1 NaProTECHNOLOGY & The FertilityCare Movement Dr. Phil Boyle MICGP MRCGP CFCMC Life Conference Cork Nov. 2005

2 NaProTechnology Natural Procreative Technology Natural Procreative Technology A newly emerging system of fertility treatment A newly emerging Scientific, Holistic, Pro-Life system of fertility treatment Inspired by Catholic teaching Inspired by Catholic teaching Highly effective in treating Highly effective in treating Infertility Infertility Recurrent Miscarriage Recurrent Miscarriage Abnormal Gynaecologic Health Abnormal Gynaecologic Health

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4 NaProTechnology Available in USA since 1990 In Galway, Ireland since 2 nd Feb In Life Health Centre, Liverpool, UK since 1999 Now 13 Doctors (5 Obstetricians and 8 GPs) have trained in Europe

5 NaProTechnology - Origin Humanae Vitae 1968 – Papal Encyclical Humanae Vitae 1968 – Papal Encyclical Dr. Thomas Hilgers Dr. Thomas Hilgers Turning point Turning point – Beautiful vision of marriage – Beautiful vision of marriage Inspired to conduct research into moral methods of family planning Inspired to conduct research into moral methods of family planning NaProTECHNOLOGY came later…. NaProTECHNOLOGY came later….

6 The Creighton Model FertilityCare System FertilityCare System A Standardised Modification of the A Standardised Modification of the Billings Ovulation Method NaProTechnology A New Reproductive Science that has developed as a result of precise information which the FertilityCare system provides

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8 Could the FertilityCare Charts be telling us something more ?

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11 AT its simplest level NaProTechnology uses a wide range of medical and surgical interventions to correct abnormal 1. FertilityCare Charting patterns 2. Subtle hormonal deficiencies 3. Ovulation defects 4. Surgical / structural abnormalities

12 NaProTechnology Co-operates with the couple’s natural procreative potential to achieve optimum function. Creighton Model FertilityCare System Creighton Model FertilityCare System Medical Treatments Medical Treatments Surgical Treatments Surgical Treatments Counselling - Stress Management Counselling - Stress Management Spiritual - Prayer! Spiritual - Prayer!

13 Many of the medical and surgical techniques have been used previously, but important NEW treatment approaches and surgical interventions have also been developed by Dr. Hilgers in, Omaha, Nebraska, USA

14 A key to the success of NaProTechnology is to apply the medical and surgical interventions in a timed fashion with respect to the FertilityCare chart And to continue treatment for at least 12 effective cycles

15 45 MINUTES per CONSULTATION

16 The Couple manage their own fertility… Directed by the “FertilityCare Physician” Assisted by their Teacher-Practitioner

17 Case Presentations 1.Recurrent Miscarriage 2.Infertility 3.Male Factor Infertility

18 G.W. - 6 Miscarriages Dec years Recurrent Miscarriages, Dec years Recurrent Miscarriages, Age 40y. DOB Aug ‘64 G0 P0 SA 6 (6-13wks) Dx Unexplained Recurrent Miscarriages Dx Unexplained Recurrent Miscarriages Regular cycles – days Regular cycles – days Surgery to remove Uterine Septum Sept 04 Surgery to remove Uterine Septum Sept 04

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20 G.W. - 6 Miscarriages NaPro Assessment Low Progesterone – 35.5 nmol/l Low Progesterone – 35.5 nmol/l Low B12 – 187 pmol/l Low B12 – 187 pmol/l Under-active Thyroid – TSH 4.42 iu. Under-active Thyroid – TSH 4.42 iu.

21 G.W. - 6 Miscarriages Treatment Treatment Femara 1.25mg daily for 3 days from day 3 Femara 1.25mg daily for 3 days from day 3 HCG 5000 on P+3,5,7,9 HCG 5000 on P+3,5,7,9 B12 4mcg tid B12 4mcg tid Thyroxine 50mg daily Thyroxine 50mg daily

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23 G.W. - 6 Miscarriages Conceived Conceived with an optimum cycle with an optimum cycle

24 31 st Aug 05 CRL 33mm 10w 5days EDD

25 G.W. - 6 Miscarriages During Pregnancy During Pregnancy Vaginal Prog 400mg Vaginal Prog 400mg Prednisolone 5mg daily Prednisolone 5mg daily Eltroxin 50mcg daily Eltroxin 50mcg daily Folic Acid/ B12 Folic Acid/ B12 Now 21 Weeks Gestation….Pray! Now 21 Weeks Gestation….Pray!

