By Ann Marschel

I want you to think about this for a little bit. Do you think of teaching the Billings Ovulation Method® (BOM) as a ministry or a business? I think most of us think of it as a ministry.

Ministry, by definition from Webster, is the spiritual work or service of any Christian. Teaching BOM is a ministry, but it also can be a business. It can be a business that allows you to help others while also making a profit and not burning out because you have lots of other jobs you are doing.

For the April webinar, BOMA-USA hosted Anna Saucier, who spoke on the promotion of the Billings Ovulation Method®. She was a dynamite speaker and gave some helpful tips on how to make teaching BOM a business and not to underplay what we, as teachers, have to offer our clients.

Client-Facing Professionalism

As I was listening to Anna speak, her words hit home for me. I can recall many times when I have spoken with clients and gone through the process of how they will learn the method with me. Then, at the end, the question comes: “How much will this cost?”

First off, I am not a salesperson. I don’t really care for that line of work at all. In fact, I steer away from it. Instead, I am someone who thinks that ALL people should learn BOM, and I believe in the message of NFP.

After this question is asked, I find myself stumbling over my words. I want to help all people learn the method, yet will they put as much effort into learning the method if they don’t have some money invested in it? Maybe or maybe not?

Overall, we want clients to feel like they are of value, and we don’t want to make it seem like a huge amount of money is needed to learn the Billings Ovulation Method®. Yet, do we charge them a huge amount of money? No. Most teachers charge $150 to $250. Plus, when they learn the method, they have it in their toolbox for the rest of their lives!

Anna said, “Those who pay, pay attention. And the more they pay, the more attention they pay.”

She goes onto say that you can approach your clients by stating, “These are my rates. I provide excellent service, and if you take these classes, they will change your life.”

This is another truth. We all know and love what the Billings Ovulation Method® provides. We value it so much that we want everyone to learn it. That is why we teach it. We can and should charge clients a professional rate and not feel bad about it.  After all, we have over 850,000 hormonal studies to back up the science of the method.

Common Objections to Charging Professional Rates

Even with this, there may still be hesitation to charge a professional rate. You may think people won’t pay that much. I would like to encourage you to reframe your thinking. Is learning BOM valuable? If someone says to you, “That is too expensive,” you could ask. “Compared to what?”

This is a lifetime method.

Maybe you think people in your city can’t and won’t be able to pay that much. Anna said this, “The people who can’t afford it may not be your purpose right now (depending if you’re trying to grow a business). Do not undervalue this professional service.” In the future, these people may benefit if you can have scholarship funds for them.

By viewing the Billings Ovulation Method® as a medical tool for fertility awareness and instilling this knowledge in our clients, we will change their lives and the world.

(Please do not send confidential information related to couples you have taught.)

If you have ever wondered what you should do with your vast array of NFP-related materials when you retire, fear not! The answer is a simple as packing everything up and sending your box (or boxes, no doubt) to the National NFP Archives located at Ave Maria University in Ave Maria, FL.

Hand chosen years ago by a small committee begun by, now deceased, Larry Kane of the Human Life and Natural Family Planning Foundation, Ave Maria was picked because of the care they promised to take in preserving the historic pieces.

Jennifer Nodes, director of library services for Canizaro Library at Ave Maria University, said the NFP archives are stored in a climate-controlled room and files are kept in archival boxes that are pH neutral.

To date, Nodes reports that they have 178.5 linear feet of NFP materials, totaling 2,364 volumes. She added, “The archives have been used more frequently by researchers both within the institution and outside. We have had several researchers this year come to view files within the archives for publications. As the archives are made more visible and more researchers become aware of them, we will see an increase in use. It is our hope that someday much of the archives will be digitized and made available online for researchers.”

Since they host the only NFP archive in the country, Nodes said it would be helpful for recording the history of the movement if they continue to update the collection, particularly regarding new developments in NFP.

Retired OB/Gyn and Medical Missionary Sister Hanna Klaus, MD, said of the archives, “It’s very valuable having a place to send materials.” Over the years, Klaus sent boxes of her treasured correspondence and other documents to Ave Maria University. As the founder of TeenSTAR, she is considering the library as a place that may make the most sense to house the historical background of TeenSTAR. 

