Gene Paulo R.

Uy August 31, 2010

PYSIOLO Dr. Maghirang

NaPro Technology

Pregnancy is something that people value and cherish if they have not yet experienced it or if its

their first time. There is nothing better than bringing new life to the world or adding a new member to

the family. However, some couples have problems in conceiving or making a new baby, this is called

Infertility. Infertility primarily refers to the biological inability of a person to contribute to conception.

Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There

are many biological causes of infertility, some which may be bypassed with medical intervention. But

when we say Infertility, we do not always mean that a woman is unable to produce a child or a woman

is incapable of producing egg cells, sometimes, its the man's fault if the couple cant conceive a child.

Male Infertility is the inability of a male to achieve a pregnancy in a fertile female. In humans it

accounts for 40-50% of infertility. Male infertility is commonly due to deficiencies in the semen and

semen quality is used as a surrogate measure of male fecundity. The first step to deciding what the best

way to treat infertility is figuring out who has the problem in the first place. Most problems in males

have to do with sperm. It could be the amount of sperm being produced, or lack of amount, or it could

be the lifespan of the sperm. Other complications and reasons for infertility are problems in the way the

sperm is delivered. In some cases the male could have erectile dysfunction, ejaculation issues, or a

blockage in the ejaculatory ducts. The male also might not be producing enough sperm, or the sperm he

is producing is malformed in some way. In women the problems are more in numerous, and vary

widely. The most common cause would be a problem during ovulation. This could prevent the

development of an egg and also could block the fallopian tubes. These problems could be caused by

endometriosis, adhesions, or scaring, pelvic inflammatory disease, or poor ovary reserves. Ovarian
failure can because of aging, but it can be because of other factors too. Often it is a defect in the

anatomy of the female that restricts the egg from being implanted. Many factors are involved in the

reason for infertility, and you need to see a doctor to have those problems diagnosed.

There are many medical or natural ways of curing Infertility, one way of doing so (and probably

one of the best ways) is by NaPro Technology. NaProTechnology (abbreviation of the term “Natural

Procreative Technology”) is a new reproductive science that uses the physician's medical and surgical

energies in a way that works cooperatively with a woman's natural reproductive function. Created at the

Pope Paul VI Institute for the Study of Human Reproduction in Omaha, Nebraska, it is touted as a

revolutionary breakthrough for helping couples who desire to achieve a pregnancy naturally. Best of

all, because the focus of NaProTechnology is diagnosis and treatment, it avoids the need for conception

to occur by any means other than the natural way It goes without saying that once a medical problem

has been diagnosed and treated, this has important health benefits that can be realized during the

pregnancy and well beyond. For the same reasons, women who get pregnant as a result of

NaProTechnology are frequently able get pregnant again. Here is a summary of what is done or what is

presented in NaProTechnology: Targeted hormone assessment of the menstrual cycle, Sonographic

classification of human ovulation disorders, Evaluation and treatment of premenstrual syndrome,

postpartum depression, ovarian cysts, and unusual bleeding, Applications in infertility evaluation and

treatment (and its effectiveness), osteoporosis, cancer detection, follicular and luteal phase deficiencies,

and thyroid system dysfunction, Effects of hypothalamic-pituitary-ovarian dysfunction, endometriosis,

polycystic ovarian disease, pelvic adhesive disease, amenorrhea, and anovulation, Perinatal

applications: progesterone use during pregnancy, preventing preterm birth, evaluating and treating

recurrent spontaneous abortion, and diagnostic laparoscopy, Surgical techniques for endometriosis,

pelvic adhesions, uterine leiomyomata, ovarian wedge resection, and tubal occlusions. The Creighton

Model System is a standardized gynecologic charting system that is an integral part of

NaProTechnology. Without the Creighton Model System, the physician who practices
NaProTechnology would have inadequate information for the diagnosis and treatment of reproductive

problems. Usually, a couple would start this program by learning how to chart the menstrual cycle

according to the Creighton Model system. A medical consultation with a physician who is trained in

NaProTechnology can be conducted at the same time. Frequently, the evaluation of infertility will

include a targeted hormone evaluation of the menstrual cycle and an ultrasound series to evaluate

ovarian function (this cannot be done without the Creighton Model System). A surgical evaluation is

sometimes needed as part of a complete investigation. The bottom line is that these techniques result in

a "functional" and/or "structural" diagnosis that can then be addressed medically or surgically and the

end result is natural conception. According the Pope Paul VI Institute, NaProTechnology success rates

are 1.5 to 3 times better than IVF (23.5% versus 38.4%-81.8%).

