IN vitro fertilization (IVF) has dominated political discourse in the United States in the past months after an Alabama Supreme Court ruling in February recognised the personhood of embryonic human life.
The Catholic Church and many other pro-life advocates are opposed to IVF.
The Catechism of the Catholic Church (No. 2377) states that IVF is “morally unacceptable” because it separates the marriage act from procreation and establishes “the domination of technology” over human life.
The process involves fertilising a woman’s eggs with sperm in a laboratory, which separates procreation from the marital act and results in the destruction of millions of human lives, the embryos of which are never implanted.
Some doctors who have ethical and medical objections to the treatment have been offering an alternative route to couples who struggle with infertility.
The process, known as natural procreative technology (or NaPro for short), has been used for decades and is designed to treat underlying conditions that cause infertility and allow women to conceive naturally by monitoring their fertility cycles.
“We’ve gone the distance … in really trying to find an ethical approach in helping women with infertility,” Theresa Notare, who serves as the assistant director of the Natural Family Planning Program at the United States Conference of Catholic Bishops, said.
How does it work?
NaPro approaches fertility treatment by two methods – identifying and treating the underlying causes of infertility and charting the woman’s fertility cycle to understand when she is most fertile.
The process can sometimes require lifestyle changes to improve fertility, surgical intervention to treat conditions that cause infertility, and medicine to induce ovulation in the woman or improve the sperm count in the man.
When the issues are addressed, and the couple has a better sense of when the woman is more fertile, the treatment helps the couple conceive a child through the marital act naturally.
“Infertility itself is not a disease,” Marguerite Duane, the executive director of FACTS About Fertility, said.
“It’s really a symptom of other underlying conditions.”
Dr Duane, a family physician, said IVF clinics “may not do a detailed work up to diagnose and treat those underlying conditions” but instead chalked the problem up to “unexplained infertility.”
The frequency of such diagnoses, she said, was “not acceptable” and a sign that “a doctor has not done their job (to) explore the underlying causes of infertility and treat those underlying causes.”
When women chart their cycle through models like the Creighton Model or Fertility Education and Medical Management (FEMM), Duane said a doctor could “identify abnormalities and then make a … diagnosis and then (prescribe an) effective treatment.”
“It is designed to work with the body and restore normal reproductive function,” Dr Duane said.
Sometimes infertility problems are caused by the results of lifestyle choices, such as obesity, or drugs or alcohol usage in either the man or the woman.
In other cases, there can be conditions — such as endometriosis, fallopian tube blockage, polycystic ovarian syndrome, caesarean-section scars, or inflammation inside the uterus — that would require medical and possible surgical treatment.
Gavin Puthoff, a gynecologist and the medical director of Veritas Fertility and Surgery, said that a “comprehensive, in-depth diagnostic evaluation” could often determine the cause for infertility, because infertility was a “symptom as opposed to a disease”.
He said “what women and couples really want” was the reason for the infertility.
“They’ve been asking themselves the ‘why’ for months if not years,” Dr Puthoff said.
When medication was used to assist in conception, he said that the medication “cooperates with their cycle” rather than trying to supersede it. The treatment in this case is “supporting their own natural fertility.”
Dr Puthoff said the NaPro technology helped ensure “a pregnancy in a state of health”.
He contrasts this with IVF, which he said was “ignoring the issue and going around it” and noted that preborn children conceived through IVF had higher rates of congenital abnormalities, preterm delivery, and miscarriage.
Dr Puthoff said NaPro showed “respect for each embryo — each life — from the moment of conception” and supports “the dignity of marriage”.
“This is a very pro-life and pro-woman, pro-marriage and pro-family type of treatment,” he said.
What are the results?
Although the data on NaPro success rates is sparse, a 2012 study of 108 people using the treatment in Ireland found that 66 per cent of couples who received the treatment were able to conceive and give birth to a child within 24 months.
Dr Puthoff said the success rate for his patients ranges between 65 per cent and 80 per cent, depending on what the underlying condition of the infertility was.
Although the process takes more time than IVF, he argued that it is “more effective”.
The success rate for IVF treatments resulting in a live birth is around 50 per cent for women under the age of 35, but significantly lower as women get older.
Virginia resident Katie Carter, a patient of Dr Duane’s, said that she conceived two children after receiving NaPro treatments to address her infertility.
One is now two years old and the other is three months old.
Prior to receiving the treatments, Mrs Carter suffered three miscarriages.
Her doctors referred her to IVF for treatment, but she worried she “would continue to miscarry” because the clinics were not “getting to the root problems”.
She said the doctors “kept telling me I had unexplained infertility and they never really tried to figure out why”.
When a friend referred her to Dr Duane, MRS Carter began charting, which she said “really hones in on how your body is responding and how your hormones are working,” allowing the doctor to diagnose the underlying conditions causing her issues.
She ultimately required surgeries to address the conditions that were causing her infertility, which she credited with helping “heal (her) body” and successfully giving birth to two children.
“I think every woman deserves this kind of care,” Mrs Carter said.