While shipping is at your expense, it will be well worth the time and effort to preserve a piece of history. They welcome everything from educational and promotional materials (books, brochures, CDs, etc.) to personal correspondence with leaders in the field as well as news articles and just about anything that would be of interest to researchers both now and in the future.
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NFP Archives
Canizaro Library
5251 Donahue Street
Ave Maria, FL 34142
 
​To find aids for the collection CLICK HERE

Abstract

Infertility is defined as the inability to conceive after 1 year of un-protected intercourse. In the U.S. it affects over 6 million couples and the causes are widespread. There are numerous mechanisms where nutritional deficiencies can alter the reproductive system. As with other organ systems in the body, when function is compromised, steps should be taken to ensure that nutritional deficiencies are not the cause. Research on how micro and macro nutrients affect reproduction is an area of recent interest. Since protein is one of the major requirements for adequate nutrition, data have been presented on consumption of meat and how that affects fertility. There were 12 papers reviewed from the fertility literature related to meat protein with one group of researchers out of Harvard contributing greater than half of the published literature on this subject. The evidence presented strongly implicate meat consumption as a causative factor in infertility.  On closer evaluation, there is the potential for bias based the existence of variables that have not been fully understood nor controlled for. The principle variable of interest for this paper is the animal feeding method and evidence for how this can alter the nutritional content of meat is presented. There were 4 pivotal references demonstrating how this variable is a significant factor in the nutritional content. In addition to eliminating potential chemical contamination, ideal production methods can alter the fatty acid and antioxidant content. The evidence for how content differences such as fatty-acids, anti-oxidants, vitamins and chemical contaminants can affect reproductive function offer a partial explanation for the negative effect of eating meat on fertility.

Introduction

Infertility affects 15-25% of couples in the United States (Thoma, et al., 2013). According to 2012 census data there were 75 million women between the ages of 15-50 and 59% of them were mothers (Monte and Ellis, 2014). Using this number of 44 million mothers, you can extrapolate that 6-11 million couples in the US are unable to conceive after a year of unprotected intercourse. This is an enormous number and the reasons for this are widespread, but nutritional factors must be considered an important factor. In fact, nutrition has only recently been evaluated more closely as evidenced by the number of papers discovered in this review that have been published in the last 10 years. Also, nutrition was rarely, if ever considered as part of the infertility work-up in many assisted reproductive technology programs as this technology was developing (Turczynski personal experience 1993-1999).

Nutrition in reproduction is a very broad topic. The study of nutritional physiology clearly indicates that there are numerous areas where deficiencies can affect the reproductive process. Put simply, adequate nutrition is a prerequisite to fertility so when difficulties with conceiving arise, it makes sense to evaluate the couple to make sure deficiencies in macro and micro nutrients are not a factor. After that, it becomes a practical consideration of which macro and micro nutrients are best, for example, the type and quantity of meat protein consumed. Meat consumption, as a form of protein, has been an area of recent research leading to some practical recommendations for women trying to conceive.

As with all areas of medicine, bias exists based on the authors experience and the political or economic environment. Peer-review is meant to reduce the prevalence of this however, politics can play a big part in the selection of review panels for major journals. It is always wise to consider the possibility of bias and to look at results with a skeptic’s eye. It is interesting how often we hear about new research findings conducted years later that contradict the prevailing standard of care, yet we take the new research as the definitive word on the subject. This holds true for areas of medicine as well as nutritional and social issues. Examples of issues where bias have or could result in misguided policies affecting millions of people include the hydrogenation of vegetable fat, overpopulation and potentially now, global climate change. This review uses this skeptical approach as the basis for analysis. The hypothesis is: The effect of meat consumption on fertility has not been adequately evaluated and allows only general recommendations when the source of the meat has not been controlled for.

