCare Movement Dr. Phil Boyle MICGP MRCGP CFCMC Life Conference Cork...

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NaProTECHNOLOGYNaProTECHNOLOGY& &

The FertilityThe FertilityCareCare Movement Movement

Dr. Phil BoyleDr. Phil Boyle

MICGP MRCGP CFCMCMICGP MRCGP CFCMC

Life ConferenceCork

Nov. 2005

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NaProTechnologyNaProTechnology Natural Procreative TechnologyNatural Procreative Technology A newly emerging A newly emerging Scientific,

Holistic, Pro-Life system of system of fertility treatmentfertility treatment

Inspired by Catholic teaching Inspired by Catholic teaching Highly effective in treatingHighly effective in treating

InfertilityInfertility Recurrent MiscarriageRecurrent Miscarriage Abnormal Gynaecologic HealthAbnormal Gynaecologic Health

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NaProTechnologyNaProTechnology Available in USA since 1990 In Galway, Ireland since 2nd Feb.

1998 In Life Health Centre, Liverpool,

UK since 1999 Now 13 Doctors (5 Obstetricians

and 8 GPs) have trained in Europe

www.fertilitycare.net

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NaProTechnology - NaProTechnology - OriginOrigin

Humanae Vitae 1968 – Papal Humanae Vitae 1968 – Papal EncyclicalEncyclical

Dr. Thomas HilgersDr. Thomas Hilgers Turning point Turning point

– – Beautiful vision of marriageBeautiful vision of marriage Inspired to conduct research into Inspired to conduct research into

moral methods of family planningmoral methods of family planning NaProTECHNOLOGY came later….NaProTECHNOLOGY came later….

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The Creighton Model The Creighton Model FertilityFertilityCareCare SystemSystem

A Standardised Modification of the A Standardised Modification of the Billings Ovulation MethodBillings Ovulation Method

NaProTechnologyNaProTechnology A New Reproductive Science that has A New Reproductive Science that has

developed as a result of precise information developed as a result of precise information which the Fertilitywhich the FertilityCareCare system provides system provides

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Could the FertilityCare Could the FertilityCare Charts be telling us Charts be telling us something moresomething more ? ?

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AT its simplest level AT its simplest level NaProTechnology uses a wide NaProTechnology uses a wide range of range of medical and surgicalmedical and surgical

interventions to correct abnormal interventions to correct abnormal

1.1. FertilityFertilityCareCare Charting patternsCharting patterns2.2. Subtle hormonal deficienciesSubtle hormonal deficiencies3.3. Ovulation defectsOvulation defects4.4. Surgical / structural Surgical / structural

abnormalitiesabnormalities

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NaProTechnologyNaProTechnologyCo-operatesCo-operates with the couple’s natural procreative potential to achieve optimum with the couple’s natural procreative potential to achieve optimum

function.function.

Creighton Model FertilityCreighton Model FertilityCareCare System System Medical TreatmentsMedical Treatments Surgical TreatmentsSurgical Treatments Counselling - Stress ManagementCounselling - Stress Management Spiritual - Prayer!Spiritual - Prayer!

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Many of the medical and Many of the medical and surgical techniques have been surgical techniques have been used previously, but important used previously, but important

NEW treatment approaches NEW treatment approaches and surgical interventions and surgical interventions

have also been developed by have also been developed by Dr. Hilgers in, Omaha, Dr. Hilgers in, Omaha,

Nebraska, USANebraska, USA

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A key to the success of A key to the success of NaProTechnology NaProTechnology

is to apply the medical and is to apply the medical and surgical interventions in a surgical interventions in a

timed fashion with respect to timed fashion with respect to the Fertilitythe FertilityCareCare chart chart

AndAndto continue treatment for to continue treatment for at least 12 effective cyclesat least 12 effective cycles

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45 MINUTES 45 MINUTES per per

CONSULTATIONCONSULTATION

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The Couple The Couple manage their own fertility…manage their own fertility…

Directed by theDirected by the

“Fertility “FertilityCare Care Physician” Physician”

Assisted by their Assisted by their Teacher-PractitionerTeacher-Practitioner

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Case PresentationsCase Presentations1.1.Recurrent MiscarriageRecurrent Miscarriage

2.2.InfertilityInfertility

3.3.Male Factor InfertilityMale Factor Infertility

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G.W. - 6 MiscarriagesG.W. - 6 Miscarriages Dec 04Dec 04 6.5 years Recurrent Miscarriages, 6.5 years Recurrent Miscarriages,

Age 40y. DOB Aug ‘64 G0 P0 SA 6 (6-Age 40y. DOB Aug ‘64 G0 P0 SA 6 (6-13wks)13wks)

Dx Unexplained Recurrent MiscarriagesDx Unexplained Recurrent Miscarriages Regular cycles – 28-30 daysRegular cycles – 28-30 days

Surgery to remove Uterine Septum Sept Surgery to remove Uterine Septum Sept 0404

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G.W. - 6 MiscarriagesG.W. - 6 Miscarriages

NaPro Assessment NaPro Assessment

Low Progesterone – 35.5 nmol/lLow Progesterone – 35.5 nmol/l Low B12 – 187 pmol/lLow B12 – 187 pmol/l Under-active Thyroid – TSH Under-active Thyroid – TSH

4.42 iu.4.42 iu.

