Principle Investigator: Dr. Joseph B. Stanford, MD, MSPH
University of Utah
Department of Family and Preventive Medicine
375 Chipeta Way #A
SLC, UT 84108
joseph.stanford@utah.edu
BACKGROUND AND INTRODUCTION
Infertility is a common problem. While most of current clinical research of infertility focuses on
in vitro fertilization and related techniques of assisted reproductive technology (ART), some
couples do not wish to use in vitro fertilization, or cannot afford it. Natural procreative
technology (NPT) is a standardized approach to the treatment of infertility that does not involve
ART. NPT incorporates standard infertility treatments (such as clomiphene or progesterone)
within a set of standardized application protocols. The goal of NPT is to identify abnormalities
of the woman’s reproductive cycle (menstrual cycle), and where possible, correct them by
medical intervention.(1, 2) An integral part of NPT is teaching women to observe and chart the
biomarkers of their fertility (menstrual) cycle, based on changes in vaginal discharge (resulting
from uterine bleeding and cervical mucus production). This charting of fertility biomarkers is
done according to the Creighton Model FertilityCare System (CrM). (3) The CrM has several
applications. First, the CrM chart alerts women when ovulation is approaching within the next
few days and therefore intercourse is most likely to result in pregnancy, even for subfertile
couples.(4, 5) Second, it also gives the physician a record that can be used as a standardized
basis for doing diagnostic tests timed in reference to ovulation. Third, the physician can also
employ standard medications to enhance ovulation, luteal hormonal production, or cervical
mucus production, and use the CrM chart to assess the immediate response of the woman to
treatment. Where appropriate, NPT may also include medical treatment for male factor
infertility, and for prior miscarriage. A CME-accredited NPT training course has trained many
physicians to apply NPT in their practices. Formal evaluation of the outcomes of NPT in medical
practice has been limited to a few studies based on single medical practices.(6-9) We plan to
conduct a multi-national prospective observational study to measure the generalizability of this
program to multiple populations and settings, and characteristics of patients that may correlate
with the likelihood of treatment success.
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