In order to test this hypothesis, the author needed to go outside of the infertility literature and look at nutritional studies focusing on the production of meat. Srdnicka-Tober, et. al., (2016) did a meta-analysis of the compositional differences between organic and conventional meat. This paper, with contributions by 25 co-authors, provides a pivotal piece of information necessary for evaluating how a meat diet can affect fertility, or health in general. Seven hundred and seven papers published between 1992-2014, in all languages were considered but the final meta-analysis was narrowed down to 67 publications. The evidence base was only strong enough to compare specific fatty acid profiles, but they were also able to calculate thrombogenicity and atherogenicity indices. Daley et al., (2010) reviewed literature and reported on the fatty acid profiles and antioxidant content of grass-fed vs grain-fed beef. Their analysis evaluated the type and quantity of saturated fat, the omega 6: omega 3 ratio and the quantity of anti-oxidants, demonstrating significant differences between these two production practices used for beef. Finally, two studies on pork production methods indicate that the diet of the pig can have an even greater impact on the nutritional content of pork because the pig is a monogastric animal as compared to the multi-compartmental ruminants (Gjerlaug-Enger et al., 2014; Dugan et al., 2015).

The purpose of this paper was to review the literature on the effect of meat protein consumption on fertility and to scrutinize the data for bias, pointing out which variables have not been controlled for. Literature was located by doing a search on google and PubMed using phrases like “fertility and protein” and “infertility and nutrition”. Key papers were read, and the bibliographies were reviewed drilling down on references specifically addressing meat consumption and infertility. Meat production methods were also searched on google and PubMed using terms like grass-fed, pastured, organic, feeding and meat, pork, beef, etc.

Results

The author will summarize some of the key findings in the papers and then present on overall combined result at the end of this section. Meta-analysis articles were incorporated into combined result because these authors further analyzed the combined data. Review articles were more closely evaluated for the specific papers related to meat consumption and the results from those individual papers were used in combined result, instead of the review article.

In Charvarro, et al., (2008), there was a total of 26,971 pregnancy or pregnancy attempts with a 12.7% incidence of infertility and 20.2% of those infertility events defined as ovulatory. This resulted in a 1.6% overall incidence of ovulatory infertility in the study group with most of the cases being a diagnosis of PCOS. Meat intake was positively associated with ovulatory dysfunction and the consequences of adding one additional serving of meat per day resulted in a 32% higher risk of ovulatory infertility. Furthermore, consuming 5% of energy as vegetable protein instead of animal protein resulted in a 50% lower risk of ovulatory infertility.

Overall, this was a very strong correlation, statistically significant, from a well published group out of Harvard. While some weakness can be attributed to the collection of data such as pregnancy, pregnancy attempt and diet being self-reported, a correlation between animal protein intake and ovulatory dysfunction is strong.

In Salas-Huetos, et al., (2017), a systematic review revealed that the components of what is considered a healthy diet for men such as whole foods, seafood, fruit, vegetables, chicken, whole grain and low-fat dairy was associated with better fertility parameters. This was related to higher levels of omega-3 fatty acids, antioxidants such as folate, Vitamin D, E, C, Beta-carotene and lycopene. Whereas, higher consumption of processed food, processed meat, full-fat dairy and cheese, alcohol, caffeine and sugar are associated with a negative influence on fertility parameters. From this paper, I was able to extract 4 studies that had specific results related to meat. Mendiola et al., (2009), Eslamian et al., (2012), Afeiche et al., (2014a) and Afeiche et al., (2014b) concluded that intake of processed meat products was associated with poorer sperm quality parameters.

In Fontana, R. and Della Torre, S. (2016), the authors have done a very thorough and thought-provoking analysis looking at the mechanisms by which macro-nutrients influence cellular and endocrine function. Their paper does not have specific information related directly to meat consumption and is therefore not used for the final combined analysis. They do however, present significant indirect evidence useful in confirming the hypothesis.  Specifically, there is plenty of evidence demonstrating that the fatty acid profile a person consumes has numerous potential mechanisms for modulating reproductive function. Overall, a higher intake of poly-unsaturated fatty acids with a greater proportion of these being omega 3 was beneficial to metabolic and hormonal characteristics. The lower ratio of omega 6 fatty acids such as arachidonic acid can influence prostaglandin synthesis and subsequently affect ovarian steroid production, pain and inflammation. The authors conclude with Hippocrates prophetic quote on how the precise amount of nourishment and exercise is the safest way to health.

