The Infertility Problem Fr. Jarosław Szymczak, PhD It is no accident that the issue of nfertility appears in the session devoted to the culture of life as opposed to the culture of death, between abortion and euthanasia. It seems that contraception would be the most suitable topic to fit in between the two subjects. The organizers of this conference, however, selected on purpose infertility as the venue where the conflict between the two cultures takes the sharpest form. And even though there are, fortunately, many people fighting for the life of the unborn or the old, contemporary public opinion deemed in vitro fertilization (IVF) as the expression of struggle for life (Nobel Prize), and not as just another, how truly tragic, manifestation of the culture of death. In 1999 in St. Louis, Blessed John Paul II said: Today, the conflict is between a culture that affirms, cherishes, and celebrates the gift of life, and a culture that seeks to declare entire groups of human beings the unborn, the terminally ill, the handicapped, and others considered unuseful to be outside the boundaries of legal protection. The former culture was described by Pope Paul VI, and then by John Paul II, as civilization of love and life. That civilization has as its principles: the primacy of person over things, the primacy of being over having, the primacy of mercy over justice, the priority of ethics over technology. Contemporary utilitarian philosophy shows an overtly anti-life, contraceptive mentality (see FC 6): the plague of pregnancy termination, surgical sterilization, and the ever 1
increasing divorce rate. In the last days of April we were alarmed by the news coming from Portugal. In more than 20 municipalities, no child has been born for the last two years and in some municipalities only one child was born. In future, they will travel 80 km to the nearest school. At the root of these negative phenomena there frequently lies a corruption of the idea and the experience of freedom, conceived not as a capacity for realizing the truth of God's plan for marriage and the family, but as an autonomous power of self-affirmation, often against others, for one's own selfish well-being. (FC 6). What does that all have to do with infertility? With the suffering of the married couples who desire... Yes, what do they desire, in fact? Do they want to become parents or to have a baby? This is where the potential parents make the decision which path to choose: the civilization of life or death. If they choose to have a baby rather than to be a parent, we deal with the inverted priorities: the primacy of technology over ethics (IVF: infertility poses a challenge to technology, which should bypass the dysfunctional organ), the primacy of things over person (we've got the right to HAVE a baby, if we are married, or a couple, or a single woman who wants to have a baby because that's the last thing she hasn't achieved at the height of her career), of justice over mercy (because we invite to our life only the children who meet the appropriate criteria: they should be healthy, as we have placed such order; we've already got a girl, so now it should be a boy; the babies with defects should be removed). What is infertility from a wider perspective? Infertility is a common, global and increasing problem. One in every 6 couples worldwide (WHO) hoping to have a baby, experiences difficulties achieving or maintaining pregnancy, serious enough to seek medical intervention. The reasons behind the increase of infertility problems are not entirely understood, but lifestyle and the use of oral contraceptives are known to delay pregnancy. There is a global tendency to treat fertility as a problem or even a disease and to suppress it, and then, after years of damaging fertility to get pregnant as quickly as possible, almost at any cost and at the moment which is precisely planned. 2
Infertility is a chronic multifactorial problem, which confronts both women and men. Being usually a symptom of underlying causes, it requires addressing multiple issues, including medical conditions and lifestyle. The diseases that cause infertility not only hinder fertility itself but they also cause other health problems. Until 1978, most of the effort in infertility treatment focused on identifying and treating the underlying causes. In 1978, in vitro fertilization produced a paradigm shift, thus bypassing the dysfunctional process. This unwillingness to address infertility problems in terms of identifying the contributing factors continues up to the present time. As a result of this treatment strategy, the gynecology has lost over 30 years of good research opportunity. Women go to the IVF clinics with underlying diseases and will walk away from the clinics with the same disease. The success rate of IVF in Europe and United States is about 20% delivery rate per treatment aspiration, which is much lower than the success rate of classic medical and surgical treatment about 30 years ago. Moreover, assisted reproductive technologies (ART) are expensive, invasive, involve the selection and death of embryos and many medical risks. For every IVF pregnancy, more than 6.4 embryos are destroyed. IVF, in addition to being unethical, does not treat a woman's health problems, but only produces a baby. The science which addresses the issue of infertility in a way that is not only effective, but also inherently ethical, is NaProTECHNOLOGY. The name comes from the conjunction of three words: natural procreative technology. NaProTECHNOLOGY (NPT), originated and developed by Dr. Thomas W. Hilgers, is a woman's health science which monitors, maintains and restores a woman's reproductive and gynecological health. It provides the missing link in gynecology: medical and surgical treatment that cooperates completely with the reproductive system. It does not employ methods that are inherently suppressive, circumventive or destructive. It supports the patient's right to understand and cooperatively manage their own fertility, with appropriate medical assistance. 3
NaProTECHNOLOGY is based on thirty years of scientific research on the menstrual cycle. Patients are individually taught to monitor biomarkers of their own fertility cycles in a precise and standardized fashion using the CREIGHTON MODEL charting system - with the assistance of a FertilityCare educator, who facilitates the process. The information included in the charts allows then the physician trained in NaProTECHNOLOGY methods to evaluate the fertility cycle further by means of new diagnostic technologies. Further steps include hormone tests, ultrasound scans and laparoscopy, along with other advances procedures, which help identify abnormalities and diseases behind infertility earlier ignored or not detected in routine gynaecologic evaluation. Establishing a diagnosis is essential and the goal of the treatment is to restore a better health and fertility potential for the couple, and thus to optimize physiologic conditions for conception in vivo. programmes. Some of the medications used with NaProTECHNOLOGY are used in other fertility What is unique to NaProTECHNOLOGY, aside from a group of specifically developed medicines, is the precise timing and monitoring of treatment using the FertilityCare charting system. If medically unsuccessful, the program will assist the couple in the area of successful family building by being supportive of adoption. Let us have a closer look at the success rate. Here we are comparing 5 different studies of in vitro fertilization to NaProTECHNOLOGY treatment for tubal occlusion, endometriosis, and polycystic ovaries. In each of these cases, the degree to which NaProTECHNOLOGY was better was shown to be statistically significant. As you can see, approximately 80% of the patients eventually have children. Natural Procreative Technology, whose high effectiveness has been scientifically proved and described, is the key to future research in restorative and reproductive medicine committed to serving human dignity. However described by anthropology and medical science, infertility - for a couple longing for a baby is, in the first place, associated with pain and asking questions why they are unable to realize to the full the potential inscribed in marriage by God himself. The doctors, who vow to follow the Hippocratic Oath, should not be the ones to inflict even more 4
pain on those who seek their help. The doctors thus, in the first place, should be conscious that a true solution of the infertility problem never betrays human dignity. The civilization of life and love offers the solutions which protect all human beings (and their right to live, to have the loving parents they might know and trust, not sperm donors or surrogate mothers). It reminds of the primacy of "being" (a mother, a father in all its beauty and depth) over "possessing" a child among many other items which satisfy their needs. NaProTECHNOLOGY, even though its name entails the term technology, is rooted in that culture of life and promotes a profoundly ethical approach which does not disrespect the potential parents and their potential children. In the end, the truth which underlies all striving after conception of a baby and assistance in that process is love. Medical Consultation: Sue and Thomas W. Hilgers, MD Natalia Suszczewicz, MD Translation to English: Małgorzata Rybak, MA 5