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NaProTechnology (Natural Procreative Technology) Surgery is a specialized form of gynecologic surgery focused on diagnosing and treating underlying reproductive disorders to restore normal anatomy and function of the uterus, fallopian tubes, and ovaries.
This page assumes you already know what NaProTechnology is. If you do not, or if what you actually need is a trained doctor rather than a procedure, start with the full NaProTechnology overview and how to find a NaPro-trained clinician and come back.
It is part of a broader NaProTechnology approach that works with a woman's natural menstrual cycle (using the Creighton Model fertility charting) rather than bypassing it.
In contrast to conventional infertility treatments (which often suppress or bypass natural fertility, as with IVF), NaProTechnology views problems like infertility as symptoms of underlying disease and seeks to correct those root causes so that couples can conceive naturally.
Surgical NaPro interventions are therefore aimed at repairing abnormalities (endometriosis, blocked tubes, ovarian cysts, uterine defects, etc.) in a way that optimizes fertility while improving overall gynecologic health.
Bottom line: NaPro may take longer on average for a pregnancy to occur (since it relies on natural cycles), but the chance of achieving a live birth over time can be greater than with IVF (AMA Journal of Ethics, 2013). Importantly, any pregnancies occur naturally, eliminating the risk of high-order multiples often associated with IVF; indeed, studies of NaPro infertility care report that virtually all resulting pregnancies are singleton births ( Natural procreative technology for infertility and recurrent miscarriage: Outcomes in a Canadian family practice - PMC ). 4. Fewer Health Risks and Ethical Concerns: Because NaPro works within the natural reproductive act, it avoids many risks of IVF. There is no ovarian hyperstimulation, egg retrieval surgery, or laboratory embryo manipulation – thus reducing physical burdens on the woman. All conceptions occur naturally, so there are no leftover embryos to freeze or discard, a factor which makes NaPro ethically attractive to those who object to IVF on moral or religious grounds (AMA Journal of Ethics, 2013) (Infertility). NaProTechnology is often embraced as an ethical alternative for physicians and patients who cannot use IVF for moral reasons (AMA Journal of Ethics, 2013). Moreover, the NaPro diagnostic workup and treatment protocols are much less expensive (Infertility). 5. Holistic Benefits: Couples frequently appreciate that NaProTechnology addresses their overall wellness. By fixing problems like endometriosis, PMOS / PCOS, or fibroids, women often experience relief of chronic pain, improved menstrual regularity, and better gynecologic health –benefits that conventional approaches (e.g. chronic birth control use or IVF) don’t provide (NaProTECHNOLOGY - Information and Benefits). In summary, the NaPro surgical approach strives to heal and restore normal function, which can improve quality of life in addition to achieving pregnancy.
NaProTechnology surgeons are trained in advanced techniques that set their approach apart from standard gynecologic surgery. Key surgical techniques include:
Because NaProTechnology’s goal is to fix the actual medical issues behind infertility or gynecologic symptoms, its surgical applications span a wide range of female reproductive disorders. Common conditions treated with NaPro surgical techniques include:
In summary, NaProTechnology surgery addresses virtually all gynecologic conditions that can impair fertility or wellness – from endometriosis and PMOS / PCOS to tubal occlusion, uterine fibroids, polyps, chronic pelvic pain, and beyond (NaProTECHNOLOGY - Information and Benefits). By treating these conditions, NaPro aims to give couples a chance to conceive without assisted reproduction, while also improving the patient’s gynecologic health.
Infertility Treatment Success: Studies of NaProTechnology in infertility have reported competitive success rates when compared to standard treatments. A large NaPro cohort (1,045 infertile patients) achieved a cumulative live-birth rate of >60% by 24 months of treatment, rising to ~70% by 36 months (AMA Journal of Ethics, 2013). This is on the same order as the cumulative live-birth rate seen in patients undergoing IVF (which is about 45–55% after multiple cycles) (AMA Journal of Ethics, 2013).
