Sunday, August 15, 2004

"New process helps with fertility problems "

By Lois M. Collins for The Deseret Morning News

      Doctors were able to help half of women with fertility problems using a new, generally noninvasive approach, according to a family practitioner from the University of Utah School of Medicine.

      Called NaPro, which is short for Natural Procreative Technology, the process is based on a careful evaluation of a couple's fertility, including ruling out physical abnormalities such as tubal blockage, then tracking of the woman's fertility cycle in detail, said Dr. Joseph B. Stanford.

      "The basic philosophy of NaPro is to try to figure out why a couple is not getting pregnant, then see what we can do to correct that. And we have some powerful tools that weren't previously available. The core of that is fertility charting, which a couple does based on biomarkers."

      Stanford is a contributor to a new textbook on NaPro. He told the Deseret Morning News that the new approach has helped many couples who previously had been unable to conceive, usually without some of the traditional expensive fertility procedures.

Couples do much of the work, assessing the woman's menstrual cycle and discharge of cervical fluid to determine if the cycle is normal and when the woman is most likely to become pregnant. Sometimes it's a window as narrow as a single day, he said.

      "When we do initiate treatment, it's directed towards trying to optimize what isn't functioning the way it's supposed to."

      NaPro also includes a monthly blood draw to check hormone levels.

      Low progesterone can affect fertility, and it's known the hormone is typically at its highest level seven days after ovulation. Drawing blood and testing it on that day, based on the fertility chart the couple created, shows if the woman produces enough of the hormone or if it needs to be supplemented.

      Medication can also be prescribed for men who have a low sperm count or inadequate hormone levels.

      NaPro requires very little in the way of medical procedures, making it less expensive than other fertility treatments such as in-vitro fertilization, Stanford said.

      An as-yet-unpublished study shows that half the women using NaPro became pregnant within two years. The women's average age was 36, and the couples had been trying to get pregnant for five years.

      It doesn't work for everyone. If a man has a low sperm count that medication won't help or a woman has a physical problem such as a blockage that prevents conception, charting alone won't do it. Ultimately, fertility treatment might involve medication and hormones and, in fairly rare cases, surgery, Stanford said.