Spontaneous abortion is defined as the spontaneous loss of pregnancy prior to the 20th

gestational week of pregnancy. Pregnancy losses which occur during this period of time are said to

occur in about 15 percent of pregnancies. At the same time, the risk of miscarriage increases

proportionately to the number of previous miscarriages experienced. Unfortunately, a definite cause has

been difficult to determine. Over the years, miscarriages have been observed as a somewhat “normal”

finding. Often it has been thought to be “nature’s way” of ending a pregnancy which was doomed to

fail in any regard. However, there has developed a somewhat more aggressive approach over the last 5

to 10 years towards evaluation and management of women with spontaneous abortion. It is now well

recognized that a definition of recurrent pregnancy loss includes two or more consecutive spontaneous

miscarriages and that this warrants a full evaluation. Furthermore, it is becoming more and more

recognized that there appears to be an association between infertility and spontaneous abortion. A

variety of factors underlie the occurrence of miscarriage. These include genetic, endocrinologic

(hormonal), anatomic, immunologic and microbiologic variations. We are slowly coming to recognize

that no miscarriage can be considered normal. All miscarriages are the result of a pathophysiologic

reproductive event. It is the current challenge of medicine to find those underlying causes and, in some
cases, underlying causes that are common occurrences are often overlooked. In the picture below, a

Creighton Model chart in a woman who achieved a pregnancy and subsequently miscarried is shown.

In this chart, various aspects of evaluation have been completed including hormonal and ultrasound

studies. This woman clearly exhibits a “limited mucus cycle” as a biological marker of her Creighton

Model cycle. Hormonally, she has a markedly decreased preovulatory estrogen profile and a markedly

decreased postovulatory progesterone and estrogen profile. The follicle that was being monitored by

ultrasound is also very small and is consistent with a condition known as the “Immature Follicle

Syndrome.” Conception occurred in this cycle and ended in miscarriage. It has now been shown that

those women who conceive and subsequently miscarry often have these limited mucus cycles.

It has also been shown that women who have short post-Peak phases are also at risk for miscarriage. In

the picture below, a hormonal profile taken in a woman with a short post-Peak phase is shown. In this

cycle, where the post-Peak phase is only five days in duration, the post-Peak or luteal phase is

inadequate to support a pregnancy. Thus, if pregnancy occurs, the woman will miscarry. This condition

is easily identified in a woman charting her cycles and, it can be easily treated, thus preventing

miscarriage altogether.
 The condition now referred to as premenstrual syndrome (PMS) has a long and varied history

among medical investigators. This history dates back to the time of Hippocrates, and the first reference

in a scientific journal was by Franc in 1931. In 1964, Dr. Katherina Dalton brought attention to this

condition with her first book on PMS, which promoted the theory that this condition was caused by

either a progesterone deficiency or an imbalance in the estrogen-progesterone ratio. Later, she also

extensively promoted the use of progesterone therapy for its treatment. While its medical and

pathophysiologic components have been difficult to crystallize, PMS has been locked in with various

political and legal perspectives. For example, murder convictions and felony charges have been

reduced to manslaughter and misdemeanors, respectively, because of the argument that the accused

woman suffered from PMS. Feminists have voiced concern about this trend indicating that the use of

PMS as a defense in criminal or civil matters could result in a negative impact on women’s push toward

equalization with men. Feminists plead that generalizations about women should not be made when

assessing the legal or political aspects of this condition. Another point of view suggests that this

condition has held back many women over the years. This should prompt interest and concern about

finding the underlying causes and treating them effectively, so that those women who suffer from

premenstrual syndrome are also given full access to opportunities. Furthermore, PMS is a condition
that has destroyed relationships, led to divorce and child abuse and has created numerous aberrant

stereotypes about the behavior of women. The diagnosis of PMS at the Pope Paul VI Institute includes

the following list of symptoms: irritability, breast tenderness, bloating, weight gain, carbohydrate

