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Choosing a method of Natural Family Planning

If you’re new to NFP, it can be confusing to hear mention of different methods, and often we only hear about whichever one is promoted in our diocese or recommended in our marriage prep, so we decided to shine a light on a handful of them. We asked instructors of 5 different methods of Natural Family Planning (NFP) all about the method they teach, what is involved and what it’s like to use that method. Below you will find comprehensive profiles of the following 5 methods: Creighton Model FertilityCare System, NeoFertility, Marquette Method, SymptoThermal Method, and Boston Cross Check Method. There are other methods of NFP available but we hope this provides you with an overview of 5 popular methods which will help you weigh up which one might suit you best for this season. We are grateful to these instructors for taking the time to share about the methods they teach.

 


Method profile: Creighton Model FertilityCare System (CrMS)


Responses from Janelle Florendo (Creighton instructor for 8 years in South Carolina, USA); Anna Grace Shaffer (Creighton instructor for 5.5 years in the USA); an instructor at Groesbeck FertilityCare Center (Creighton instructor for 5 years at Groesbeck FertilityCare Center in the USA); and Aubrey Adams (Creighton instructor for 3 years in the USA).


“Many couples come to the Creighton Model to conceive after trying a lot of different things, because there is reproductive medicine (NaProTechnology) that works with this method.”


About the Creighton Model

What does the Creighton Model do for couples?

Janelle: It is about fertility appreciation and education in order to monitor, maintain and evaluate gynecologic health. It can lead to diagnosis and management of identified conditions through NaProTechnology. It builds intimacy between couples because this is a shared program.

Anna: It enables them to understand their fertility and know what the woman’s hormones are doing in real time.

Groesbeck: It shows them what their fertility is like as a couple.  

Aubrey: Couples learn how to avoid or achieve pregnancy, and identify biomarkers that can suggest hormonal imbalances, risk of miscarriage, risk of infertility and much more.


What is the efficacy of the Creighton Model?

Janelle: For avoiding pregnancy, it’s 99.5% effective but with “use effectiveness”, it’s 96.8% (source: www.creightonmodel.com/effectiveness/). For achieving pregnancy, with endometriosis it is 56.7% with NaPro, compared to 21.2% with IVF (Guzick) (source: www.naprotechnology.com/infertility/).

Groesbeck: When trying to achieve pregnancy, conception will occur 76% of the time in the first cycle of using a defined day of fertility. By the 6th cycle, 99% of couples have achieved pregnancy. When trying to avoid pregnancy, it is over 99% effective when properly taught by a qualified teacher and then correctly applied (perfect use). In a peer-reviewed journal article, the typical use effectiveness was found to be 96.8% to avoid pregnancy (source: Journal of Reproductive Medicine, June 1998). This means the Creighton Model is among one of the most effective forms of family planning available. With infertility, 20%-40% of couples will achieve pregnancy with the FertilityCare™ System only, using fertility-focused intercourse. Up to 80% will conceive with additional cooperative medical assistance.   


Is there a particular season where the Creighton Model stands out?

Anna: Creighton can be used in any reproductive season but in my opinion is the best for TTC compared to other methods.

Groesbeck: TTC. Many couples have come to the Creighton Model to conceive after trying a lot of different things, because there is reproductive medicine that works with this method (NaProTechnology). 

Aubrey: TTC/infertility and PMS, as it really helps identify cycle abnormalities.


Does the Creighton Model identify underlying concerns?

Janelle: Yes, PCOS, endometriosis, hormonal imbalances and more.

Anna: Tonnes! Hormonal imbalances are the most common concerns spotted, but I’ve also helped clients improve abnormal bleeding by strategically removing certain foods from their diets, identify undiagnosed cervical inflammations and uterine infections, and understand why their sleep quality, skin clarity and mood are different throughout the cycle. Health issues both big and small can be identified, tested for and treated by charting.

Groesbeck: Yes! That is a big part of what this method does. Working with a practitioner you can identify things like low hormone issues, PCOS, help with irregular cycles, or PMS symptoms. 

