Cassar, Debono placate Gozitan opinion with Catholic ‘infertility science’

It is tagged as "an emerging science" because it tackles women's infertility problems by treating gynaecological health problems. But in reality, naprotechnology is simple, natural family planning being repackaged as a 'science' that is morally acceptable to people of all faiths.

News that naprotechnology - 'discovered' at the Pope Paul VI institute in Nebraska, USA - has been introduced at the Gozo hospital was welcomed by the Gozo diocese. And the health ministry's official statement took note, welcoming "with pleasure the positive reaction of the Gozo diocese."

On the sister island, IVF is taken seriously by Gozo bishop Mario Grech, who through his well publicised sermons often calls on legislators to hold themselves accountable to their consciences.

But there is trepidation over how government regulation will affect or limit the so-far-unregulated sector of in vitro fertilisation in Malta, and what chances, if any, will exist to freeze additional embryos created during hyper-stimulation of the ova.

The health ministry is keen to point out that naprotechnology is not IVF, describing it as "a completely natural" system to tackle infertility "without resorting to artificial methods".

But is this even 'science'? Prof. Pierre Mallia, the ethics advisor to the Medical Council, says naprotechnology is nothing new.

"It's nothing new really, but simply an extension of what before we used to call 'natural procreation' - or natural family planning, which can be used both to have babies or to prevent pregnancies. It was 'invented' (not really true - other than the name) by an American physician who pioneered it and in fact offered it as a Catholic alternative to IVF; this gave him a direct club class passage to be a permanent member of the Pontifical Academy for Life."

Thomas W. Hilgers is the director of the Pope Paul VI Institute for the Study of Human Reproduction and the National Center for Women's Health in Omaha, Nebraska. He was appointed to permanent membership to the Pontifical Academy for Life after his 'discovery' of naprotechnology, which distinguishes itself by monitoring the biomarkers of the mucus patterns during the course of the menstrual and fertility cycle.

"The difference lies in educating patients more about the woman's cycle and directing them to have sexual union within the period when the woman is ovulating. But isn't this already what we are doing?" Mallia says.

Mallia points out that Prof. Hilger has never put his name to any medical paper found in journals, and the only paper on naprotechnology is a study by three people who compared naprotechnology with IVF in Ireland. "They look at only two GPs offering the service and admitted its results were promising but stopped short of saying it was as good as IVF. In fact, they say that cohorts of patients should be studied. So the scientific evidence is still lacking."

But the more worrying point he makes is that when these biomarkers fail, the technology offers medical treatment like administering the drug clomiphene, and if necessary even surgical treatment to open the tubes if these are clogged.

Mallia makes no bones about pointing that clomiphene, a drug overshadowed by harmful, side effects, is "the demon of multiple births".

"One pragmatic argument against IVF was that it produces multiple pregnancies. Yet so does clomiphene (a medical treatment which does not forego intercourse). In fact, clomiphene is the real demon of multiple births. So why is the argument used only against IVF?"

In fact, Mallia is quick to observe that the Catholic repackaging of what is normal and health family planning "takes a ride on Catholic teaching to have a technology which competes with IVF."

"Why give it such a buzzword of a name?" Mallia asks. "One gets the feeling that the Catholic population is being manipulated."

Such concerns are also scientific ones. Naprotechnology in itself has never been part of mainstream medical care, because normal natural procreation is part of the medical curriculum. At best, Mallia calls naprotechnology 'complementary' and adds that its alleged success rates relate to pretty much any successful treatment that does not include IVF. "This is not only not fair, but also unscientific and probably fraudulent, as one should compare like with like."