The One that's Mostly about Marketing

This is likely going to be a short one. (Ed. note from the future: I cannot write anything that actually qualifies as ‘short’, as it happens.) We just got back from vacation, I have one million things to do, and (FULL DISCLOSURE) I’m in the second half of my cycle, a superfun spate of days wherein I just can’t. 

Today, we’re delving into NaPro Technology. In our quest to find a non-invasive and non-crazy-expensive way to figure out what’s up with us and why we’re struggling, based on research we’ve done and recs from you guys, we’ve been led to TCM (which we’ve spoken about here) and NaPro. Earlier this month, I went ahead and scheduled introductory appointments with an acupuncturist and the sole NaPro guy in Cincy. 

Acupuncture’s been great so far. More on that later. 

It’s time to get excited about NaPro prior to my visit next week. But first! What is NaPro? What should I expect? What are its methods and success rates, and how much should I be planning to invest? These are the metrics we’re using to evaluate all other fertility … amplifiers, shall we say. Let’s see what we can find. 

What the Internet and Other People I Know Have to Say About NaPro

We’ll start with what the Internet’s turned up.

I’m ridiculously open to this working, but as someone who works in marketing, I get really turned off by … vagueness and obviously bad marketing. When I found bad marketing here, in the Catholic infertility world, in this sensitive area where I needed a lot of support, I … was not happy. 

Anyway. Marketing buzzphrases we found, a non-exhaustive list:

• Fertility care, not fertility control. 
• Works with the female body, not against it. 
• Maintains procreative potential, doesn’t destroy it. 
• Teaches the woman about her body, instead of masking symptoms. 

Marketing point: These phrases all sound substantive and attractive, but notice that they define NaPro by what it isn’t. Good marketing, generally speaking, doesn’t need to play defense. Good marketing will tell you what the thing is. 

All of these phrases suggest values I support. I’m a food-and-movement-are-medicine girl. I’m trying to ‘work with the female body, not against it’ for my cholesterol problems, not just my infertility. These are all GREAT things.

However, these phrases don’t tell me much about what NaPro does specifically. And the fact that many NaPro websites feature these phrases exclusively with a distinct lack of precise examples of methodology does not make me want to pull out my wallet and entrust my actual body to this practice. We need (much) more information before we invest. 

Another illustrative example: I was looking for Cincy NaPro options specifically, and Google directed me to the Infertility page of the Archdiocese website. There was a little blurb about how the Church endorses the Catholic ways to get pregnant, which was literally just a paragraph of those same bad marketing phrases (maybe I’ll make a bingo board?) followed by three links. 

The first was the sole Cincy NaPro guy, who I’ll be seeing next week. The other two were for adoption centers.

I CANNOT EMPHASIZE ENOUGH HOW MUCH I DID NOT NEED TO SEE THAT. Adoption is a lovely option which we’ll be considering strongly in the future if we need it. However, when looking for Church-endorsed fertility options...wow, that was a buzzkill. 

Anyway. Moving on. Let’s end on a positive: I LOVE LOVE LOVE the idea that, next week, I’ll be able to sit down with a doctor who will care about my charts as much as I do. (My ex-OBGYN didn’t care that I charted, which hurt.) I love that he will have the expertise to see problems in my charts (or symptoms, or bloodwork) that I haven’t found, or validate those that I have noticed. I love that he’ll hopefully be able to suggest specific lifestyle changes or medications to reroute those issues so we’ll have a better chance of conception moving forward. I love all of that. 

(I wish that we could cut the marketing BS and focus on this sensible, problem-oriented approach in the website copy, but, I said I was moving on.) 

Let me keep digging. 

Looking Further and Digging for NaPro Specifics

I’m disregarding NaPro websites for a sec. As a general rule of thumb, I try to avoid sources with very vested interests in retaining my business; so, even though there are lots of credible-sounding sources and lovely graphs on the NaPro website, I’m looking for a) testimonials from real women, and b) unbiased third-party validation. (This is what I do for all decisions, including our recent investment in acupuncture.) 

