On Coffee and Shoelaces

It was my first Mother’s Day mass after being married.  The previous month I had an experience where I was sure I was pregnant. I can’t explain this experience, and no test I took that month was positive.  But the next cycle did arrive later than usual and with more pain than normal.  During the consecration, my husband and I began to sob.  We felt a sense of loss that we couldn’t explain, a sense of deep heartbreak. And then during the blessing for mothers, the priest saying mass didn’t include Godmothers or spiritual mothers, so I didn’t stand up for the blessing.  And I cried even more, because I so wanted to be able to stand up for that blessing.  It was after that experience, that my husband and I decided to seek medical help for fertility because of my medical history. Making that decision was very emotional for me, because it meant opening up a very private part of our lives to medical intervention.

Infertility is not merely a cross or a struggle.  It is a symptom of an underlying disease. According to RESOLVE, about 12% of married women (1 in 8 couples) have trouble getting pregnant or carrying a pregnancy to term.  Of those struggling with infertility, approximately one-third is related to female causes, one-third related to male causes, and one-third is attributed to both or is unexplained. Trying to figure out what is causing this struggle has been a trying and long journey. Besides my hormone levels and pain, we have very few clues as to what could actually be behind our infertility.  The CDC lists numerous possible causes for infertility in women, including but not limited to Polycystic Ovary Syndrome (PCOS), improper function of hypothalamus or pituitary glands, obstruction of the fallopian tubes, abnormalities of the uterus, and endometriosis.  Infertility in men can be caused by varicoceles, diabetes, autoimmune disorders, heavy alcohol use, improper function of the pituitary and hypothalamus, and cancer treatments.  However, many of the causes of infertility remain unknown.  It is my hope that our scheduled consultation with a NaPro surgeon might give us some answers.  Sometimes a couple can be perfectly healthy in all respects though, and still struggle with infertility.

Infertility needs to be treated as any disease would be.  I am grateful for the experience I had with Napro-technology as a teenager.  Rather than simply handing me the pill, they showed me how to track my cycles.  I learned more about my body, my cycle, and how I was affected by my cycle.  I learned more about what should happen when my reproductive system is functioning normally. I took bio-identical progesterone timed with my cycle to help adjust my hormone levels. I learned from my experience with Napro-Technology as a teenager that I should expect medical care that respects my dignity and seeks to provide me with a treatment that addresses the underlying cause of my symptoms.

It was natural then, when we decided to seek medical advice for achieving pregnancy, that we turned to Napro-Technology (NaPro) again.  Developed by Dr. Hilgers at Creighton University, it is a system of treating infertility that is rooted in Catholic theology and modern science.  I am immensely grateful for my doctor and the doctors that trained him in this system.  NaPro is an alternative approach to infertility treatment.  Many treatment systems begin with trying to identify physiological causes of infertility, but then move into artificial reproductive technologies such as artificial insemination, IUI, IVF, and others. NaPro sets itself apart from other treatment systems because it uses knowledge about the women’s cycle and hormone levels based upon her fertility charts to treat her.

Unlike common suppressive or destructive approaches, NaProTECHNOLOGY works cooperatively with the procreative and gynecologic systems. When these systems function abnormally, NaProTECHNOLOGY identifies the problems and cooperates with the menstrual and fertility cycles that correct the condition, maintain the human ecology, and sustain the procreative potential. -NaProTechnology site

Since NaPro is rooted in Catholic theology, I know that none of the treatments recommended by my doctor will be contrary to Catholic teaching.  The Church teaches that the procreation of children should remain within the marital act.  Having experienced the heartbreak of infertility, I can understand why couples turn to artificial means for having a child, and they have my deepest sympathies.  We should not treat parents who have turned to artificial means of treatment harshly, nor should their children be treated differently, as their children have equal dignity.  That being said, for my husband and me, we know that these are not an option for us.  I see in treatments like IVF and IUI the same sort of approach that using the pill to treat all cycle issues results in–treating the symptoms and not the disease. This is precisely part of Dr. Hilger’s motivations for creating the system of NaProTechnology, after he observed a paradigm shift in the treatment of infertility.

“Until 1978, most of the effort in medicine in evaluating and treating women with infertility was placed in trying to identify and treat the underlying causes.  In 1978, in vitro fertilization produced a paradigm shift.  It led to a “skipping over” the causes and this continues up to the present time to be the foundational management approach.  In essence, this is a symptomatic or Band-Aid approach to treatment, not one that gets to the root causes.” -NaProTechnology site

Fortunately, NaPro is just as effective (and in some cases more effective) as IVF and it is less expensive.  Treatments used by NaPro involve hormone correction, fertility-focused intercourse, use of modern fertility medications such as Clomid or Metformin, and surgery to correct possible endometriosis, tubal occlusions, and other physiological issues. NaPro results in pregnancy in 38.4-81.8% of cases, depending on underlying causes (NaPro textbook, pg 691).  IVF, however has between a 20-40% success rate.

If you are struggling with infertility, there are options for you.  You don’t have to spend $10,000-$12,000 on fertility treatments.  You can seek treatment that helps you understand the underlying cause of your fertility issues. There is hope, and there are doctors that don’t use NaPro that take a similar approach.  I do know that NaPro isn’t for everyone, and that many Catholics approach NaPro as a miracle fix for infertility.  It can actually be hurtful to couples with this struggle when NaPro is approached as the “end all be all” infertility treatment.  The reality is that 20-60% of NaPro patients don’t get pregnant, depending on the underlying cause.  There is nothing that any person can do to guarantee a pregnancy. Sometimes that is hard to accept. The greatest blessing of using NaPro is remembering that children will happen in God’s time.  We cooperate with Him by seeking medical help and better understanding my fertility, but in the end, the Lord is in control.  It is God who creates and gives life.  And while I sometimes want to shout at the Lord, “Why not now, God?” I know that this suffering is not without purpose.  I know that His timing is perfect, though His timing doesn’t seem to match my plans.

Through it all, I learn to let go.

I let go of control, I let go of my pride.  I let go of my desire for having a child to be easy.  I am humbled each time I have to take medicine so that my body can do what it already should. For a time I would spend the evening crying after every blood draw, as they were a reminder to me that my body was broken. I now begin to look at every pill, every medication, every procedure as part of my labor. For after the fall of man, God said to Eve, “I will intensify your toil in childbearing; in pain you shall bring forth children” (Genesis 3:16).  I have come to understand that toil in childbearing is not limited merely to the actual birth of the child.  For those with infertility, it is all that they undergo in order that their bodies may function as they should.  It is all that they do to try to cooperate with God in procreation.  I still struggle with accepting the medicalization of this process.  It feels like medicine is invading something that should be very private and deeply personal.  I still struggle with the stress that comes with trying and hoping again each month.  But I have learned that when I hand these things over to Christ and say “Not my will, but thine” that I feel a sense of peace.

My husband and I are helpless in a sense–there is nothing in our power that we could do to guarantee that this month will be “the month.” But what we can know is that Christ holds us close to His Heart.  He walks with us as we try to walk with Him on the path to Calvary.  And when we reach Calvary, we cling to hope.

For we know that on the third day, there will be the resurrection.

This is the third post in a series for National Infertility Awareness Week. You can read the first two here: Gratitude: The Gift Amidst the Cross and here: Put Out Into the Deep