craving, crying easily, depression, headaches, fatigue and insomnia. The important aspect of diagnosis

is that these symptoms must begin at least four days prior to the onset of menses. If they occur within

three days of the onset of menses, they are considered to be normal premenstrual molimina. In addition

to these 10 core symptoms, other symptoms have also been documented in this group of patients. By

charting one’s cycle, a physician can target the postovulatory phase of the cycle with an adequate

hormonal evaluation. In women who have premenstrual syndrome, both progesterone and estrogen

levels, along with beta-endorphin levels, are decreased late in the cycle. By treating these hormonal

abnormalities cooperatively with either cooperative progesterone replacement therapy or targeted HCG

support (which should also improve both progesterone and estrogen production) and/or with the use of

naltrexone as an opiate receptor antagonist, a high degree of success can be obtained with hormonal

treatment. At the present time, fluoxetine (Prozac) is considered the treatment of choice for women

with premenstrual syndrome. However, in comparing targeted hormonal supplementation (cooperative

progesterone replacement therapy) with Prozac, the targeted hormonal therapy is significantly more

effective.

Now we go to Postpartum Depression, which is one of the major problems faced by the

teenagers today. The earliest documentation of postpartum mental illness was provided by Hippocrates

in 400 B.C. In spite of its evaluation over the years, postpartum depression (PPD) has remained an

enigma. Pregnancy, miscarriage or pregnancy loss, infertility, and the postpartum period challenge a

woman’s mental health. Virtually no life event rivals the hormonal, psychological and social changes

associated with pregnancy and childbirth. Because of depressive episodes, up to 32 percent of women

may alter their future childbearing plans by resorting to either adoption, sterilization or abortion. At
some point in their lives, 20 percent of women will suffer from depression. Many seek treatment from

primary care providers, but up to 50 percent may go unrecognized and more go untreated. Recognition

and treatment of depressive disorders in pregnancy and during the postpartum period is critical for the

healthy outcomes of both the mother and infant. Postpartum depression is identified as a major

depressive disorder with postpartum onset. It is a major depressive episode that usually begins within

the first four weeks following delivery. It can be extremely variable in both severity and duration.

Symptoms include the following: fatigue, changes in appetite or sleep, dysphoric mood, loss of interest

in usually pleasurable activities, psychomotor agitation or retaliation, recurrent thoughts of

death/suicide, feelings of worthlessness or guilt (especially failure at motherhood), and excessive

anxiety over the child’s health. Postpartum psychosis is a more severe postpartum syndrome. Its onset

is usually within the first three weeks following delivery and often within just a few days. Most

episodes are related to a psychotic condition of bipolar disorder or major depression. The symptoms

include delusion, hallucinations, rapid mood swings ranging from depression and irritability to

euphoria, sleep disturbances and obsessive ruminations about the baby. The risk of suicide in

postpartum psychosis is high (up to five percent) and up to four percent of women with postpartum

psychosis may attempt infanticide. Postpartum psychosis is a psychiatric emergency that often warrants

hospitalization. The prognostic implications are different from postpartum depression. Nearly two-

thirds of these patients will suffer subsequent non-puerperal psychotic episodes. Postpartum mood

disorders are common, with nearly 40 percent (or more) of women experiencing them. The risk of

psychiatric hospitalization within the first three months postpartum is seven times more common than

at other times in a woman’s life. A traditional approach to therapy in this condition usually involves

either psychotherapy or the use of antidepressant medications. In 1988, Dr. Katherina Dalton visited the

Pope Paul VI Institute because of our interest in premenstrual syndrome. During the course of that visit,

she commented on her long experience with the use of progesterone in the treatment of postpartum

depression. In addition, she seemed to think that postpartum depression was a very common problem.
In our own clinical experience, this condition has actually been very rare. The incidence of postpartum

depression at the Pope Paul VI Institute is only 2.1 percent. At the time, we thought that because

progesterone support during pregnancy in our high-risk pregnancy population was common, it may

have had an impact on the overall incidence of postpartum depression in our patient population. These

discussions prompted an interest in the use of progesterone support for the treatment of postpartum

depression. Studies were then undertaken to understand the role of progesterone therapy for women

with PPD. The use of progesterone for the treatment of postpartum depression symptoms can be very

dramatic. One of the most important aspects of obstetrical care is to date, as precisely as possible, the

beginning of pregnancy so that the estimated time of arrival (ETA) can be calculated (sometimes

referred to as the estimated date of confinement – EDC). The standard textbook of obstetrics, Williams

