Napro experiences

iguana

I had my first Napro appointment yesterday and thought I'd start a thread of it's own about it rather than stick it in the chat thread. That way it will be easier for anyone looking for information to find it, now or in the future.

First off we called for the appointment on the 23rd of December and were told we could either wait until mid/late April for a Dublin appointment or go to Galway for an appointment on the 14th of February. We jumped at the Galway appointment as a wait of under 2 months seems miraculously short for this clinic. This decision paid off as now that we have had our initial consultation we can continue on our treatment in Dublin. We have another doctor's appointment in the Beacon in Dublin in May and between now and then we will have numerous sessions with a 'fertility teacher.'

Secondly it's worth mentioning that in my case I was diagnosed and treated for endometriosis in Tallaght hospital in early January. If you already have a diagnosis of a potential fertility problem it will obviously speed things along in terms of your treatment. If you don't, obviously they may recommend tests in order to diagnose/rule out certain problems. The day before the Napro appoinment I had a follow up appointment with my gynaecologist about the endometriosis. They basically recommended a wait and see approach. The Napro doctor however had a plan of action if I wanted to follow it.

Thirdly I wasn't that sure what to expect from Napro. It's origin is very Catholic and it was devised as an alternative to IVF as the church is opposed to IVF because they believe embryos have souls and IVF can involve the destruction of weaker embryos. Personally I have no moral problem with IVF and it will certainly be my next step if Napro doesn't work out for me. I just don't want to do IVF because I'd ideally rather conceive through love-making as opposed to following a painful egg extraction. The religious background of Napro can feel a bit dubious to cynical atheists (like me) but from what I could tell despite the religious purpose of the treatment, the treatment itself appears to have scientific basis. However, Napro only treat married couples because of their religious ethos, so if you aren't married it's not for you. (Unless you decide to get married, obv.)

iguana

The appointment itself.

First off we had to fill in a medical history questionnaire. This had lots of questions which you would expect: How long have you been trying? Miscarriage history? Family miscarriage history? Past diagnosis of endo/cysts/etc? Previous contraceptives used?
And some less usual questions like personal or family history of illnesses like Type 1 Diabetes, Crohn's Disease or Rheumatoid Arthritis.
For this part of the consultation you should ideally bring in your doctors notes on any past tests/treatment you have had, like day 3/21 blood tests or scan results. We didn't do that so will have to bring them in next time.

Then the doctor goes through their charting system. For this you will have to study your cervical mucus. A Lot! There is a chart with stickers and a code you have to learn in order to document your daily mucus. It's pretty full on and I can see myself keeping a notebook handy for each bathroom trip from now on. The chart is to filled in late at night and involves stickers and the code. They advise that the husband takes charge of filling the chart in, so it's a shared responsibility.

They place a huge amount of importance on the information gathered on your chart so it's important to be willing to commit to doing it right. The major negative of this is that you will need to spend one full cycle with no unprotected sex so you do it right. I was really, really resentful of this when I was told it. I don't like taking a month off and I've already had to take last month off because of the laparoscopy. In my head I was hoping that they would just give me tablets based on my endo diagnosis and I could just go away and try with them next month, get pregnant and (super fantasy) have boy-girl twins for Christmas. They thought of taking next month off to fill in a chart seemed pretty stupid. I mean what do I need a chart for? I already have a fertility monitor. I sometimes do temperature charts, even though I hate them. I have occasionally had scans and been told I was about to ovulate/have just ovulated. I know when I ovulate and as we do sperm meets egg plan most months, I know we nearly always have sex at exactly the right time. So taking a month off for the sake of charting seemed dumb.

However while this type of charting will tell you when you peak it does a lot more than that. The quality of the mucus is important as it tells them a lot about the quality of your eggs and other fertility issues. They can then medicate for this and medicate with precise doses. They can then (hopefully) improve whatever is wrong, like increase your mucus, increase/decrease certain hormones and increase your production of very good eggs. This will then increase your odds of getting pregnant and maintaining a healthy pregnancy. So I'm going to give it a go and see how I get on.