Aubrey: Yes! So many underlying concerns including low progesterone, estrogen dominance, signs of PCOS or endometriosis, risk of miscarriage/infertility, PMS, polyps and much more. Creighton goes hand-in-hand with NaProTechnology, whereby a certified provider in NaProTechnology can read a Creighton chart and diagnose certain problems.


Do you recommend the Creighton Model for single women as well as married couples?

Anna: Absolutely, especially if she is working to improve her hormonal/reproductive health.

Groesbeck: Yes! It’s never too early to understand what is happening with your fertility. 

Aubrey: Yes! It’s very good to help them understand their hormones.


Learning the Creighton Model

Where can you find a Creighton Model instructor?

You can find an instructor at www.fertilitycare.org 


What is the expected financial commitment? Do practitioners in the USA accept insurance?

Janelle: For us, the intro session is $20. Follow-ups cost $35. For 8 sessions paid in advance, it’s $285 with materials. 

Anna: Most Creighton practitioners cannot accept insurance, but most NaPro doctors can. Every practitioner works independently so they can charge what they choose. My practice charges $65/meeting or 8 meetings for $450, plus materials.

Groesbeck: Our center unfortunately does not accept insurance. All FertilityCare centers have different rates so it’s dependent on which center you work with.

Aubrey: I accept insurance as long as they come to my clinic between 8am and 5pm, otherwise the out of pocket cost is $350 for 5 sessions and $50 for the user manual, chart, and stamps. Renewal of chart and stamps is only $15. Long term, this method is very affordable once you get the hang of it.


Using the Creighton Model

Why should couples utilize NFP?

Janelle: It’s good for their body, mind and soul.

Anna: I don’t think all couples should use NFP at all times but it can be an invaluable asset for those who’ve discerned a certain family planning path or those who need medical intervention for health or fertility.

Groesbeck: Using NFP allows couples to grow closer together and also grow in virtue, as well as helping them discern with the Lord what their family could look like. It is the healthiest way to assess what’s happening with your body and gives you the ability to actually find answers to any issues you may be having.

Aubrey: It maintains and supports the beauty of sexuality and a solid marriage. 


What does the Creighton Model involve and what is the time commitment?

Janelle: The method is based on standardized cervical mucus monitoring. Women take observations throughout the day.

Anna: Users make multiple observations per day. It’s a big commitment, but many women/couples are willing to make it if their desire to meet their goal is high.

Groesbeck: It involves checking for your biological markers (cervical mucus) and learning how to interpret and chart them. We have our clients observe several times throughout the day and then chart every night before bed. 

Aubrey: Users must observe for cervical mucus every time they go to the bathroom (before and after urination/BMs) and before/after being in a body of water (eg. shower, bath, pool, hot tub, etc). They must also check for mucus before going to bed.


What tools or equipment are needed?

Janelle: No equipment is involved, just a willing heart and an open mind. Women use flat white tissue for observations, and a chart for recording them.

Anna: A Creighton chart and stamps (stickers).

Groesbeck: You use what your body has got, and your chart and stamps. 

Aubrey: Chart and stamps, and you could also purchase a user manual.


How can husbands be involved?

Janelle: He can be right there from the start by attending the intro session and being a constant support throughout. He can put stamps on the chart and be involved in answering inquiries such as SPICE sessions, observation and cycle reviews, double peak questions and more.

Anna: We include husbands in every step; wherever they can be helpful/supportive, we encourage and expect them to do so! Much of the weight of FABMs comes down to the woman, so when the man can take some of that weight off, we let them.

Groesbeck: Husbands can support their wives by reminding and encouraging them to observe as well as by charting for them at the end of the day. They can also be part of all the follow-ups with the practitioner. 

Aubrey: Women perform the observations all day but men can do the charting.


Infertility

If couples are using the Creighton Model and not conceiving, what are the next steps? 

Janelle: Seeing NaPro trained medical consultants and surgeons. 

Anna: Hormonal testing with a Creighton literate provider and referral to NaPro or FEMM medical consultants.

