Restorative reproductive medicine has everyone talking

Infertility and how best to treat it is having a moment. There’s been a lot of buzz in the news and on social media lately about infertility and access to treatment. Some of this buzz has been centered around an approach called restorative reproductive medicine that is being promoted as an alternative to science-based advanced reproductive treatments, such as intrauterine insemination, IUI, and in vitro fertilization, IVF.

But is restorative reproductive medicine, or RRM for short, really anything new and ground-breaking? Our Louisiana fertility specialists want to be up front about what this term really means, and how these treatments already fit into our personalized approach to fertility care for every patient.

What exactly is restorative reproductive medicine?

Restorative reproductive medicine can best be described as an ideology, not a medical practice or treatment, currently being promoted by politicians and conservative-leaning groups. It typically excludes IVF and related treatments on conservative moral or religious grounds, pushing aside clinical evidence. RRM instead focuses on restoring the body’s natural fertility by identifying the causes of the reproductive problem and treating them in the least-invasive way.

RRM is being marketed as holistic and ethical alternatives to reproductive medicine and advanced fertility technologies. Treatment might include lifestyle changes (losing weight, for example), hormone supplementation, or surgery to help patients overcome certain barriers to getting pregnant. RRM generally includes the following treatments:

• Cycle tracking: Monitoring a woman’s menstrual cycle and biomarkers to identify the fertile window and underlying issues.
• Lifestyle and nutrition: Focus on improving overall health through diet, exercise, and sleep.
• Hormone and medication therapy: Using personalized hormonal support or other medications to correct imbalances or support ovulation.
• Surgery: Performing surgical interventions to address issues like endometriosis.
• Treating underlying conditions: Addressing a variety of conditions such as PCOS, endometriosis, recurrent miscarriage, and hormonal imbalances.

In short, RRM is simply fertility medicine minus key tools like IUI and IVF. Fertility practitioners already do all of the above treatment, turning to advanced therapies when less invasive treatments fail or there is clear medical evidence that IUI or IVF is the more effective or only treatment to induce pregnancy.

Restorative reproductive medicine can only help some patients

While RRM treatments are presented as IUI and IVF alternatives, the truth is, restorative reproductive medicine will only potentially help a subset of infertility patients. Specifically, RRM treatments cannot solve the reproductive issues of patients with these specific diagnoses:

• Women with severely diminished ovarian reserve (a very low egg supply).
• Women who need to use donor egg, donor embryo, or a gestational surrogate to conceive.
• Women with blocked or missing fallopian tubes.
• Men with extremely low sperm count.
• Single women and members of the LGBTQ community wishing to build families.
• Couples with a family history of genetic disorders that can cause inherited genetic illnesses in children (for example, sickle cell anemia, cystic fibrosis, Tay-Sachs Disease).

Additionally, women who have other fertility diagnoses or time constraints due to age, may opt to use advanced reproductive technologies to save time and money in their journey to building a family. In all of these cases, and many others, IUI and IVF is often the best or only options. Practitioners of restorative reproductive medicine have nothing to offer these patients.

Criticisms of restorative reproductive medicine

Fertility providers and the American Society for Reproductive Medicine (ASRM) argue that restorative reproductive medicine delays effective treatment, uses misleading terminology, cannot treat all diagnoses, and restricts patient access to the full range of reproductive options.

We all know infertility is emotionally and financially hard. Delaying access to proven fertility care prolongs patient suffering and increases the financial and emotional burdens without improving outcomes. And, for those pursuing pregnancy later in life, delays in using effective treatment can negatively impact future fertility outcomes. In other words, if you spend years trying to solve a fertility problem with RRM that has no chance of being solved, you’ve wasted those prime fertile years.

Critics also argue the “restorative” and “ethical” framing unfairly presents RRM as superior to science-based reproductive therapies. For many patients, IVF is often the only option for pregnancy and no amount of “restoration” can get them pregnant. Additionally, positioning RRM as the morally preferable option fosters stigma towards individuals who require IVF and may restrict their access to the most effective treatment for infertility. 

The bottom line on RRM

Our Louisiana fertility specialists have always relied on evidence-based decision-making to create personalized treatment plans for every patient. Whether that plan leads to IVF or other advanced reproductive technologies is influenced by many factors: your age, your personal family-planning goals, existing medical conditions, your insurance coverage and how much you are willing to spend.

The bottom line is that you deserve the most effective treatment for your specific diagnosis. You and everyone else should have access to the full range of family-building health care grounded in medical science, compassion, and the freedom to make decisions with your physicians about which options will work best for you. Contact your representatives and demand that they support real treatment for infertility.