Finding the causes of infertility


By charting a woman’s cycle, the NaPro fertility treatment can identify a specific problem, writes MICHELLE McDONAGH

MORE AND MORE Irish couples are turning to fertility clinics. Women who defer having babies until they are in their 30s can find that they have difficulty conceiving naturally. The inability to have a child can bring great personal despair and suffering and has the potential to take over the entire life of a couple.

Many couples turn to assisted reproductive technology (ART), such as in vitro fertilisation (IVF), for help, but Galway GP and fertility specialist Dr Phil Boyle believes that these interventions do not do enough to address the underlying causes of infertility.

“Infertility is not an acute condition,” he says. “It is a chronic health condition that often has several underlying causes which, if diagnosed and treated correctly, will result in restoration of normal reproductive function. Physicians ought to consider broader diagnostic possibilities in their evaluation of infertile couples.”

A less well-known form of fertility treatment available to couples in Ireland is natural procreative, or NaPro, technology, which Dr Boyle has been providing here since he returned from the US in 1998. He runs weekly clinics in Galway and Dublin and there are also doctors providing NaPro in Cork, Navan and Donegal.

The technique, which was developed by the American consultant obstetrician and gynaecologist Dr Thomas W Hilgers, teaches couples how to become their own fertility experts.

“The key to the success of NaPro is the use of the FertilityCare charting system, which allows us to identify abnormal menstrual bleeding patterns, poor cervical mucous flow and subtle hormonal deficiencies that are often not detected by routine gynaecological evaluation. The goal of treatment is to restore a normal appearance to the fertility chart and restore optimum fertility potential for the couple,” says Boyle.

Each couple has regular appointments with a NaPro tutor (there are 50 around the country), who teaches them how to do their chart correctly and who can also act as an informal counsellor.

Any intervention they are offered is based solely on what shows up on the monthly chart, and may include surgery, hormone treatment or both.

“Our success rates have been improving over the years since we started in Galway,” says Boyle. “In the general population we have a 40 to 50 per cent success rate, while in older couples with a history of failed IVF we have an average 30 per cent success rate. We have about 300 conceptions a year and more than 1,200 babies born at this stage.

“One of the truly appealing things about this treatment if that if you can solve the problem or problems that are causing the infertility, usually the couple can have repeat successful pregnancies.”

Boyle has defended his policy of offering fertility treatment only to married couples, saying that he thinks that “marriage is required in order to safeguard the best interests of any child that may be conceived through our programme”.

For further information on NaPro technology, go to

‘I was doing something positive to help myself get pregnant’

Louise McMullan and her husband, Eamonn, a GP in Omagh, have three daughters – Alice (11), Lucy (eight) and Rose (five) – all born through NaPro technology.

“We got married in 1994 and when we didn’t get pregnant within the first 18 months, I went to see my GP,” she says. “I was referred to a gynaecologist who put me on the fertility hormone Clomid for six months.

“When this didn’t work I was sent to the regional fertility centre in Belfast.

“Nobody seemed willing to find out what was wrong with me. They seemed happy to accept a diagnosis of unexplained infertility and to have people pay thousands of pounds for IVF. After another year on Clomid without getting pregnant, IVF was recommended, and I had that done a couple of times. I produced lots of eggs, but it didn’t work. It was a terrible time.

“The afternoon of my father-in-law’s funeral, I was feeling miserable. The IVF had failed again. A friend had taped Phil Boyle talking about NaPro on The Late Late Show, but I had written the technique off as quackery, and hadn’t watched it. I decided to watch it that afternoon.

“He was talking about how women tended not to be investigated fully, but if you took the time to look carefully at their cycles through charting and regular blood tests, you could get a proper diagnosis for their infertility. This made a lot of sense to me. All of my blood tests were being done on a 28-day cycle, which is useless if, like many women, you don’t have a 28-day cycle.

“The following day I contacted Phil and made an appointment to see him in Galway. We also saw a tutor in Navan, who taught us how to chart. We went to Phil in June with a couple of charts and he could see I was not ovulating, so he gave me Clomid and a drug to enhance mucous. He was able to tell from my charts that my period was coming too quickly after ovulation and that the egg could never implant. I had to inject the hormone hCG on days three, five, seven and nine after ovulation to give the eggs a chance to implant.

“I starting doing this at the end of August and was pregnant at the start of September. Had Phil not been on The Late Late Show, I don’t think I would have ever have had any babies because I would never have found out that my eggs could not implant.

“I found the charting super. It meant I was doing something positive to help myself get pregnant. Suffering infertility is a very lonely time; you feel nobody understands or can help you, and you could be waiting six months between appointments at the fertility centre while your biological clock is ticking audibly as you approach your mid-30s.

“After having Alice, we went back to Phil about three years later and had a second baby, Lucy. After Lucy, I got pregnant out of the blue but miscarried at 10 weeks and then lost another baby at 18 weeks, which was horrible.

“At that stage, I went back to Phil, who put me on an antibiotic to clear up a low-grade infection from my miscarriage. I started charting and having my blood levels measured again, and got pregnant again quite quickly with Rose.