Groesbeck: If you can find a NaPro technology doctor in your area, that is ideal. If a couple comes to us and is working with us for a while and is still not able to conceive, we can do one of three things. 1) the couple can take a break for a while and just be a couple and not worry about all the charting and doctors visits; 2) the couple can take their case to the Pope Paul VI Institute and have their case reviewed there; 3) we can help them look into adoption.

Aubrey: We would start with a hormone work-up (cycle day 3 hormone profile and trend progesterone/estradiol after ovulation), an ultrasound and an HSG. Seeing a NaPro doctor is ideal.


Is the Creighton Model still helpful for couples who don’t have access to a NaProTechnology doctor?

Janelle: Yes, any reproductive medicine doctor can interpret a Creighton chart easily.

Anna: Yes, but you’d be hard pressed to find someone who could not get connected with a NaPro medical consultant of some kind. 

Groesbeck: Yes, there are still plenty of doctors out there who are familiar with fertility awareness based methods, so not all hope is lost if you can’t find one in your area. 

Aubrey: Yes, but you will need your practitioner to tell you what to say to your doctor and how to advocate for yourself.


Learn more about the Creighton Model:


 

Method profile: NeoFertility


Responses from Freda McMahon (Chartneo instructor for 3 years at Natural Fertility Matters in the UK).


The client only needs to focus on good observations and enter all meaningful data into the app. The app will in turn determine, to a high degree of accuracy, the fertile and infertile windows of the cycle.”


About Chartneo and NeoFertility

What does Chartneo do for couples?

It is suitable for avoiding and achieving pregnancy.


What is the efficacy of Chartneo?

NeoFertility does not have any published efficacy statistics but since the method leverages the best of all the top methods, we are confident that the method is effective.


Is there a particular season where Chartneo stands out?

It is particularly good for TTC. Patients on the NeoFertility treatment plans are recommended to chart using the NeoFertility method via the Chartneo app to benefit from full integrations between clinic and patients.


Does Chartneo identify underlying concerns?

Yes, such as PCOS with continuous mucus, non-anovulatory cycles or abnormal bleeding.


Do you recommend Chartneo for single women as well as married couples?

Yes, for women's health and underlying gynae conditions such as PCOS.


Learning Chartneo

Where can you find a Chartneo instructor?

There is a map of advisors and clinics within the Chartneo app. While the Chartneo app can be used on a solo basis, accurate identification of the fertile and infertile windows relies on good observation. In addition, avoiding rules also differ before and after the ovulatory fertile window. Both of the above do not come with the app and have to be learned. Therefore we recommend all TTA couples to learn NFP properly from a trained advisor.


What is the expected financial commitment? Do practitioners accept insurance?

An initial session costs £80+, followed by £40 per month for 6 months+ of instruction, depending on the couple's goal. The app is $13.99 (USD) per year. No insurance.


Using Chartneo

Why should couples utilize NFP?

If you are looking to achieve pregnancy, NFP has similar success rates as IVF (30%) but with significantly lower economic costs (in real terms) and emotional stress. NFP generally enhances your spousal relationship. If you can talk about cervical mucus, then you can talk about anything!


What does Chartneo involve and what is the time commitment?

It’s the best of Billings, Creighton and Sensiplan all in one. A woman takes mucus observations throughout the day. Basal body temperature is either taken once at waking time, or Femtech is used. For BBT Femtech, we recommend using tempdrop which measures the BBTs throughout the night.


What tools or equipment are needed?

There are no paper charts. A thermometer or Femtech is required for taking BBT. The Chartneo app can identify the mucus peak day correctly in almost 90-95%+ of the cycles in my clients' group. Effectively the Chartneo app takes away a lot of the rules that clients used to have to know very well. This means that the client now only needs to focus on good observations and enter all meaningful data into the app. The app will in turn determine, to a high degree of accuracy, the fertile and infertile windows of the cycle.


How can husbands be involved?

They can log into the wife's Chartneo account and follow her chart.


