What is NaPro Technology?
NaPro Technology (Natural Procreative Technology) is a systematic medical approach to treating infertility by identifying and correcting underlying causes of reproductive dysfunction, rather than bypassing them, using fertility awareness methods combined with targeted medical and surgical interventions to promote natural conception in vivo. 1, 2
Core Components
NaPro Technology consists of several integrated elements:
Fertility tracking using the Creighton Model FertilityCare System (CrMS), which teaches couples to identify fertile days of the menstrual cycle through standardized charting of cervical mucus patterns 2, 3, 4
Comprehensive diagnostic evaluation to identify specific causes of infertility, with couples typically receiving an average of 4.9 diagnoses per couple that contribute to their reproductive dysfunction 2
Targeted medical treatments including medications to enhance cervical mucus production (used in 81% of patients), ovulation stimulation agents like clomiphene (used in 62-75% of patients), and luteal phase support 2, 3
Surgical referral for conditions like endometriosis, with approximately 46% of couples referred for specialized laparoscopic surgery 2
Clinical Outcomes
The effectiveness of NaPro Technology has been documented across multiple primary care settings:
Cumulative live birth rates at 24 months range from 52.8% to 66% per 100 couples in life-table analysis across studies from Ireland, Canada, and the United States 2, 3, 4
Crude live birth proportions range from 25.5% to 38%, with higher success rates in younger women (34% for women under age 35) and women with BMI <25 (40%) 2, 3, 4
Multiple gestation rates are significantly lower than with assisted reproductive technology, with twin rates of 4.6% and no higher-order multiples reported, compared to the risks associated with IVF 3, 5
Term birth rates are favorable, with 92% of births occurring at term in one study, and 54% at ≥37 weeks in another 2, 4
Key Distinctions from Assisted Reproductive Technology
NaPro Technology differs fundamentally from conventional fertility treatments:
It seeks to restore normal reproductive function rather than bypass it through artificial means like IVF 1, 5
Conception occurs naturally in vivo through the marital act, rather than through laboratory fertilization 5
It avoids the maternal risks associated with ovarian hyperstimulation syndrome and high-order multiple pregnancies that occur with IVF 5
No embryos are created or destroyed, eliminating the ethical concerns regarding embryo disposition that arise with IVF 5
Clinical Implementation
NaPro Technology is particularly suitable for primary care practice:
Family physicians can be trained to provide this approach systematically, as demonstrated in studies from general practice settings in Ireland, Canada, and the United States 2, 3, 4
Treatment typically begins with CrMS instruction alone, with 24% of couples conceiving with fertility awareness instruction only, before progressing to medical or surgical interventions 4
The approach is effective for both primary infertility and recurrent miscarriage, with studies including couples who had experienced 2 or more unexplained miscarriages 4
Important Clinical Considerations
Several factors influence outcomes with NaPro Technology:
Age is a critical prognostic factor, with significantly higher success rates in women under 35 years, similar to all fertility treatments 2, 3
Prior failed ART attempts do not preclude success, as 22-33% of couples in published studies had previously attempted assisted reproductive technology before NaPro Technology treatment 3, 4
Duration of infertility varies widely, with mean durations of 2.7 to 5.6 years in published cohorts, indicating the approach can be effective even after prolonged infertility 2, 3
Genetic testing may enhance outcomes by identifying underlying genetic causes of infertility that can be addressed through targeted treatment 1