After that I had a scan. The fun transvaginal kind :rolleyes:. That showed that I have either recently ovulated or am about to, so there is a possibility that I conceived this month already as we had been trying at the start of the week. And it once again showed up that I have no cysts and everything that the scan can see, looks good.

Then came the bit for my husband. They want to do a full sperm test. (They don't usually test for DNA sperm fragmentation but will as we asked them to. I've read up on fragmentation and as it can be the cause of a lot of previously unexplained infertility, we want to be sure that isn't part of our problem right from the start of these tests so we asked for that test to be done too.) Now for the 'fun' part. Napro have an interesting stance on sperm tests. In their experience the usual 'masturbate into a cup' type test doesn't provide an accurate reading, they want their sample to be produced 'under sex conditions.' What does this mean? Well they give you a male factor pack, which is basically a special type of condom and you have to have sex while the man wears it. Then, with no time for cuddling, jump into the car and get the sample to the clinic within one hour. We are both incredibly apprehensive about that, especially him. But I guess it gives us something to look forward to during our 'no try month' next month.:pac:

Lastly the doctor explained about the unusual questions on the questionnaire. The illnesses listed are common types of auto-immune disease, as is endometriosis and, I think, PCOS. And they believe that a personal/family history of those illnesses can be a factor in your fertility problems. I felt this was really interesting as I don't really meet any of the usual genetic criteria for an endo sufferer. I didn't know of any family members with the diseases listed but decided to double check with my mother once I got home. The doctor then explained that auto-immune diseases are associated with low endorphin levels and women with endo and some other infertility problems, including recurring miscarriage. Improving my endorphin levels is their first step. She gave me a prescription for Low-Dose-Naltrexone (LDN) to help with this.

Naltrexone is a drug for treating addictions, especially to opiates, though it's used for alcoholism and other drugs too. It works by switching off the part of the brain that receives pleasure from these drugs. When delivered in very, very low doses, especially at night, it promotes endorphin production and will hopefully push my endorphin levels from low to slightly higher than normal. LDN is off-license for this purpose but I had actually read about it before and know someone who is taking it for Multiple Sclerosis (another auto-immune disease) and finding it helpful. I asked about it's safety if I happened to be pregnant and the answer was that their patients on this drug all take it until the end of the first trimester and their babies have all been not only healthy, but in most cases, healthier than average with a much lower incidence of miscarriage. I'm going to look into this a lot more before deciding to take the drug, which is being posted to me, so I have a few more days to be sure about my decision to take it, though I probably will. I'm just very cautious about the health of any baby I have.

Further reading:
http://webcache.googleusercontent.com/search?q=cache:E7MsjgJCFZ8J:www.lowdosenaltrexone.org/_conf2006/P_Boyle.pdf+low+dose+naltrexone+fertility&cd=2&hl=en&ct=clnk&gl=ie&client=firefox-a

http://www.lowdosenaltrexone.org/further_q_and_a.htm

Also in the last few weeks I started up an exercise regime which I'm also hoping will increase my endorphin levels. I've read about links between exercise and improved fertility, so I'm more determined after this appointment to keep up exercising as previously I was wary about exercise while TTC.

When we were leaving we were given a pack with our charts, stickers, a dvd, a book, lots of leaflets and the condom thingy. I was also advised to consider getting a food tolerance test as food intolerance can be an aggravating factor with endo. We'll be contacting the teacher this/next week to arrange our first fertility class.

The costs were €220 for the consultation and scan, €55 for the pack and to the pharmacy €57 for the LDN.

