May 5th 2018


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COVER STORY HECS: hastening our demographic winter

EDITORIAL Liddell is the 'fly in the ointment' of the NEG

AFRICAN AFFAIRS African Continental Free Trade Area ... in the spirit of GATT

CANBERRA OBSERVED Bernardi foray looks to be fading out of view

ENVIRONMENT Is a prolonged freeze on the way for the earth?

MEDICINE NaProTechnology: an ethical alternative in reproductive health

MEDICAL ETHICS Grounds for objection: a declaration on freedom of conscience

OPINION What a republic would really mean for Australia

LAW AND FREEDOM 'Rule of law' does not support exemptions: a reply to Robin Speed

INTERNATIONAL AFFAIRS Saudi Crown Prince challenges Wahhabists

HIGHER EDUCATION Undoing the dis-education of Millennials

GENDER POLITICS Why are patients being denied freedom of choice?

ASIAN HISTORY Jinmen: the forgotten crisis that brought the world to the brink

HUMOUR

MUSIC Grammy salute to Elton John: Revealing revisit to the 1970s

CINEMA The Isle of Dogs: Man's best friend in exile

BOOK REVIEW Australia, we need to talk about China

BOOK REVIEW Novelised life a vivid drama of survival

POETRY

LETTERS

NATIONAL AFFAIRS Committal hearing dismisses main charges against Cardinal Pell

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MEDICINE
NaProTechnology: an ethical alternative in reproductive health


by Dr Terrence Kent

News Weekly, May 5, 2018

NaProTechnology (Natural Procreative Technology, or NPT) is a fresh approach to women’s health science that offers a genuine alternative to assisted reproductive technology (ART) and in-vitro fertilisation (IVF).

NaProTechnology provides medical and surgical treatments that cooperate completely with the reproductive system. It seeks to identify and treat underlying illness in women, unlike IVF, which suppresses a woman’s system and takes control to achieve pregnancy. NaProTechnology treats fertility problems in men as well.

NaProTechnology uses the Creighton Model FertilityCare System biomarkers to monitor easily and objectively the occurrence of various hormonal events during the menstrual cycle.

NaProTechnology was developed by Thomas W. Hilgers, MD, director of the Pope Paul VI Institute for the Study of Human Reproduction and the National Centre for Women’s Health in Omaha, Nebraska. Dr Hilgers began his work almost 50 years ago and continues to work on the system today.

NPT can assist with recurrent miscarriage, premenstrual syndrome, postnatal depression, low progesterone in pregnancy, prevention of preterm birth and polycystic ovarian syndrome.

A study carried out in an Irish general practice evaluated outcomes from treatment of infertility with NaProTechnology. The cumulative proportion of first live births for those completing up to 24 months of NPT treatment was 52.8 per 100 couples. Patients were seen between February 1998 and January 2002. NPT provided by trained general practitioners had live birth rates comparable with cohort studies of more invasive treatments, including ART. It is to be noted that this treatment did not have a surgical focus as the treatment was carried out by general practitioners. Combined with a gynaecological approach, results may be even better.

Another study analysed outcomes in a Canadian family physician practice (that is, a general practice) in treatment the of infertility and miscarriage, and recorded similar results. The cumulative adjusted proportion of first live births for those completing up to 24 months of NPT treatment was 66 per 100 couples.

The National Perinatal Epidemiology and Statistics Unit at the University of NSW published a report in October last year entitled “Assisted Reproductive Technology in Australia and New Zealand 2015”.[4] In that year, there were a total of 77,721 initiated cycles. Of the initiated cycles, 22.8 per cent resulted in a clinical pregnancy and 18.1 per cent in a live delivery.

A study to estimate cumulative live birth rates (CLBRs) following repeat ART ovarian stimulation cycles, including all fresh and frozen/thawed embryo transfers (complete cycles), was published in the Medical Journal of Australia in July 2017. This was a prospective follow up of 56,652 women commencing ART in Australia and New Zealand over the period 2009–12 and followed until 2014 or the first treatment dependent live birth.

CLBRs and cycle-specific live birth rates were calculated for up to eight cycles. Conservative CLBRs assumed that women discontinuing treatment had no chance of achieving a live birth had they continued treatment. Optimal CLBRs assumed that they would have had the same chance as women who continued treatment. The Overall CLBR was 32.7 per cent in the first cycle, rising by the eighth cycle to 54.3 per cent (conservative) and 77.2 per cent (optimal).

Controversies

An ACCC investigation 12 months ago concluded that some major Australian IVF clinics “made success-rate comparisons without adequate disclosure about, or qualifications of, the nature of the data or graphics used to make the claims”. In other words, they were not transparent about what the figures really meant.

Also, ACCC commissioner Sarah Court commented: “Some IVF clinics used technical terms understood by industry participants but which may be misleading to consumers without further clarification or explanation.

“For example, some IVF clinics used ‘clinical pregnancy rate’ data to compare their success rates where that data reflected the clinic’s success in creating an embryo, rather than live birth rates.”

After 12 months, the situation largely remains unchanged. The Huffington Post reported in November 2017: “Many IVF clinics’ websites are continuing to advertise confusing and potentially misleading claims to aspiring parents despite the industry being put ‘on notice’ by the ACCC a year ago.”

An article in the Australian and New Zealand Journal of Obstetrics and Gynaecology first published on November 12, 2017, analysed the current situation compared with the situation a year ago. It concluded: “To allow people who consider ART to make informed decisions about treatment they need comprehensive and accurate information about what treatment entails and what the likely outcomes are. As measured by a scoring matrix, most ART clinics had not improved the quality of the information about success rates following the ACCC investigation.”

Costs

IVF clinics charge per cycle of IVF treatment. In Choice magazine (last updated July 2014), it was stated that there are large price differences between clinics. In Sydney, for example, the out-of-pocket costs after Medicare benefits and safety nets for three IVF cycles can range from $1870 to almost $9000.

NaProTechnology costs are a fraction of IVF costs. Teachers of the Creighton Model System of Charting are known as practitioners. They provide a fundamental part of the treatment. Their charges are measured in only hundreds of dollars. Out-of-pocket medical expenses may be less than $1,000 for 12 months. Out-of-pocket expenses for surgical interventions such as laparoscopy may cost under $2,000 for those with private cover. There are additional expenses for investigations, for example blood tests and ultrasounds, and also for medication.

In conclusion, NPT is effective, cheaper than IVF, natural and works cooperatively with the reproductive system and does not try to suppress or override the system. It is also compatible with Catholic and Christian ethics.

I have been applying NPT in my general practice for 12 years. In that time, using NPT’s simple but effective treatments, I have been able to help couples with long-term infertility, some with failed IVF, women over 45 years of age, and some who have had seven, eight, nine, even 16 miscarriages.

Dr Terrence N. Kent M.B.,B.S., FRACGP, NFPMC, FCP is a general practitioner in Raceview, Ipswich, Queensland, and is president of the Guild of Saint Luke (Catholic Doctors Queensland).




























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