In Nassan et al., (2018), the total meat/fish intake per day ranged from 0-4.12 and averaged 1.2 servings per day. Egg consumption range and average was 0-4, .44 servings/day and vegetable protein range and average were 0.04-7.56, 1.29 servings/day. Processed meat intake was associated with lower fertilization rates (negative observation) and fish intake was associated with lower peak estrogen concentrations during hyperstimulation (possibly a positive observation). Total meat/fish intake, egg consumption or vegetable protein consumption was not associated with assisted reproductive technology success rates, but fish intake was significantly associated with a higher birth rate. This same effect was not duplicated with fish oil supplementation.

Using statistical analysis, the authors estimated the effect of substituting one type of protein for all other types of protein, both animal and plant derived. Substituting fish for all other proteins consistently increased the chance of live birth and this substitution effect was strongest when fish substituted for processed meat.

Interestingly, unprocessed meat was positively correlated with live birth rates when data was evaluated in categories but not when evaluated as a continuous variable. Another example of additional variables possibly influencing the results was that women with higher meat consumption also had higher BMI, total fat, carbohydrate and protein intake, higher total energy intake, higher alcohol consumption and greater adherence to a “western” dietary pattern. Making it difficult to accept the conclusion that the effect was due to eating meat alone.

Gaskins and Chavarro’s (2018) review paper was useful for pulling out 2 additional studies not previously reported here on the meat consumption and fertility. Jeong et al., (2010) assessed the risk of contaminants such as hormones on human health and concluded that levels are negligible and not likely to pose a risk when utilized according to approved veterinary practices. Antibiotics and anti-microbials on the other hand could affect the gut microflora of the person consuming the meat and need to be further investigated. This is an important observation since we know gut microflora can have profound affects on human health, however, it only reinforces the need to use healthier meat production methods to eliminate this possible health effect. Briga, et. al., (2015) reported on the development of 2659 human embryos cultured in-vitro from 269 patients and observed a negative influence of the consumption of red meat on the ability of the embryo to form a blastocyst. Consumption of red meat and BMI also had a negative effect on implantation and pregnancy.

Scrutiny of all the studies leaves 3 original papers evaluating meat consumption on female fertility factors and 4 original papers evaluating male fertility. The male fertility papers however, specifically looked at processed meat only and some studies had other dietary differences between the study subjects. These studies are summarized below in Figure 1.

Q.        Tell us about your family.

A.         My parents live in St. Paul, MN, as does my brother, Tom, and his wife and their six children. We spend a lot of time going to athletic games and theater events thanks to my talented nieces and nephews. My weekends give me great diversion! My younger brother, Joe, invented a cool retractable leash for dogs called the SmartLeash™. It has a braking mechanism that works like a seatbelt when a dog lurches at something like a squirrel. He won an award for best pet product of the year a few years ago. It’s saved my little dog a couple of times when she tried chasing loud cars and motorcycles. Both of my brothers are in the pet industry. (Tom has a five-state sales territory for a company that is based in Rhode Island.)

Q.        How did you get involved with Billings?

A.         Dr. John Billings spoke at a conference at a Catholic university near St. Cloud, MN, back in 1972. The local diocesan bishop, George Speltz, was in the audience, and he decided to bring the Billings Method™ to the Diocese of St. Cloud. He asked his family life director for someone he could send to a training. Fr. Ed Kraemer knew my parents, Dave and Kay Ek, as active volunteers and a couple who were committed to Church teaching. My mother was hesitant to commit because she had three fairly young children at the time. So, she and my dad said a rosary novena. Well, you can imagine that pretty much cemented the decision. Mary Hughes and her husband were another couple from the area who coordinated the marriage prep program. They joined my parents for the training in New Orleans, LA. The trainer was Mercedes Wilson, who developed the stickers we use today.

The two women had no idea until years later that it was the first-ever training held in the United States. Practically as soon as my mother returned to St. Cloud and word spread about this new method, it took off like wildfire. We would travel to various parishes on the weekends at the invitation of the pastors. It was fun as kids to have an adventure every weekend.