It’s important to note that IVF often yields a quicker time-to-pregnancy (higher success per cycle), but NaPro’s approach can catch up over time: one analysis found that although the monthly fecundability (chance per cycle) on NaPro treatment was around 3.1% vs. 13.3% with IVF, the overall per-woman pregnancy rate ended up higher with NaPro because couples continued trying and did not face the attrition seen in ART programs (AMA Journal of Ethics, 2013).
In practical terms, this means many couples who might not succeed in a few IVF attempts do eventually conceive with the continued, personalized treatments of NaPro (even if it takes longer) (AMA Journal of Ethics, 2013).
Comparative Studies: Notable studies in Ireland and Canada have documented NaProTechnology outcomes in real-world clinical settings. In an Irish general practice study (Stanford et al. 2008), about 52.8% of couples achieved a live birth after up to 2 years of NaPro treatment (life-table analysis) (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility). A subsequent Canadian study (Tham et al. 2012) reported an even higher success: 66% of couples had a live birth within two years on NaPro (life-table rate), with a crude live birth rate of 38% (some had dropped out early) (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility).
Both studies had patient populations with an average maternal age in the mid-30s and several years of prior infertility (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility) (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility). These results are quite encouraging, given that a comparison group of similar infertile women who received no specialized intervention had only a ~20% live birth rate over 2 years (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility).
The Canadian authors noted that IVF in general yields around 50% live birth after 1 year of attempts, whereas NaPro in their cohort showed a 1-year live birth rate of ~32% (crude) to 45% (adjusted) (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility). They cautioned against a direct head-to-head comparison due to differences in patient characteristics, but it’s clear that NaPro offers a substantial chance of success approaching that of IVF for many couples (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility).
Specific Conditions: For certain diagnoses, NaPro surgical treatment appears especially effective compared to conventional alternatives:
Maternal and Fetal Outcomes: An added benefit of achieving pregnancy naturally via NaPro is that the pregnancies tend to be lower-risk compared to ART pregnancies. In the Canadian NaPro study, all pregnancies were singletons (no twins or triplets) ( Natural procreative technology for infertility and recurrent miscarriage: Outcomes in a Canadian family practice - PMC ), which greatly reduces obstetrical risks like premature birth. Over 54% of those births were at term (≥37 weeks) and the majority of babies had healthy birth weights ( Natural procreative technology for infertility and recurrent miscarriage: Outcomes in a Canadian family practice - PMC ).
In contrast, IVF pregnancies have a higher incidence of multiples (though this has improved with elective single embryo transfer) and some studies show higher rates of preterm birth or low birth weight even in singleton IVF babies. NaPro avoids those concerns by fostering normal conception and gestation.
Additionally, because NaPro addresses health issues (like correcting a hormonal deficiency), it may also lower miscarriage rates for some women. NaPro protocols often include luteal phase support and other therapies that continue into early pregnancy to help sustain it, which could improve outcomes for those with recurrent miscarriage histories – though more research is ongoing in this area.
In summary, patient outcomes with NaProTechnology surgery are very favorable: high pregnancy and live-birth rates over time, resolution of symptoms, and healthy pregnancies with minimal complications. These outcomes are achieved without the need for high-tech fertilization, demonstrating that many couples can succeed through a restorative approach rather than assisted reproduction.
NaProTechnology’s surgical approach is supported by over four decades of research and a growing body of medical literature. Dr. Thomas Hilgers, the gynecologist who developed NaProTechnology, has documented extensive experience in his textbook The Medical & Surgical Practice of NaProTechnology (2004) and subsequent papers.
Notably, Hilgers reported the progressive refinements in adhesion prevention that led to dramatically improved outcomes. In a 2010 article, he described “Near Adhesion-Free Reconstructive Pelvic Surgery” after 23 years of applying these techniques, highlighting that meticulous use of adhesion barriers (Gore-Tex) and microsurgical methods virtually eliminated the problem of postoperative adhesions in his cases (AMA Journal of Ethics, 2013). Such findings underscore that with proper technique, reproductive surgeries can be done without compromising future fertility – an insight that has influenced other surgeons as well (AMA Journal of Ethics, 2013).