The very, very last thing is that when I got home I called my mother and asked about the diseases listed as examples on the leaflet about auto-immune diseases and fertility. She didn't know of any with the diseases listed so I looked up other auto-immune diseases. Right at the top of the list was mention of inner ear, so I scrolled to M and found Ménière's disease. An illness that my dad developed a severe case of over 20 years ago and has had ever since. So I looked up Ménière's and endo and what do you know, there appears to be a definite link between the two. So there's my link, I finally know why I was susceptible to endo. I have to say that in itself has made me glad to have gone to the appointment. I prefer having a reason for my disease and I would never, ever have made the link between an inner ear problem in my father and a problem with my uterus lining growing in the wrong place.

barbiegirl

Iguana thank you so much for that. I really appreciate it as I'm sure some of the others do too.
Fingers crossed we'll be Napro baby buddies this year

Fluffyduck11

Youre very good to take the time to share youre experience Iguana, I didnt do any research on Napro till after my referral was made for the Hari, the charting seems quite intense but probably just a matter of getting used to. Depending on what news we are given as to what our problem is, I wonder could we switch and do the Napro route before going down the Ivf route?

Keep us posted on your experience, for those who have yet to decide where to start this is a great way to find out all the info


Thanks again and best of luck xx

bubbaloo

Hi Iguana (and others).
I am a long term Napro patient - and Napro fan - and I have severe endo too, but I have a little boy who is almost 3, thanks to Dr B and the surgeon he referred me to. I have already put my story into the chat thread so I won't bore you all with it here but I really believe that with patience and perseverance Napro can answer many questions. It's not a magic spell and requires hard work from the couple as well as from the doctors, but I think if couples can walk away from this journey with an answer it's better than a lifetime of wondering "why?" - obviously if you walk away with a clatter of kids it's even better!! !:D

On the subject of LDN, I took it for about 18 months before my pregnancy and I also took it throughout my pregnancy. I had a fairly healthy pregnancy with the only real complication being my high blood pressure - I have a history of this (including family history) and I was also overweight which didn't help. Anyway, the result of my pregnancy was a very healthy, very happy boy - who at almost 3 years old has probably had a sum total of 4 anti-biotics in his life. That's fairly good going for a child who's been in a germ-filled creche 5 days a week since he was 9 months old. He has always been a great eater and a strong sturdy child so my experience of LDN in pregnancy has been excellent. The only negative I'd say about it is the hangover you get after just one drink. Because it's used for addicition, I found that just one drink gave me a terrible headache and I actually just gave up alcohol completely. I haven't been drunk in about 5 years!

As for the abstinence from sex - try not to get too upset about it. It will fly by and you can make up for it the following month! But seriously, the charting work you do in that month is worth so much towards the ultimate goal!
Best of luck to you.

iguana

Bubaloo how did you feel when you started Napro? I've done a week on 2mg and tonight will be day 3 at 3mg and I'm starting to feel really miserable. I feel more tired and weepy each day. The worst thing is I feel awful during and after exercise and if I exercise it completely zaps me of energy for the day. I know traditional use of Naltrexone inhibits the brain's reception of all opioids, including natural endorphins so people taking it don't feel any mental benefit of exercise. I didn't think this would happen with such a low dose taken at night. Is this a normal early side effect that my body will learn to compensate for?

iguana

Scratch that bubbaloo. I got a positive test this morning, so I guess it's the pregnancy hormones that are making me so tired, rather than the LDN.

LegacyUser

Congrats on the pregnancy Iguana & thanks for the excellent, thorough posts.

Does anyone know if Napro is good for low ovarian reserve cases?

My history in brief: I'm now 37 and was diagnosed with low ovarian reserve over two years ago. I did ivf/icsi three times. 1st time I got 3 eggs, 2 embroyos implants and a BFN. Next time I got 7 eggs, only 4 mature; 1 fertilised embryo and a BFN. Third time I got 4 eggs but none fertilised at all & we didn't make it to transfer. Cue devastation. But as it turns out, miracles do happen, because three week later I got pregnant naturally for the first time - that was nearly six months ago. Words cannot describe how much I love my bump

I'm so, so, so happy right now I'm even superstitious about thinking about ever ttc again, but I saw this thread... basically, I wonder if all those ivf drugs were too tough on my system and just weren't doing my eggs any favours. If we were ttc again and had the money (we don't) I would hop on a plane to London for natural ivf. I'm wondering would napro be a cheaper way to go about things - of course I realise they don't do ivf but maybe they could handle egg quality issues?

