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At the Gianna Center at Saint Peter's University Hospital, Dr. Monika B. Potocki says she can not only help women overcome fertility issues without resorting to in vitro fertilization or other procedures that violate Catholic health care guidelines, but also help women experiencing reproductive challenges improve their overall health.

Potocki, an obstetrician-gynecologist, started seeing patients in April at the Saint Peter's Gianna Center, which is dedicated to providing more natural alternatives to assisted reproductive technologies. "Our point is to restore fertility and restore health," Potocki said. "Usually, our treatments make people feel better, because we're actually fixing an underlying issue."

The center is the namesake of St. Gianna, the patron saint of mothers, physicians, and unborn children. The center and the hospital are part of Saint Peter's Healthcare System, based in New Brunswick, New Jersey.

Potocki's start at the center came in the wake of a ruling by the Supreme Court of Alabama that embryos, including those created for in vitro fertilization but not implanted, are legally protected like any other child. The ruling set off a national debate about a procedure that the Centers for Disease Control and Prevention says results in about 2% of births every year.

At the Gianna Center, all services adhere to the Ethical and Religious Directives for Catholic Health Care Services established by the United States Conference of Catholic Bishops. Those guidelines prohibit infertility treatments that involve "the destruction of human embryos, or their deliberate generation in such numbers that it is clearly envisaged that all cannot implant and some are simply being used to maximize the chances of others implanting."

Alternative approach
Potocki offers care within those guidelines using an alternative approach to birth control and infertility called NaProTechnology. She trained in the method for a year as a fellow at the Saint Paul VI Institute for the Study of Human Reproduction in Omaha, Nebraska.

NaProTechnology, or Natural Procreative Technology, works to identify problems and cooperate with women's menstrual and fertility cycles, using more of a fertility-care based medical approach rather than a fertility-control approach. The method is based on the Creighton Model FertilityCare System, the natural family planning method that helps couples achieve or avoid pregnancy by tracking a woman's menstrual cycle.

Potocki said her medical education at a non-Catholic residency program had left "a sense that if you're not prescribing birth control, you're not doing abortions, you're not doing tubal ligations, you're not offering much."

NaProTechnology changed her point of view. "I realized that not only could I stop feeling like I'm not offering the full scope of OB-GYN practices, I could actually say I'm offering something better," Potocki said.

In the majority of cases, Potocki said, women experiencing conditions such as painful or irregular periods, premenstrual syndrome and postpartum depression get the same remedy from their OB-GYNs: a prescription for a birth control medication.

"Sometimes that works, and a lot of times it doesn't, and a lot of times that has side effects," she said. "And Catholic patients, which make up about 70 to 80% of who I see, don't tend to want to have that (treatment)."

Treating underlying causes
Potocki said infertility care at the Gianna Center is all about identifying and treating underlying causes such as hormonal imbalances or anatomic problems. When patients first come in, she has them create a chart that tracks their ovulation. Later visits include blood tests that show how patients' hormone levels are rising and falling. Infertility patients undergo ultrasounds to capture whether their ovulation is normal.

The findings lead to medication interventions.

"If we think they're still not achieving their goals, either pain-wise or fertility-wise, we do offer a surgery where we take a look at the uterus, the fallopian tubes, the entire abdomen, and try to figure out if there's anything wrong that that could be explained from an anatomical standpoint, and, if possible, correct it," Potocki said.

The success rate for her care varies and depends on several factors, and a major one is aging. She counsels a 25-year-old much differently than a 42-year-old and has candid conversations with older patients who may be otherwise healthy but may have a much lower chance of conceiving a baby because of their age.

"One thing I cannot do is turn back time. So those are the sadder situations," she said. "It's usually the ones that I see that haven't, unfortunately, learned about us until very recently. Those are the ones that are more painful because you're like, if I had seen you earlier, I think I could have done better for you."