Infertility

If couples are using Chartneo and not conceiving, what are the next steps?

They will be referred to a NeoFertility doctor. There is one in the UK.


Is Chartneo still helpful for couples who don’t have access to a NaProTechnology doctor? 

If you have been charting with the method via the Chartneo app then it should be easy to find a NeoFertility doctor if diagnosis and treatment is required.


Learn more about Chartneo and NeoFertility:


 

Method profile: Marquette Method


Responses from Dr. Stephanie Kafie (Marquette instructor for 4 years at Totally Yours Family Medicine in Ontario, Canada); and Lauren Zamora BSN, RN, C-EFM, MMCP (Marquette instructor for 3 years in Florida, USA).


The Marquette method typically has the fewest days of abstinence when compared to other NFP methods. We are the only NFP method with a specific protocol for breastfeeding.”


About Marquette 

What does Marquette do for couples?

Dr Stephanie: It can be used to avoid or achieve pregnancy, and gives you information about your health.

Lauren: It helps you detect your fertile window and learn about your overall health and wellbeing. The Marquette method typically has the fewest days of abstinence when compared to other NFP methods. It also objectively helps you track data!


What is the efficacy of Marquette?

Dr Stephanie: The method is 98-99% effective for avoiding pregnancy. 

Lauren: The Marquette method is 98% effective for preventing pregnancy in typical use, and 98.4% effective at preventing pregnancy in perfect use.


Is there a particular season where Marquette stands out?

Dr Stephanie: The postpartum protocols are excellent.

Lauren: We are the only NFP method with a specific protocol for breastfeeding (and we are so proud of it)!


Does Marquette identify underlying concerns?

Dr Stephanie: Yes, PCOS and other health concerns.

Lauren: Yes, by objectively tracking your urinary hormones we can tell so much about your overall health. Your menstrual cycle is actually known as your 5th vital sign!


Do you recommend Marquette for single women as well as married couples?

Dr Stephanie: Yes, but we adjust it to meet needs and cost-effectiveness strategies. 


Learning Marquette

Where can you find a Marquette instructor?

Dr Stephanie: You can find an instructor at www.totallyyoursfamilymedicine.com 

Lauren: You can find an instructor at www.marquettemethod.com 


What is the expected financial commitment? Do practitioners in the USA accept insurance?

Dr Stephanie: The cost of the monitor and test strips. Yes, I accept insurance.

Lauren: Instruction and follow-ups cost around $250. Marquette method certified professionals are required to at the minimum be a RN with a BSN then attend the Marquette University graduate degree program, take a board exam, and stay up to date on current research. They value the clinical aspect we can bring to the table and of course helping those with irregular cycles or other underlying health conditions. Unfortunately, insurance is not accepted at this time.


Using Marquette

Why should couples utilize NFP?

Dr Stephanie: It is a natural and effective method of family planning that is in accordance with the Catholic faith and values.

Lauren: Natural Family Planning allows you to learn about the God-given gift of fertility. It allows you to learn about your body and understand how it works without any medical side effects! NFP strengthens a marriage through communication and intimacy. There are so many natural benefits but also an ability to connect mind, body and spirit. You truly appreciate life! 


What does Marquette involve and what is the time commitment?

Dr Stephanie: It involves using a fertility monitor and natural signs of fertility once daily.

Lauren: Marquette involves monitoring your urinary hormones to determine your fertile window. Typically, that means testing your urine in the morning about 10 days in your cycle on average.


What tools or equipment are needed?

Dr Stephanie: A fertility monitor, LH sticks optional.

Lauren: The Clearblue fertility monitor and test strips.


How can husbands be involved?

Dr Stephanie: They can help with charting.

Lauren: Husbands can help chart and can technically they can even test the urine for their wife! 


Infertility

If couples are using Marquetted and not conceiving, what are the next steps?

Dr Stephanie: Investigations with a physician.

Lauren: Referral to a NaProTechnology doctor.


Is Marquette still helpful for couples who don’t have access to a NaProTechnology doctor?