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TreatmentTreatment Femara 1.25mg daily for 3 days Femara 1.25mg daily for 3 days

from day 3from day 3 HCG 5000 on P+3,5,7,9HCG 5000 on P+3,5,7,9 B12 4mcg tidB12 4mcg tid Thyroxine 50mg dailyThyroxine 50mg daily

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ConceivedConceived with an optimum cyclewith an optimum cycle

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31st Aug 05

CRL 33mm

10w 5days

EDD 24.3.06

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G.W. - 6 MiscarriagesG.W. - 6 Miscarriages During PregnancyDuring Pregnancy

Vaginal Prog 400mgVaginal Prog 400mg Prednisolone 5mg dailyPrednisolone 5mg daily Eltroxin 50mcg dailyEltroxin 50mcg daily Folic Acid/ B12Folic Acid/ B12

Now 21 Weeks Gestation….Pray!Now 21 Weeks Gestation….Pray!

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C.H - InfertilityC.H - Infertility April 00April 00 10 years Primary Infertility, 10 years Primary Infertility,

Age 36y. G 1 P 0Age 36y. G 1 P 0 Dx PCOD and EndometriosisDx PCOD and Endometriosis Long Irregular cycles - 4 light menses Long Irregular cycles - 4 light menses

per yearper year Clomiphene x 2 cycles 1991Clomiphene x 2 cycles 1991 IUI x 12 cycles 1992-1993 – conceived IUI x 12 cycles 1992-1993 – conceived IVF x 7 cycles 1993 -1999 (5 embryo IVF x 7 cycles 1993 -1999 (5 embryo

TF)TF)

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C.H - InfertilityC.H - Infertility Ultrasound Ultrasound

right side Endometrioma 2.5cmright side Endometrioma 2.5cm

Surgical Referral Surgical Referral Laparoscopy and Diathermy Laparoscopy and Diathermy

Aug 00Aug 00

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C.H - InfertilityC.H - Infertility• Restored a normal appearance to Restored a normal appearance to

the Fertilitythe FertilityCareCare Chart through Chart through surgical and medical interventionsurgical and medical intervention

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C.H - InfertilityC.H - Infertility Clomiphene 150mg x 5 days – Clomiphene 150mg x 5 days –

ovulation inductionovulation induction HCG 5000 sc HCG 5000 sc day 21 –day 21 – follicular follicular

rupturerupture Progesterone 400mg pv - luteal Progesterone 400mg pv - luteal

supportsupport Glucophage 500mg tid Glucophage 500mg tid Prednisolone 5mg dailyPrednisolone 5mg daily

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C.H - InfertilityC.H - Infertility Conceived on 11th cycle of Conceived on 11th cycle of

treatmenttreatment

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C.H - InfertilityC.H - Infertility Live Birth, Live Birth, 3131stst Dec 2003 Dec 2003 Healthy Male Infant - JOSEPHHealthy Male Infant - JOSEPH Elective LSCS at 32 Weeks Elective LSCS at 32 Weeks

(Nervous Obstetrician!!)(Nervous Obstetrician!!) Weight 3 lb 4 oz (1.477 Kg)Weight 3 lb 4 oz (1.477 Kg)

Mother and baby well.Mother and baby well.

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3. Male factor Infertility 3. Male factor Infertility Dx: Infertility for 5 years, Female Age 34yrsDx: Infertility for 5 years, Female Age 34yrs

Sperm CountSperm Count 50,000 per ml50,000 per ml10,000 per ml10,000 per ml

200,000 per ml200,000 per ml 4,000,000 per ml4,000,000 per ml 800,000 per ml800,000 per ml

Hx: Gravida 1 para 0 Misc 1, (ICSI Hx: Gravida 1 para 0 Misc 1, (ICSI Pregnancy)Pregnancy)

3 Failed ICSI, 2 – 3 embryos each time3 Failed ICSI, 2 – 3 embryos each time

Problem – Male FactorProblem – Male Factor

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3. Male factor Infertility3. Male factor Infertility NPT Additional Female Dx: Low Prog. And Low E2NPT Additional Female Dx: Low Prog. And Low E2 Conceived 8Conceived 8thth Cycle NPT, Cycle NPT, Male Tamoxifen, L carnitine, PycnogenolMale Tamoxifen, L carnitine, Pycnogenol

VolumeVolume 4 mls4 mls CountCount 4 Million/ ml4 Million/ ml MotilityMotility 45%45% Morphology Morphology 4% Normal 4% Normal

Healthy Girl born, 8lb 8 oz. June 2004 Healthy Girl born, 8lb 8 oz. June 2004 Mum aged 35yrsMum aged 35yrs Progesterone support during pregnancy until 28 wksProgesterone support during pregnancy until 28 wks Very important to treat the female…often combined Very important to treat the female…often combined

problemproblem

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?? Just Lucky ???? Just Lucky ??