Does anyone have any experience of this?

bubbaloo

Wow - usernamehh - what a fantastic story. Congrats on your big bump and enjoy every minute.
I don't know if Napro can help with low ovarian reserve but they're very open to discussion so you could give them a ring and have a chat about it. As for natural IVF, is there nowhere in Ireland that does this yet? I thought I read that SIMS do it, but that could have been a dream - you know what fertility drugs do to your head!!
Best of luck with your pregnancy.

LegacyUser

Thanks bubbaloo. HARI also do natural, but only as a last resort, and it still costs thousands. Don't know what SIMS stance on it is. I just think they probably have more expertise in London. Will get onto NAPRO at some point in the future, though with my age & diagnosis I should probably just be very happy with one baby - all going well. It's just hard to break the baby-hunger habit!
Best of luck with your own journey.

rudydaisy

Hi All I just started Napro in January and am on my second cycle charter.. Im finding extremely good and so thorough he how they investigate. I have been trying to conceive 4+ years and was diagnosed with hyperprolactinoma, however that has now been leveled. I conceived in 2009 and MC in Dec at 8 weeks, which was devastating, and nothing has happened since.. we went to every test and they can find nothing wrong with me or hubby and were advised IVF as I am 37 now. We wanted to try Napro while we are saving for IVF treatment. I had my Peak on day 8 this month and had bloods done oestradiol at 494 and Prgesterone at 57.9 which is lower than last month in Prgesterone but my oestradiol is higher by 100... I was hoping we would conceive this month as my scan showed a good size folicle for rupture.. I am also taking naltroxone and on second week now at 3mg.. so fingers crossed. Just wondering if anyone has had experience with same. Thank you.

Hellrazer

Dont usually post here that often but I had to respond after our experience with Napro


Im not going to quote your whole post Iguana but our two younger ones were concieved through Napro with LDN.

Heres a post I made about it back in 2008

http://www.boards.ie/vbulletin/showpost.php?p=57382359&postcount=7

We had tried everything including multiple IVF cycles and no luck at all.My wife had completely unexplained infertility and all I can say is that thanks to Dr Boyle we have two that I honestly dont think we would have had.

At first it was quite daunting with the charting and all that but after a couple of months it becomes part of the everyday routine--Mrs Hellrazer had me filling in the stickers just because Dr B said I had to to :D

Wishing you the best of luck with this as Mr Boyle is in my opinion a miracle worker and doesnt stop until he tries absolutely everything he can.

The first time it took us about 10 months to concieve and the second was within 6 since he had the treatment down to a fine art after what worked the firt time and he knew exactly where to start.

Best of luck.

Richie.

barbiegirl

Well we had our first Napro appointment today, and it was a lot to take in.
He suspects I have endometriosis and I've to book in a laparsocopy to check for that, I've had bloods taken for food allergies, I've been put on Naltrexone for my dopermine levels, lots of vitamin C, Vit D, Fish Oils and free radicals.
We've to meet our teacher in 2 weeks to start blood tests and are due back with him the end of July
I feel positive that we are doing something and that he feels we have an 80% plus chance of a successful outcome, whereas the time we went to SIMShe said 60% chance of mis-carrying.
Overall a very positive experience, so fingers crossed girls

pmarro

I'm doing the creighton method and taking lose dose naltrexone. I dont like the way it makes me feel. And I am taking it in the morning bc it affected me sleep so much. We have been charting for over 8 months and taking the low dose n for about 5 months. Waiting is so hard. I also have endometriosis. Does anyone else how horrible side affects taking low dose nalt?

iguana

I'm gad you feel good about how it went barbiegirl, fingerscrossed it works for you. I have to say in my experience having endo is a massive problem that was very solvable once treated.

pmarro, I thought the LDN was making me feel awful initially but it turned out I was already pregnant. The tiredness is supposed to level off after a few weeks once your body gets used to the dosage.