My mother was on a few national boards over the years. Throughout high school and college, I helped in the office. Eventually, I was working full-time with the local diocese. Then, in 1996, my mom was elected president of BOMA-USA. We had permission to house BOMA under the auspices of the St. Cloud diocesan NFP office. I was juggling a full-time position as NFP coordinator and the additional work of the national organization on top of that.  Back in those days, the St. Cloud marriage prep course brought in huge numbers of new Billings clients each year. We sometimes had a 50% acceptance rate after a marriage prep weekend. I was doing a lot of the marriage prep instruction and follow-ups in addition to the other work. It was crazy! At the end of 2000, we decided to separate the national organization from the diocese. That’s when I became the first executive director, which was in January of 2001.

Q.        What have been some of the highlights of your work?
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A.         Drs. John and Lyn Billings invited my parents and me to join them at their summer residence, about an hour outside of Melbourne, one year following a conference in Melbourne, Australia. It was Holy Week, and we will never forget getting up at 3 a.m. to drive down a long, winding, and narrow mountain path to get to an Easter Vigil Mass in a country parish. Afterward, there was a bonfire, and we had sweet rolls and tea in the rectory. We later learned that we were their last guests before they sold that home. We also visited their home in Melbourne a couple of times and had meals together. One evening they took us to a lovely restaurant where Dr. John ordered appetizers that included caviar. That was when my dad discovered he was very allergic to caviar! Dr. John quipped, “The next time you go to the doctor and they ask you what you are allergic to, you can say caviar!"

When visiting with the Drs. Billings, I found them to always be very interested in the work that was being done in the U.S., particularly in St. Cloud because our numbers were higher than anywhere in the country. They had a great sense of humor. I remember laughing with them a lot.

Drs. John and Lyn were guests of ours in St. Cloud more than once. In fact, they stayed in our home.

Q.  That is fascinating that you had the Drs. Billings stay in your home. Have you had any other famous people in the NFP world as your guests?

A.  Yes! Mostly the others were over for dinner and didn’t actually stay overnight.  Some of them included Dr. Erik Odeblad of Umea, Sweden; Dr. Josef Roetzer of Austria (who developed the Sympto-Thermal Method); Dr. Hanna Klaus of Maryland (TeenSTAR developer); Marian and Jim Corkill of WOOMB in Melbourne, Australia; Dr. Mary Martin of Oklahoma; Dr. Richard Fehring of Wisconsin; Dr. Ruth Taylor (now deceased); Fr. Ronald Lawler, O.F.M, Cap. (a now-deceased theologian); Mary Pat Van Epps of Memphis, TN; Eileen Wood  of Massachusetts (among other past and present board members along with quite a few others over the years.

Another highlight for me was having the privilege of meeting Saint John Paul II three times. The first time, my parents and I were invited to a private Mass in the papal summer residence outside of Rome. We were there at the invitation of Mercedes Wilson, whose daughter was being married the following day. She and the pope were good friends, so he offered a special Mass the day before the wedding. Another time, I presented the Holy Father a copy of the first edition of the book by BOMA called A Preachable Message. The next evening, we had a message waiting for us at the convent where we were staying, telling us that we were invited to Mass in his private chapel. There were about 35 of us. It was such a privilege!

Q.        What have been some of the challenges with your work?

A.         The ebb and flow of money throughout the years has been a challenge. I know this work is God’s work so I choose to trust that He will continue to help us. It’s exciting that we have added Craig Turczynski as our new Director of Development and Strategic Planning. He has great vision for our future. I am very hopeful having him be a part of the BOMA team.

​Another challenge is some of the bias against the Billings Method™ that we have faced. I, like others, wish we had more published studies to confirm the effectiveness rates that we know are true. One time I was at a conference in Milwaukee, and the editor of a major medical journal was at the podium. Someone posed the question, “Why aren’t there more published studies on the Billings Method™?” His answer was a shrug and, “Well, we all know the Billings Method™ works!” I remember his words exactly. It felt great to hear him say that as I was sitting next to a colleague from another NFP method who tended to misrepresent our statistics.