Or Or A Promising Scientific A Promising Scientific

advance?advance?

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For those who believe, For those who believe, No Explanation is No Explanation is

NecessaryNecessary

For those who refuse to For those who refuse to believe,believe,

No Explanation is No Explanation is Possible!Possible!

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Staggering Scientific Staggering Scientific Bias against NaPro! Bias against NaPro!

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The Irish NaPro The Irish NaPro StatisticsStatistics

Over 2000 couples over 7.5 years Over 2000 couples over 7.5 years since Feb. 1998since Feb. 1998

For the first 4 years of treatmentFor the first 4 years of treatment Average Female age - 36 yrs.Average Female age - 36 yrs. Average time trying to conceive - 5 Average time trying to conceive - 5

yrs.yrs. Over 25%Over 25% - history of - history of

unsuccessful IVFunsuccessful IVF

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The Irish NaPro The Irish NaPro StatisticsStatistics

20 – 50% Successful pregnancies20 – 50% Successful pregnancies

submitted for publicationsubmitted for publication

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Following previous Following previous failed IVFfailed IVF

Range of 20 to 30% success per Range of 20 to 30% success per couple with failed IVF couple with failed IVF


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TWINSTWINS

< 4 % Rate, compared with 28% < 4 % Rate, compared with 28% IVF IVF

So Less prematurity, low birth So Less prematurity, low birth weight, Morbidity, Mortality and weight, Morbidity, Mortality and cost for NPT Birthscost for NPT Births


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123 Conceptions 123 Conceptions from 95 couples from 95 couples

with previously failed with previously failed IVFIVF

Dr. Phil BoyleDr. Phil BoyleMICGP MRCGP CNFPMCMICGP MRCGP CNFPMC

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IVF - UK. Declining success with increased ageIVF - UK. Declining success with increased age

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Women’s Age at conceptionWomen’s Age at conception

Average 36.8 Years 44% Aged 38 Years or olderAverage 36.8 Years 44% Aged 38 Years or older

123 conceptions from 95 couples Previous Failed ART

5

13

25 2628

15

74

0

5

10

15

20

25

30

<30 31-33 34-35 36-37 38-39 40-41 42-43 44+

Woman's Age

Num

ber

of W

omen

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Average 6 YearsAverage 6 Years

Years Trying to conceive 95 couplesPrevious Failed IVF

4

21

40

22

8

05

1015

2025

3035

4045

<2 yrs 3 to 4 yrs 5 to 6 yrs 7 to 9 yrs >10 yrs

Nu

mb

er

of

co

up

les

95 Couples - Previous Failed 95 Couples - Previous Failed ARTART

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75% never Delivered Previously75% never Delivered Previously

Previous Pregnancies

25%

31%

44%

Previous full term deliveryConceived but always miscarriedNever conceived naturally before

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95 Couples ART Diagnosis

0

55

22

101

102

117 8

13

010

2030

4050

60

Conce

ived

pre

IX

une

xplai

ned

end

omet

riosis

low p

roge

stero

ne

low e

strog

en

not

ovu

lating

hosti

le/lim

ited

muc

us

poor

sem

en a

nalys

is

block

ed tu

bes

pelvi

c adh

esion

s

Other

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95 Couples NPT Diagnosis

150

22

7361

4

43

11 7 823

01020304050607080

Conce

ived

pre

IX

our u

nexp

laine

d

our e

ndom

etrio

sis

our l

ow p

roge

stero

ne

our l

ow e

strog

en

our n

ot o

vulat

ing

our h

ostile

/limite

d m

ucus

our p

oor s

emen

ana

lysis

our b

lock

ed tu

bes

our p

elvic

adh

esio

ns

Other

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Months of treatment to first conception95 Couples previous failed ART

2

7

10 10

7 7

4

2

6

8

4 4 43 3

4

10

0

2

4

6

8

10

12

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16-20

20+

Months

Nu

mb

er

of

co

up

les


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95 Couples - Previous 95 Couples - Previous Failed IVFFailed IVF

78% successful Pregnancies per couple78% successful Pregnancies per couple

Final Pregnancy Outcome from 95 couples

73%

5%

18%4%

Live Birth Ongoing Miscarriage Ectopic

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TWINSTWINS

3 out of 89 Live Births = 3.4%3 out of 89 Live Births = 3.4%

3 out of 123 conceptions = 2.4%3 out of 123 conceptions = 2.4%

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www.naprotechnology.comwww.naprotechnology.com

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How relevant to Pro-Life How relevant to Pro-Life Movement?Movement?