LegacyUser

By the way, congrats on the new addition to come. Well, I've been it on for some time. Once it started to affect my sleep (horrible vivid dreams and constant waking) I asked my Dr. if I could take it during the day. He said it was ok. So, for about 2-4 hrs after taking it, I get a really bad slump of extreme tiredness. I have found if I am moving around and doing things, it isn't so bad. But if I am sitting and perhaps reading, etc., forget it. I can barely keep my eyes open.

On a good note, we do have one child who is turning 6 in June. So, God has blessed us, but we have a very strong desire for more. It took us over 2 yrs of trying with him. It's been almost 4 now. I am really encouraged though to read that some people on here had failed IVF, but conceived with charting, etc. Makes me feel so hopeful. I am so excited to finally find others who are going through the same thing as me. Sometimes you feel so alone in this season of your life, because most people don't understand.

barbiegirl

I think what is annoying me is that I have mentioned that endometriosis runs in my family to every other clinic and none of them paid any attention. I as so happy that he was asking questions about things that nobody else ever has.
Thinking back I have lost my bounciness in the past 5-6 years, so heres hoping all of this brings me back to who I am really with a baby of course too.

iguana

barbiegirl wrote: »

I think what is annoying me is that I have mentioned that endometriosis runs in my family to every other clinic and none of them paid any attention. I as so happy that he was asking questions about things that nobody else ever has.

Wow, I can't believe that it runs in your family and no-one ever took that as a sign that you might have it, it's a genetic illness! I was very lucky that mine caused me so much pain, as no-one else in my family has it and Napro is the only place that seems to be making the link between endo and other auto-immune diseases.

Not to wish a disease on you but fingers-crossed it is what the problem is, and they remove it. Have they a date for you to have the laparoscopy yet? If you can try and arrange it that if they find it, they do the laser ablations in the same surgery. Imo, it's best to have it all done at once rather than have to have two lots of surgery. I remember being so happy when I woke up in the recovery room to be told I had it and it was gone. I felt brand new.

barbiegirl

I know and I always mentioned it. From what I've read the doc I've been reffered to will do it all at once. Of course the fact I didn't have pain was why they didn't investigate it. I've left a message and waiting on them to call me back.

I just want to know it's all been cleaned out.

bubbaloo

Barbiegirl - I'm so glad to hear that your appointment went well and that you at last feel someone is listening to you. I am a Napro patient with severe endo - I have a 3 year old boy thanks to my endo being cleared out and Napro finding the right drug combination for me. I'm on the road of ttc #2 now and hoping Napro will work it's magic again.
Best of luck.

iguana

Not having pain doesn't necessarily mean anything. I had it on the outside of my ovary so what was happening was that, as the growths are sticky like soft toffee, they were sticking to my other organs and pulling at them causing pain in the ovary and to whatever they stuck to. Then they'd eventually come apart and stick to something else. If the endo is inside your tubes, for example, then they wouldn't be sticking to and pulling off anything, so you are less likely to feel it.

barbiegirl

Just a quick question, I am due to attend Dr Sharon Moss in the Beacon for a consultancy on May 31st, my insurance won't cover the op there but will in the Rotunda where she also practices. We don't mind paying for the consultation in the Beacon, but does anyone know if she would then do the op in the Rotunda if we asked?

bubbaloo

Hi barbiegirl - she should do if you ask her. I can't answer for her but I know that my husband had to attend a consultant last year in his private rooms - which were in one hospital. We weren't covered for that hosp so he did my husband's surgery in another hospital. i can't see why it would be a problem. Good luck.

yellow hen

barbiegirl wrote: »

Just a quick question, I am due to attend Dr Sharon Moss in the Beacon for a consultancy on May 31st, my insurance won't cover the op there but will in the Rotunda where she also practices. We don't mind paying for the consultation in the Beacon, but does anyone know if she would then do the op in the Rotunda if we asked?