Dr Stephanie: Yes

Lauren: Yes


Learn more about Marquette:


 

Method profile: SymptoThermal Method


Responses from Emma Goff (SymptoThermal instructor with SymptoPro for 1 year at Charleston Fertility Awareness in South Carolina, USA); and Julie Houston (SymptoThermal instructor with CCL - Couple to Couple League - for 10 years in the USA).


There is so much power in knowing exactly what your body is doing throughout a cycle for both family planning and health knowledge.”


About SymptoThermal

What does SymptoThermal do for couples?

Emma: Learning this method allows couples to determine their fertile window and make family planning choices each cycle.

Julie: It teaches them the female cycle and asks for the spouse to be involved because it is their fertility together. It helps with communication as well.


What is the efficacy of SymptoThermal? 

Emma: The method effectiveness is 97-99.9% and the use effectiveness rate is 90-99% effective (see https://symptopro.org/images/PDFs/SymptoPro_Citations.pdf).


Is there a particular season where SymptoThermal stands out? 

Emma: It’s particularly good for TTA. If a couple ever feels like their instructor or chosen method isn’t a good fit, please search for a new one. There are seasons of life when certain methods might work best for a couple and figuring that out is important. 

Julie: The method works a little differently for postpartum and menopause.


Does SymptoThermal identify underlying concerns?

Emma: All SymptoPro instructors are trained to notice any abnormalities or concerns in a chart and refer you to a medical provider. This might look like seeing how the temperature pattern reflects hormonal imbalances.

Julie: Yes. In my case, my daily temperature averages dipped lower than usual, which indicated my thyroid was off. Also it can detect other issues like when a woman isn’t ovulating.


Do you recommend SymptoThermal for single women as well as married couples? 

Emma: This is a great option for singles because it allows for a deeper understanding of their bodies. The reference book that we give to each user is written with couples in mind but I believe that it can still be extremely helpful for single users. 

Julie: It can be used by single women, but it is more common for couples. (CCL stands for Couple to Couple League.)


Learning SymptoThermal

Where can you find a SymptoThermal instructor? 

Emma: You can find a SymptoPro instructor at www.symptopro.org/about-us/find-an-instructor.html 

Julie: You can find a CCLI instructor www.CCLI.org 


What is the expected financial commitment?

Emma: Couples can learn SymptoPro online via symptopro.org for $130, individual instructors may charge more or less than that depending upon their costs.

Julie: CCLI has a fee for the classes, which can be in person or online now. The fee is under $200 (at the time of writing). You can buy paper charts or use the CCLI app.


Using SymptoThermal

Why should couples utilize NFP? 

Emma: There is so much power in knowing exactly what your body is doing throughout a cycle for both family planning and health knowledge, which can allow for increased communication and help a couple to figure out what their goals are each cycle. No matter what season of marriage couples are in, there are benefits to being able to discern what the next steps are for their family and health. 

Julie: It brings them closer as a couple and the divorce rates are extremely low. If a couple can talk about this stuff, they can talk about anything.


What does SymptoThermal involve and what is the time commitment?

Emma: SymptoPro has users take their basal body temperature at the same time each morning (within an hour and a half window) after a night of rest with at least an hour of sleep beforehand. They observe their cervical mucus in two ways throughout the day (in a tissue exam and sensation). The tissue exam for observing mucus is done before and after each time you go to the bathroom; the observation of sensation is done mentally throughout the day as a general awareness. They then chart the most fertile sign of the day that is observed and interpret their charts based on scientific data. There is also an optional observation of physically checking the cervix that is done once a day at the end of the day.


What tools or equipment are needed?

Emma: a basal body thermometer, toilet paper, and a chart (either a paper chart or on the Read Your Body app).


How can husbands be involved?

Emma: Some couples have found that husbands can help enter the observations into the chart, work on interpretations together, and even hand the thermometer to their wife in the morning. The most important thing is open communication about how this might work best for a specific relationship! 

Julie: They can do the charting and check the cervix. They should also be part of communication about whether they should try for a baby or postpone pregnancy.