Ted found a University of Utah study delving into NaPro, here. These researchers wanted to know the rate of success of women with infertility or recurrent miscarriage treated by NaPro doctors. The couples in the study were taught to chart, received a NaPro eval, and some were put on meds or given non-invasive interventions. 108 couples; the women were, on average, a bit older than I am - 35 years of age. (I’m 28.) Of those 108 couples, 51 conceived after 24 months of treatment. (Although they do note that the median time to conception was much lower, at circa four months.) 

This is ...under half of the couples who began the study. However, the researchers do note that a lot of the patients left the study or discontinued NaPro treatment. (Two years is a long time.) They say that the actual adjusted live birth proportion was 66 positive outcomes for every 100 patients, which is a bit of a rosier number, especially given the fact that those couples tried to conceive naturally or with other means of assistance for an average of three years prior to NaPro. Here’s another study, with a slightly lower live birth percentage - 52.8/100 couples after 24 months of treatment. 

[Note that in these studies, the success (pregnancy and live birth) rate with NaPro was only about 53%-66% over the course of 2 years. That doesn’t seem very compelling. It’s disheartening that that’s only a little better than a coin flip. It’s discouraging that the results indicate that couples who struggle with infertility for about 3 years can try NaPro, and there remains a high chance that they still won’t have a baby after 2 more years.

With this data, it seems like NaPro could offer a similar timeframe as adoption. Given the choice between 3-5 years of fertility struggles with a coin flip chance of a baby, and a few years of adoption processes to give a kid a home...well. It’s, again, not exactly confidence-boosting.]

this has been a tedtalk.

(We’ve had days when we’ve been more optimistic….)

Here’s a Verily piece (disclosure: I write for Verily) that contrasts NaPro with other fertility tech options...and presents NaPro in a more positive light than I have, here, if you’re looking for a less jaded angle, haha. As the writer points out, NaPro has been deemed successful by many unbiased authorities, who note that NaPro may take longer but ultimately has higher success rates and lower associated costs than, say, IUI or IVF. 

The writer also notes that - although it’s hard to gauge investment before figuring out whether you’ll need just charting instruction or surgery, for example - many NaPro interventions are covered by insurance, because they’ll be targeted to treat specific underlying conditions (like PCOS or endo) instead of the more nebulous ‘unexplained infertility’, which is not usually recognized by insurance. (A rant for another time.)

From reading (at this point, I think literally) thousands of testimonials about NaPro, here’s what I’m getting as far as specific methods: 

• NaPro doctors will help you learn how to chart - initially or more effectively.
• Based on the info from your chart, targeted bloodwork, and other symptoms you may be experiencing, your NaPro doctor will formulate theories about conditions you may have which could impact fertility. This could be anovulation. This could be a latent thyroid problem. This could be chronic low or high blood sugar. Endometriosis. Luteal phase deficiency. Undue levels of stress. A lack of information leading to your timing your Special Hugs ineffectively. The list goes on. A very common one seems to be low progesterone, particularly in the second half of the cycle/early pregnancy.
• Based on those specific underlying issues, your NaPro doctor will prescribe medications, schedule simple/non-invasive procedures, or recommend lifestyle changes to bring you back to a place of optimal fertility.
• Your NaPro doctor will work with you on an ongoing basis to see if those practices optimize your chart, and help you figure out when to Special Hug your partner to get pregnant most efficiently. 

This makes a lot of sense to me. (And if any NaPro practitioners out there need a website copywriter, please please please please please send me an email.) 

It seems like NaPro diagnoses are likely very specific to each woman (makes sense) and likely guided by respect for how a woman’s body naturally works (yay). I will ALSO say that I belong to a few FB groups with NaPro couples, and the amount of biohacking/troubleshooting wisdom from the women who post is INSANE (in a good way). It’s very clear that these women know their bodies very well and know how to manage symptoms, how to stick to incredible diets and fitness regimens, and how to take care of themselves/their partners/their children through a very difficult journey.

I just wish the practice and community were just presented in a much more accessible and transparent light.