NaPro is Good News for Everybody!NaPro is Good News for Everybody! Real Pro-Life Alternative to IVF Real Pro-Life Alternative to IVF

Kind to couplesKind to couples No Moral DilemmasNo Moral Dilemmas Real Chance of successReal Chance of success

BUT…..There is MORE!BUT…..There is MORE!

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How relevant to Pro-Life How relevant to Pro-Life Movement?Movement?

With greater use of NaPro, comes With greater use of NaPro, comes greater use of the FertilityCare greater use of the FertilityCare System System family planning family planning gynaecologic health maintenancegynaecologic health maintenance

Less Use of ContraceptivesLess Use of Contraceptives

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Contraceptive Pregnancy Contraceptive Pregnancy Rates Rates

The pill 8% per year The pill 8% per year

The condom 14% per The condom 14% per yearyear

Source: Source: Fam Plann Perspect. 1999 Mar Fam Plann Perspect. 1999 Mar Apr ;31(2):56 63.Fu H, Darroch JE, Haas T, Apr ;31(2):56 63.Fu H, Darroch JE, Haas T, Alan Guttmacher Institute (AGI), New Alan Guttmacher Institute (AGI), New York, USA York, USA

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......adolescent women who are not adolescent women who are not married married

but are cohabiting experience a but are cohabiting experience a Pregnancy Rate of Pregnancy Rate of about 31%about 31% in the in the first year of first year of

contraceptive use, contraceptive use,


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25% of the 2,157,473 25% of the 2,157,473 conceptions conceptions

due to contraceptive failure due to contraceptive failure

were aborted in the USA in 1995.were aborted in the USA in 1995.


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There is a Direct link between There is a Direct link between the use of contraception and the use of contraception and an increase inan increase in

Unplanned PregnanciesUnplanned Pregnancies Sexually Transmitted InfectionsSexually Transmitted Infections Abortion Abortion

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With ContraceptionWith Contraception Pleasure (Yes) …..Baby (No)Pleasure (Yes) …..Baby (No) Sever linkSever link between Love and Life between Love and Life

With FertilityCareWith FertilityCare Pleasure (Yes) …..Baby (Maybe)Pleasure (Yes) …..Baby (Maybe) Restore linkRestore link between Love and between Love and

LifeLife

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With ContraceptionWith Contraception Abortion is “necessary” for Abortion is “necessary” for

unintended pregnancy from unintended pregnancy from failed contraceptionfailed contraception

With FertilityCareWith FertilityCare A Baby is always a possibilityA Baby is always a possibility

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ContraceptionContraception Disrespect for Disrespect for

FertilityFertility Newly conceived lifeNewly conceived life

Subconscious mental shift in Subconscious mental shift in favour of abortionfavour of abortion

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FertilityCareFertilityCare Respect for Respect for

FertilityFertility Newly conceived lifeNewly conceived life

Subconscious mental shift in Subconscious mental shift in favour of LIFE!favour of LIFE!

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FertilityCareFertilityCare Builds a real culture of respect Builds a real culture of respect

for life, from the beginning…for life, from the beginning…preconceptionpreconception

Couples receive “Crisis Couples receive “Crisis Pregnancy” Pregnancy” counsellingcounselling before before they have an unplanned they have an unplanned pregnancy pregnancy

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FertilityCareFertilityCare Offers authentic Procreative and Offers authentic Procreative and

Gynaecologic Healthcare, instead Gynaecologic Healthcare, instead of the LIE on offer from the of the LIE on offer from the planned parenthood ideologyplanned parenthood ideology

Fertility is not a disease that Fertility is not a disease that needs to be suppressed or needs to be suppressed or feared….It is a normal aspect of feared….It is a normal aspect of health, that ought to be health, that ought to be understood, treasured and understood, treasured and respected by men and womenrespected by men and women

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Each approach offers a Each approach offers a completely final destinationcompletely final destination

… …..Life or Death..Life or Death

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www.fertilitycare.netwww.fertilitycare.net

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QuestionsQuestions

Dr. Phil BoyleDr. Phil BoyleMICGP MRCGP CNFPMCMICGP MRCGP CNFPMC

Life ConferenceCork

Nov. 2005

1 NaProTECHNOLOGY & The FertilityCare Movement Dr. Phil Boyle MICGP MRCGP CFCMC Life Conference Cork...

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Transcript of 1 NaProTECHNOLOGY & The FertilityCare Movement Dr. Phil Boyle MICGP MRCGP CFCMC Life Conference Cork...