Multiple peer-reviewed studies validate the success of NaProTechnology in infertility treatment. The Irish and Canadian cohort studies cited earlier (Stanford et al. 2008 (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility) and Tham et al. 2012 (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility)) both concluded that NaProTechnology is an effective approach, with live birth rates comparable to those seen in assisted reproduction, despite their patients often having prior failed treatments.
An editorial in the Journal of the American Board of Family Medicine noted these studies “demonstrate the success” family physicians can have using NaPro to help infertile couples (Natural Procreative Technology for Treating Infertility | AAFP). In fact, the American Academy of FertilityCare Professionals (the professional organization for NaPro providers) has trained hundreds of physicians worldwide, and they frequently cite these outcomes as evidence that restorative reproductive medicine can rival ART results (Natural Procreative Technology for Treating Infertility | AAFP) (Natural Procreative Technology for Treating Infertility | AAFP).
The AMA Journal of Ethics (2013) profiled NaProTechnology as a viable option for physicians who conscientiously object to IVF, and in doing so it highlighted the scientific merits of NaPro’s surgical approach. The article emphasized the “unique medical and surgical application” of NaPro and specifically lauded its adhesion prevention achievement and strong pregnancy success rates (AMA Journal of Ethics, 2013).
It even referenced a meta-analysis supporting surgery over IVF in endometriosis cases, bolstering the argument that conventional gynecologic surgery – when done in the advanced manner of NaPro – can outperform assisted reproduction in certain scenarios (AMA Journal of Ethics, 2013).
At the Pope Paul VI Institute (the center founded by Dr. Hilgers in Omaha, Nebraska), NaProTechnology has been applied for decades, and they report high aggregate success. According to the institute’s data, up to 80% of couples treated (especially those with diagnoses like PMOS / PCOS or endometriosis) eventually achieve pregnancy using NaPro methods (Infertility). Even in more challenging infertility cases, average success rates around 50% or higher are claimed, which are quite competitive with standard infertility care (Infertility).
These numbers are frequently cited by NaPro practitioners as evidence that a majority of couples can be helped without resorting to IVF. While some of these figures come from internal analyses, they are backed by the published studies mentioned and decades of clinical experience. Expert opinions often stress that NaProTechnology aligns medical practice with patient wellness. For instance, research on premenstrual syndrome (PMS) and postpartum depression led to the use of isomolecular progesterone to restore natural hormonal function while greatly decreasing symptom burden (NaProTechnology Benefits and Applications for Modern Women - FACTS About Fertility).
Fertility specialists who have adopted NaPro techniques note that they are able to find and fix problems that standard protocols might overlook – as one patient testimony put it, NaPro doctors “found something my other fertility doctor missed for years” (NaProTECHNOLOGY - Information and Benefits). This kind of qualitative success has helped build a positive reputation for NaPro among patients seeking alternatives to IVF.
In summary, numerous studies and expert reviews support the efficacy of NaProTechnology surgery. Its proponents – including peer-reviewed research authors and ethics commentators – highlight the approach’s ability to achieve competitive pregnancy rates, its advances in surgical technique (especially adhesion reduction), and its alignment with a more patient-centered, healing philosophy of care (Natural Procreative Technology for Treating Infertility | AAFP) (AMA Journal of Ethics, 2013).
As awareness grows, NaProTechnology is increasingly recognized as a valid and effective option for treating infertility and gynecologic disorders, offering hope to couples who want to conceive by correcting underlying issues rather than by artificial reproduction (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility).
The call for further research is ongoing, but existing evidence and expert experience strongly support NaProTechnology surgery as a beneficial alternative or complement to conventional treatments (NaProTechnology for Infertility and Recurrent Miscarriage: A Review of Research - FACTS About Fertility).
Technique is what separates a good outcome from a repeat operation, so the surgeon matters more than the procedure name. RRM Academy is building a verified directory of restorative clinicians, and every listing is checked before it goes live.