I didnt know she practiced in the rotunda. I dont really understand how insurance will cover the rotunda but not the beacon?

Anyways, I had an op under Sharon Moss too and was very happy with her. Im still seeing her as my consultant now. Best of luck to you.

stargirl.gra

Do you have to be referred for this by a doctor or can you just arrange it yourself? And do you have to have some explanation as to why you have not concieved i.e endo? And long term what would the costs be amounting to, is it a very expensive process?

bubbaloo

stargirl.gra wrote: »

Do you have to be referred for this by a doctor or can you just arrange it yourself? And do you have to have some explanation as to why you have not concieved i.e endo? And long term what would the costs be amounting to, is it a very expensive process?

Hi Stargirl. You refer yourself to Napro and you need absolutely no reason. That's what they aim to do - find a reason and overcome it. The expense can vary, depending on what treatment you need. You'll find all the info on how to contact them, prices etc on www.fertilitycare.ie The only requirement is that you are married. Then you chart your cycle with the help of a teacher for about 3 months. After that you meet a Napro doctor and they decide on a course of treatment. They may also want to do follicle tracking which is scanning you over a few days to be sure you're ovulating. Then each month you get your bloods done and after that you have to add the cost of buying the drugs. The drugs payment scheme means this will cost at most €132 per month.

I am a big fan, as I have a 3 year old boy conceived through Napro. But the best news of all is that I have just got another Napro BFP this week!
I am delighted and nervous (having suffered m/cs before discovering Napro) but hoping that my positive Napro history will repeat itself.
Best of luck.

barbiegirl

Huge congrats Bubbaloo Delighted for you

stargirl.gra

Does it have to be catholic marriage or does civil count?

iguana

Civil is fine, or any other religion.

yellow hen

bubbaloo wrote: »

Hi Stargirl. You refer yourself to Napro and you need absolutely no reason. That's what they aim to do - find a reason and overcome it. The expense can vary, depending on what treatment you need. You'll find all the info on how to contact them, prices etc on www.fertilitycare.ie The only requirement is that you are married. Then you chart your cycle with the help of a teacher for about 3 months. After that you meet a Napro doctor and they decide on a course of treatment. They may also want to do follicle tracking which is scanning you over a few days to be sure you're ovulating. Then each month you get your bloods done and after that you have to add the cost of buying the drugs. The drugs payment scheme means this will cost at most €132 per month.

I am a big fan, as I have a 3 year old boy conceived through Napro. But the best news of all is that I have just got another Napro BFP this week!
I am delighted and nervous (having suffered m/cs before discovering Napro) but hoping that my positive Napro history will repeat itself.
Best of luck.

Hi Bubaloo, Do you pay each time you visit them? I am curerntly in the beacon but its €100 every time I go and I have to pay extra for any scans (excl. internal) s its easy to run up a big bill. I am considering contacting Napro. Do you know if there is a waiting list?
thanks.

bubbaloo

Hi Yellowhen,

You pay for each consultation (approx €200) but you might only have a consultation every 6 months. If they want to do follicle tracking, they will scan you every second day for 5-6 days - at €50-60 for each scan so that's another €150 approx. Bloods cost whatever your GP charges and drugs cost €132 through the drugs payment scheme. The initial cost of the charting teacher at the beginning is probably the most expensive part. You can't really know how often you need to go until you start charting and see how you're getting on with it - but maybe three visits would be enough. I'm not sure how much each session would be because I had my teaching sessions in 2005 and I'm sure things have changed since then - back then it was €50 per session.

If you ring the office in Galway the girls are very helpful and will answer all your questions. Good luck.