Why I’m Frustrated

It’s clear that this post is coming from a very frustrated place. Perhaps I’m cycling through the five stages of grief again (a fun thing infertile couples do every so often). Perhaps, as I noted in the first paragraph of this post, I’m more hormonal than usual and that’s coming across with a vengeance. 

These are likely very true. 

Here are a few more possible reasons: 

• I’m already all-in for ‘working with my body’, addressing the underlying problem/not the symptom, not using hormonal birth control and contraception, and charting. So, this is very probably just me, but I find a lot of the marketing surrounding NaPro….underwhelming.
• Any time that I’ve spoken with a NaPro advocate over the past [long time], they’ve gotten really excited about teaching me about basal body temperature and cervical fluid. Which is great. I just don’t need to be taught about that. (I’ve always been very enthusiastic and polite, but in the back of my mind, I’m going, What do you think I’ve been doing for the past three years?)
• I had a lot of dairy over the past few days, which, like, no question, that Kahlua milkshake was definitely worth it, but it’s also definitely impacting my mood now. 

Put another way: If I weren’t Catholic and weren’t predisposed to making NaPro work and game for hunting for weeks for research and testimonials to convince me to give NaPro a try, I wouldn’t have given it a second thought. Which seems like an issue, to me, given that the Church kinda has a vested interest in providing workable alternatives to more invasive fertility treatments, right? 

But again, positives: 

• I believe that a chart-loving, work-with-the-female-body, won’t-suggest-invasive-procedures doctor can and will help me. At the very least, I’m excited to get more comprehensive bloodwork done - I’ve long suspected that I have a thyroid issue that my ex-OBGYN wouldn’t test for. 
• Much like TCM, I am finding loads of convincing testimonials, and reassuring stories about doctors who really took the time to Sherlock their patient’s underlying fertility issues. I like that. 
• I can also appreciate that fertility is a) a sensitive subject, b) very complicated and unfortunately politicized, and c) ultimately not control-able. All factors which very likely impacted marketing decisions. I get that.  

As we go further down this road, I’m glad that we’re coming at this from an Eastern-med-holistic-health angle as well as a Western-med-let’s-remove-actual-fertility-obstacles angle. (For the record, so is my acupuncturist.) 

A Request

I’m going to issue two requests this week. But first! An apology. I know I took a lot of angst out on NaPro this week, and I’m deciding to publish it anyway because we want to keep this real, and this is what we’ve been ranting about in our living room as we’ve researched it. I’m sorry that I didn’t present this with more neutrality - and, if you’re a passionate advocate of NaPro, I’m very sorry if I have crossed any lines. If I need to update/re-broadcast this post, please let me know. 

I truly hope to be a future advocate of NaPro. I’m finding that difficult right now, because I’m in the trenches, and I don’t have enough information. So! Here are my requests. 

• If you know more about NaPro than I do, which would not be difficult, tell me about it! Comment, DM, email. However, I’m looking for specifics. I’m not interested in charting, which I do...too much of, or generalities like I found on the NaPro website. If you’re comfortable sharing a specific condition your NaPro doctor diagnosed, helped treat, and you had a good experience, please do let me know. 
• If that’s too personal (which, obviously, that’s a big ask), I’m still curious - do you have a NaPro success story? I think anecdotal marketing is huge, here, and, like, I believe I know several people who exist because of NaPro, which is big. Again, if you’re comfortable just sharing that you had success because you worked with a NaPro doctor, that would be … really confidence-boosting. 

I have my consult next week, and I will be bringing charts, questions, charts, studies, charts, and yet more charts. Don’t worry, I’ll be polite! I want this to work! 

Thanks for tuning in! NEXT WEEK, we’re talking about weight loss and preconception health. Trigger warning, again - it’ll be less ~spicy~ than this week’s post, but we will be talking about diets and exercise and specific weight numbers and goals. 

AFTER THAT, we’ll be doing an Acupuncture update: What it was like to go to an acupuncturist, what our experience has been, what our plans are going forward, and things I’ve noticed after treatment. YAY! See you then!