Creighton Model FertilityCare System

Creighton Model / FertilityCare
Background
Birth control type	Behavioral
First use	1980
Failure rates (first year)
Perfect use	0.5%
Typical use	3.2%
Usage
Reversibility	Immediate
User reminders	Accurate instruction & daily charting are key.
Clinic review	None
Advantages and disadvantages
STD protection	No
Periods	Prediction
Weight gain	No
Benefits	Low direct cost; no side effects; in accord with Catholic teachings; may be used to aid pregnancy achievement

The Creighton Model FertilityCare System (Creighton Model, FertilityCare, CrMS) is a form of natural family planning which involves identifying the fertile period during a woman's menstrual cycle. The Creighton Model was developed by Dr Thomas Hilgers, the founder and director of the Pope Paul VI Institute. This model, like the Billings ovulation method, is based on observations of cervical mucus to track fertility.

History

Dr Thomas Hilgers began research in 1976 which led to the development of the Creighton Model FertilityCare System, which was first fully described (as the Creighton Model) in 1980.^[1] In 1981, the American Academy of Natural Family Planning was founded to promote use of the Creighton Model as a form of natural family planning (the term for methods of family planning approved by the Roman Catholic church).^[2] In 1985, Hilgers created the Pope Paul VI Institute to medically support the directives given by Pope Paul VI in Humanae Vitae: On the Regulation of Birth.

In 1991, Hilgers self-published a manual titled The Medical Applications Of Natural Family Planning: A Physician’s Guide to NaProTECHNOLOGY through his Pope Paul VI Institute Press. NaProTechnology is described as Natural Procreative Technology. In 2001, the AANFP was renamed the American Academy of FertilityCare Professionals, to reflect the relabeling of the Creighton Model as FertilityCare. In 2004, Hilgers self-published a reference manual titled The Medical and Surgical Practice of NaProTECHNOLOGY. Hilgers refers to the Creighton Model FertilityCare System as "the foundational family planning system to NaProTechnology".

Hilgers describes the Creighton Model as being based on "a standardized modification of the Billings ovulation method", which was developed by John and Evelyn Billings in the 1960s.^[1] The Billingses issued a paper refuting the claim that the CrMS represents a standardization of the BOM.^[3] They are two different methods and should not be seen as interchangeable.

Overview

The CrMS teaches women to observe certain biological signs to monitor their own gynaecological health, and to identify times of fertility and infertility. These biological signs include cervical mucus and bleeding patterns, and can be observed and analysed in all types of menstrual cycles. These signs are charted daily to give a picture of the woman's individual cycle.

Doctors can use the fertility charts which couples are taught to keep as the basis for further investigations if needed.

Blood tests for Oestrogen levels prior to ovulation and for both Progesterone and Oestrogen levels after ovulation, ultrasound follicular tracking, and other diagnostic procedures, can be accurately timed according to the woman's cycle, using the data recorded on a couple's fertility chart. This allows doctors to make a more precise diagnosis of abnormalities, e.g. subtle hormonal deficiencies, various ovulation defects etc.

Uses

As a form of fertility awareness or natural family planning, the CrMS may be used to avoid pregnancy, or to increase chances of conception depending on the couple's intentions. The CrMS is used in conjunction with NaProTechnology (Natural Procreative Technology), which aims to restore fertility naturally, by identifying and then correcting the underlying causes of the couples' infertility.

Effectiveness in avoiding pregnancy

The effectiveness of the CrMS, as of most forms of birth control, can be assessed two ways. Perfect use or method effectiveness rates only include people who follow all observational rules, correctly identify the fertile phase, and refrain from unprotected intercourse on days identified as fertile. Actual use, or typical use effectiveness rates are of all women intending to avoid pregnancy by using CrMS, including those who fail to meet the "perfect use" criteria.^[4]

The Pope Paul VI Institute reports a perfect-use effectiveness rate of 99.5% in the first year.^[5] In clinical studies of the CrMS conducted at the Pope Paul VI Institute, researchers excluded most pregnancies from the typical-use rate calculation, on the grounds that they believed the affected couples had used the method to deliberately attempt pregnancy.^[6] The Institute reports a typical-use effectiveness of 96.8% in the first year.^[5] Most studies of similar systems do not exclude such pregnancies from the typical-use failure rate.^[7][8]

Treatment

• Use of natural hormones and other medications to correct any hormonal disturbances or ovulation abnormality.
• Use of medications if necessary to correct any other abnormalities e.g. cervical mucus deficiency, biochemical or haematological deficiencies, endocrine (glandular) deficiencies etc. to restore normal physiologic function, and thereby enhance fertility.
• Referral to a gynaecologist if there are physical abnormailities needing surgery, for example
  • blocked fallopian tubes
  • endometriosis
  • adhesions

References

1. ^ ^{a b} Creighton Model
2. ^ American Academy of FertilityCare Professionals
3. ^ Some Clarifications Concerning NaProTECHNOLOGY and the Billings Ovulation Method
4. ^ Hatcher, RA; Trussel J, Stewart F, et al. (2000). Contraceptive Technology (18th Edition ed.). New York: Ardent Media. ISBN 0-9664902-6-6. http://www.contraceptivetechnology.com/table.html. 
5. ^ ^{a b} "CREIGHTON MODEL FertilityCare System: Effectiveness of the System". creightonmodel.com. http://www.creightonmodel.com/effectiveness.htm. Retrieved 2008-07-16. 
6. ^ Use effectiveness of the Creighton model ovulation...[J Obstet Gynecol Neonatal Nurs. 1994] - PubMed Result
7. ^ Weschler, Toni (2002). Taking Charge of Your Fertility (Revised Edition ed.). New York: HarperCollins. pp. 349–350. ISBN 0-06-093764-5. 
8. ^ Kippley, John; Sheila Kippley (1996). The Art of Natural Family Planning (4th addition ed.). Cincinnati, OH: The Couple to Couple League. pp. 141–142. ISBN 0-926412-13-2. 

External links

• Creighton Model official site
• Pope Paul VI Institute for the Study of Human Reproduction
• Interview With Dr. Thomas Hilgers, Director of the Pope Paul VI Institute
• NaProTechnology: A Rational Approach to Reproductive Medicine