Obstetrics, states vigorously that “precise knowledge of the age of the fetus is imperative for ideal

obstetrical management!” (emphasis in the original). And yet, even with all of the available technology,

one of the puzzles of modern obstetrics, is that the obstetrician has not yet learned how to accurately

date the beginning of a pregnancy. Pregnancy can be measured in two different ways. The most

common and most often used in clinical obstetrics is the measurement of the gestational age of the

pregnancy. The gestational age of the pregnancy is measured from the first day of the last menstrual

period. In this way of dating the pregnancy, the pregnancy is 40 weeks in duration (on average) instead

of the actual 38 weeks. In other words, it dates the pregnancy, on average, two weeks longer than it is.

The other way of measuring the dates of the pregnancy is to measure the fetal age. The fetal age of the

pregnancy is measured from the time of conception or the estimated time of conception (ETC). When

measuring the pregnancy in this fashion, it will be 38 weeks long or two weeks shorter than the

gestational age dates. The fetal age, of course, is the actual age of the pregnancy. Historically, the

obstetrician has focused on the first day of the last menstrual period for two reasons. First of all, the

menstrual flow itself is a fairly dramatic symptom which the woman can be expected to remember. In

addition, it is easy to teach her to record the first day of the last menstrual period so that when that
information is elicited by the physician, at a later time, it is available. However, in the midst of all of

this, the obstetrician and many women have missed the point that the cervical mucus discharge is very

much a flow in the same fashion as the menstrual flow. In some countries, they refer to menstruation as

the red flow and the mucus discharge as thewhite flow. Unfortunately, modern obstetrics has paid little

attention to the white flow. When one is charting the Creighton Model FertilityCare™ System (CrMS),

however, one can date the pregnancy accurately from the actual or estimated time of conception.

Therefore, one can date the pregnancy according to its true date (or true beginning) or in fetal age

terms. This is measured by evaluating the acts of intercourse that occur during the time of fertility and

establishing an estimated time of conception through this approach. Now we move to Progesterone

Support in pregnancy. Progesterone support in pregnancy has been in use for nearly 60 years, having

received its start with publications dating back to the 1940s. Its initial use was in patients who had

habitual spontaneous abortion caused by luteal phase deficiency. Luteal phase deficiency is due to a

failure of the function of the corpus luteum in the production of progesterone from the corpus luteum is

indispensable during the first seven weeks of pregnancy. Surgical removal of the corpus luteum during

this period of time results in pregnancy loss and progesterone replacement can help maintain the

pregnancy. There is evidence of support in the concept that progesterone given in early pregnancy may

be useful in some women with recurrent miscarriage and that the measurement of serum progesterone

levels in early pregnancy can be an adjunctive marker for the further assessment of pathologic

pregnancies. The administration of progesterone later in pregnancy has been considered to be justified

because of an observed decrease in circulating progesterone with the onset of labor, and association of

premature labor with decreased progesterone concentrations and the observation that progesterone has

a tocolytic effect. It is thought that the administration of exogenous progesterone might, therefore,

reduce uterine contractions and help prevent preterm labor. This idea has received a considerable boost

from the recent wide-spread publicity given to two papers which showed a significant reduction in

preterm delivery rates with the prophylactic administration of either progesterone or 17 alpha-
hydroxyprogesterone caproate. While this was portrayed as a “major breakthrough” by the national

media, in reality, the use of progesterone (or 17 alpha-hydroxyprogesterone caproate) for the

prevention of preterm labor has appeared in the medical literature for nearly 30 years abortion.

Overall, I would say that NaProTech is the way to go, since it is very safe and efficient since it

uses the natural resources or the natural ways of the human body (particularly the women). I consider it

to be one of the best treatments or routes an infertile couple should take.

Sources:
http://en.wikipedia.org/wiki/Infertility
http://en.wikipedia.org/wiki/Male_infertility
http://adviceoninfertility.com/infertility-insurance/infertility-whats-is-wrong-with-me/
http://www.naprotechnology.com/naprotext.htm