Infertility

If couples are using SymptoThermal and not conceiving, what are the next steps?

Emma: If a couple is using the defined fertile window and not conceiving, instructors are recommended to refer them to health care professionals by 6 months of trying. 

Julie: We would recommend seeing an OB/GYN who is familiar with NFP (local to me, Dr Joseph Behan is a Dallas doctor who specializes in this). Alternatively, see a NaProTechnology doctor or a doctor that understands the charts. For couples that are struggling, I think knowing more than one method can be beneficial. Some other methods dive deeper into the education about the mucus. I would combine that with the SymptoThermal method to see if I could gather more information. However ultimately it is in God’s hands and perfect timing. Only He knows the plans He has for us.


Is SymptoThermal still helpful for couples who don’t have access to a NaProTechnology doctor? 

Emma: It could be. If you're specifically looking for medical intervention, charting with SymptoPro could be a good first step.


Learn more about SymptoThermal:

 

Method profile: Boston Cross Check Method


Responses from Nicole Boylson (Boston Cross Check instructor for 2 years in Texas, USA).


This method is particularly wonderful for those TTA. Because we have cross checks, and several of them.”


About Boston Cross Check

What does Boston Cross Check do for couples?

It helps them to be extra secure in their intimacy decisions and truly plan whether to avoid pregnancy or achieve.


What is the efficacy of Boston Cross Check?

It is 98-100% effective.


Is there a particular season where Boston Cross Check stands out?

This method is particularly wonderful for those TTA. Because we have cross checks (and several of them), it allows couples to be extra confident in knowing their fertile window has ended and there is no chance of a pregnancy. It’s also great for TTC for the same reasons. With so many biomarkers you’re able to really know when your body is ready to conceive.


Does Boston Cross Check identify underlying concerns?

Yes. By tracking temperatures, you’re able to see if there may be a progesterone issue since that is what causes the temps to rise or fall. The monitor tracks LH and estrogen, so having abnormal monitor readings could indicate an issue there as well.


Do you recommend Boston Cross Check for single women as well as married couples?

Yes, the more you know about your body the better! Every woman deserves to know what her body is doing during her cycle and why.


Learning Boston Cross Check

Where can you find a Boston Cross Check instructor?

All the instructors are listed at www.bostoncrosscheck.com


What is the expected financial commitment? Do practitioners in the USA accept insurance? 

For regular cycles, 4 sessions will total $200. For postpartum charting, it’ll be $300 (from birth to the sixth menses) or $350 (if you haven’t already completed the regular cycles course before). No insurance.


Using Boston Cross Check

Why should couples utilize NFP?

If you’re Catholic, it’s awesome because it allows you to plan your family in accordance with Church teaching. Even if you’re not Catholic, it’s a wonderful way to let your body function in the way it was created by planning your family without any added hormones, devices or interferences. This all natural way is amazing and everyone should know how to do it.


What does Boston Cross Check involve and what is the time commitment?

The method involves hormonal monitoring, basal body temperature and cervical fluid, or any combination of two of these. You will check your basal body temperature once every morning, use the monitor once a day for about 10 days per cycle, and observe your cervical fluid multiple times throughout the day. 


What tools or equipment are needed?

A ClearBlue fertility monitor for hormonal monitoring and a thermometer or tempdrop for talking your basal body temperature.


How can husbands be involved?

They can do the charting, stick the test stick in the monitor, set an alarm for the wife to take her temperature in the morning, and put flat folded sheets of toilet paper by the toilet ready to go.


Infertility

If couples are using Boston Cross Check and not conceiving, what are the next steps?

After six months of no conception with accurate charting, I’d suggest they bring their chart to their OB/GYN and explain what their chart means so the doctor can have a clear understanding of what’s been going on in her cycle.


Is Boston Cross Check still helpful for couples who don’t have access to a NaProTechnology doctor? 

Yes! NaPro doctors use Creighton charts but with Boston Cross Check we recommend bringing your charting information to your OB/GYN.


Learn more about Boston Cross Check:

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