26 C.H - Infertility April years Primary Infertility, Age 36y. G 1 P 0 April years Primary Infertility, Age 36y. G 1 P 0 Dx PCOD and Endometriosis Dx PCOD and Endometriosis Long Irregular cycles - 4 light menses per year Long Irregular cycles - 4 light menses per year Clomiphene x 2 cycles 1991 Clomiphene x 2 cycles 1991 IUI x 12 cycles – conceived IUI x 12 cycles – conceived IVF x 7 cycles (5 embryo TF) IVF x 7 cycles (5 embryo TF)

27 C.H - Infertility Ultrasound Ultrasound right side Endometrioma 2.5cm right side Endometrioma 2.5cm Surgical Referral Laparoscopy and Diathermy Aug 00 Surgical Referral Laparoscopy and Diathermy Aug 00

28 C.H - Infertility Restored a normal appearance to the FertilityCare Chart through surgical and medical interventionRestored a normal appearance to the FertilityCare Chart through surgical and medical intervention

29 C.H - Infertility Clomiphene 150mg x 5 days – ovulation induction Clomiphene 150mg x 5 days – ovulation induction HCG 5000 sc day 21 – follicular rupture HCG 5000 sc day 21 – follicular rupture Progesterone 400mg pv - luteal support Progesterone 400mg pv - luteal support Glucophage 500mg tid Glucophage 500mg tid Prednisolone 5mg daily Prednisolone 5mg daily

30 C.H - Infertility Conceived on 11th cycle of treatment Conceived on 11th cycle of treatment

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32 C.H - Infertility Live Birth, 31 st Dec 2003 Live Birth, 31 st Dec 2003 Healthy Male Infant - JOSEPH Healthy 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.

33 3. Male factor Infertility Dx: Infertility for 5 years, Female Age 34yrs Dx: Infertility for 5 years, Female Age 34yrs Sperm Count 50,000 per ml Sperm Count 50,000 per ml 10,000 per ml 200,000 per ml 200,000 per ml 4,000,000 per ml 4,000,000 per ml 800,000 per ml 800,000 per ml Hx: Gravida 1 para 0 Misc 1, (ICSI Pregnancy) Hx: Gravida 1 para 0 Misc 1, (ICSI Pregnancy) 3 Failed ICSI, 2 – 3 embryos each time 3 Failed ICSI, 2 – 3 embryos each time Problem – Male Factor Problem – Male Factor

34 3. Male factor Infertility NPT Additional Female Dx: Low Prog. And Low E2 NPT Additional Female Dx: Low Prog. And Low E2 Conceived 8 th Cycle NPT, Conceived 8 th Cycle NPT, Male Tamoxifen, L carnitine, Pycnogenol Male Tamoxifen, L carnitine, Pycnogenol Volume4 mls Volume4 mls Count4 Million/ ml Count4 Million/ ml Motility45% Motility45% Morphology 4% Normal Morphology 4% Normal Healthy Girl born, 8lb 8 oz. June 2004 Healthy Girl born, 8lb 8 oz. June 2004 Mum aged 35yrs Mum aged 35yrs Progesterone support during pregnancy until 28 wks Progesterone support during pregnancy until 28 wks Very important to treat the female…often combined problem Very important to treat the female…often combined problem

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36 ?? Just Lucky ?? Or A Promising Scientific advance?

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38 For those who believe, No Explanation is Necessary For those who refuse to believe, No Explanation is Possible!

39 Staggering Scientific Bias against NaPro!

40 The Irish NaPro Statistics Over 2000 couples over 7.5 years since Feb Over 2000 couples over 7.5 years since Feb For the first 4 years of treatment Average Female age - 36 yrs. Average Female age - 36 yrs. Average time trying to conceive - 5 yrs. Average time trying to conceive - 5 yrs. Over 25% - history of unsuccessful IVF Over 25% - history of unsuccessful IVF

41 The Irish NaPro Statistics 20 – 50% Successful pregnancies 20 – 50% Successful pregnancies submitted for publication submitted for publication

42 Following previous failed IVF Range of 20 to 30% success per couple with failed IVF Range of 20 to 30% success per couple with failed IVF submitted for publication submitted for publication

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44 TWINS < 4 % Rate, compared with 28% IVF < 4 % Rate, compared with 28% IVF So Less prematurity, low birth weight, Morbidity, Mortality and cost for NPT Births So Less prematurity, low birth weight, Morbidity, Mortality and cost for NPT Births submitted for publication submitted for publication

Conceptions from 95 couples with previously failed IVF Dr. Phil Boyle MICGP MRCGP CNFPMC

46 IVF - UK. Declining success with increased age

47 Women’s Age at conception Average 36.8 Years 44% Aged 38 Years or older

48 Average 6 Years 95 Couples - Previous Failed ART

49 95 Couples - Previous Failed ART 75% never Delivered Previously

50 95 Couples - Previous Failed ART

51 95 Couples - Previous Failed ART

52 95 Couples - Previous Failed ART

53 95 Couples - Previous Failed IVF 78% successful Pregnancies per couple

54 TWINS 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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56 How relevant to Pro-Life 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 couples Kind to couples No Moral Dilemmas No Moral Dilemmas Real Chance of success Real Chance of success BUT…..There is MORE! BUT…..There is MORE!

57 How relevant to Pro-Life Movement? With greater use of NaPro, comes greater use of the FertilityCare System With greater use of NaPro, comes greater use of the FertilityCare System family planning family planning gynaecologic health maintenance gynaecologic health maintenance Less Use of Contraceptives Less Use of Contraceptives

58 Contraceptive Pregnancy Rates Contraceptive Pregnancy Rates The pill 8% per year The pill 8% per year The condom 14% per year The condom 14% per year Source: Fam Plann Perspect Mar ­Apr ;31(2):56­ 63.Fu H, Darroch JE, Haas T, Alan Guttmacher Institute (AGI), New York, USA

59 Contraceptive Pregnancy Rates Contraceptive Pregnancy Rates... adolescent women who are not married but are cohabiting experience a Pregnancy Rate of about 31% in the first year of but are cohabiting experience a Pregnancy Rate of about 31% in the first year of contraceptive use, contraceptive use, Source: Fam Plann Perspect Mar ­Apr ;31(2):56­ 63.Fu H, Darroch JE, Haas T, Alan Guttmacher Institute (AGI), New York, USA

60 Contraceptive Pregnancy Rates Contraceptive Pregnancy Rates 25% of the 2,157,473 conceptions 25% of the 2,157,473 conceptions due to contraceptive failure due to contraceptive failure were aborted in the USA in Source: Fam Plann Perspect Mar ­Apr ;31(2):56­ 63.Fu H, Darroch JE, Haas T, Alan Guttmacher Institute (AGI), New York, USA

61 There is a Direct link between the use of contraception and an increase in There is a Direct link between the use of contraception and an increase in Unplanned Pregnancies Unplanned Pregnancies Sexually Transmitted Infections Sexually Transmitted Infections Abortion Abortion

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63 With Contraception With Contraception Pleasure (Yes) …..Baby (No) Pleasure (Yes) …..Baby (No) Sever link between Love and Life Sever link between Love and Life With FertilityCare With FertilityCare Pleasure (Yes) …..Baby (Maybe) Pleasure (Yes) …..Baby (Maybe) Restore link between Love and Life Restore link between Love and Life

64 With Contraception With Contraception Abortion is “necessary” for unintended pregnancy from failed contraception Abortion is “necessary” for unintended pregnancy from failed contraception With FertilityCare With FertilityCare A Baby is always a possibility A Baby is always a possibility

65 Contraception Disrespect for Disrespect for Fertility Fertility Newly conceived life Newly conceived life Subconscious mental shift in favour of abortion Subconscious mental shift in favour of abortion

66 FertilityCare Respect for Respect for Fertility Fertility Newly conceived life Newly conceived life Subconscious mental shift in favour of LIFE! Subconscious mental shift in favour of LIFE!

67 FertilityCare Builds a real culture of respect for life, from the beginning…preconception Builds a real culture of respect for life, from the beginning…preconception Couples receive “Crisis Pregnancy” counselling before they have an unplanned pregnancy Couples receive “Crisis Pregnancy” counselling before they have an unplanned pregnancy

68 FertilityCare Offers authentic Procreative and Gynaecologic Healthcare, instead of the LIE on offer from the planned parenthood ideology Offers authentic Procreative and Gynaecologic Healthcare, instead of the LIE on offer from the planned parenthood ideology Fertility is not a disease that needs to be suppressed or feared….It is a normal aspect of health, that ought to be understood, treasured and respected by men and women Fertility is not a disease that needs to be suppressed or feared….It is a normal aspect of health, that ought to be understood, treasured and respected by men and women

69 Each approach offers a completely final destination Each approach offers a completely final destination …..Life or Death …..Life or Death

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71 Questions Dr. Phil Boyle MICGP MRCGP CNFPMC Life Conference Cork Nov. 2005

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