Restorative Reproductive Medicine

“IVF is your only hope of having children.” This is the news many couples receive after months or even years of prayers, tears, and longing for a baby. Infertility cases are varied and complex. Yet, these couples are offered one hope in their pursuit of holding a baby: in vitro fertilization (IVF).

In a nutshell, IVF involves the retrieval of eggs from a woman that are then fertilized in a laboratory, resulting in the creation of multiple embryos. At least one embryo is transferred to the uterus of the woman with the hope that the embryo will implant and lead to a healthy pregnancy and birth. The rest of the embryos are typically frozen for future transfer. This process creates complex ethical issues, including the vast loss of embryonic life, embryo testing and freezing, commodification of children, and more.[1]

With IVF dominating the fertility industry for years, even couples who know of the risks of IVF may feel that their only two options are IVF or empty arms. But what if there is a third way, a path to biological children without the ethical pitfalls and complex procedures? Hidden in the shadow of the IVF industry, such an alternative has been quietly operating for years: Restorative Reproductive Medicine (RRM)—a promising alternative for couples facing infertility without the ethical issues, cost, and risks of IVF.

As couples face some of the hardest decisions of their lives, they should be aware that they do not have to choose between IVF and a dead end. RRM is a third path that allows couples to pursue a family while honoring life and the God who gives it.

What is RRM?

RRM is distinct from IVF in the way it views and addresses infertility. Given an infertility diagnosis, IVF manipulates and circumvents natural reproductive processes to achieve pregnancy. In contrast, RRM views infertility as a symptom, not a diagnosis. According to the International Institute for Restorative Reproductive Medicine (IIRRM), RRM “is a specialized field of medicine that focuses on identifying the underlying health conditions that contribute to reproductive dysfunction and suboptimal reproductive health, treating them to restore the natural functions of the reproductive system.”[2] RRM seeks to find and treat the root causes of infertility to achieve holistic reproductive health.

RRM can help couples who experience infertility, recurrent miscarriages, or even failed IVF. While the description of the RRM process below focuses primarily on women, RRM specialists also assess men’s health and can treat certain causes of male infertility.

How does RRM Work?

There are different variations of RRM, but for women it usually involve implementing a fertility awareness-based method (cycle charting). These methods track reproductive markers, providing extensive information about women’s reproductive health and timelines to perform testing. Other diagnostic methods include hormone testing, ultrasounds, and other minimally invasive assessments. Practitioners trained in techniques such as Natural Procreative Technology (NaProTechnology) or NeoFertility use this information to find the root causes of patient infertility or illness. Due to the complexity of the human body, possible diagnoses are many and varied and may include everything from diabetes, thyroid issues, and hormone imbalances to endometriosis, PCOS, and tubal blockage. In a recent study at a NaProTechnology clinic in Spain, doctors found an average of 2.5 diagnoses per couple.

This process might seem overwhelming, but learning about the body and its needs one step at a time is better in the long term than remaining in the dark. It is better to find and heal a broken bone than to walk on crutches forever. Why slap a Band-Aid on a broken bone?

Armed with test results, practitioners work with patients to craft individualized treatment plans. Treatments vary but tend to be as natural and noninvasive as possible, such as adjustments to lifestyle and nutrition, hormone supplements, and, when necessary, specialized surgeries to clear blocked tubes and remove endometriosis. One of the unique elements of RRM is the way husbands and wives are both involved in the process, learning and working as a team to create and implement treatment plans.

How Do RRM Outcomes and Costs Compare to IVF?

The above RRM study in Spain found a basic take-home baby rate of 35.3%. This rate rose to 62.1% after removing data from patients who ended treatment before 11 months. Referring to a variety of studies, Dr. Joseph Stanford of the IIRRM states, “On average more than 50% of couples who complete their RRM treatment will have a live birth, and higher rates are achieved with continuing care.” Success varies by age, with rates decreasing with the increasing age of the woman seeking treatment.

In 2021, the average live birth rate for one cycle of IVF was 37.3%. However, this rate varies significantly according to the age of the women, number of IVF cycles, and other variables. The IVF data that may be most comparable to that of RRM over time is the percentage of patients using IVF for the first time who achieved a live birth after multiple egg retrievals over the course of one year. In 2021, this rate was 61.5% for women under 35 years of age and 13.2% for women over 40. Additionally, children conceived using IVF have a higher rate of pre-term delivery, prenatal complications, and congenital malformations.

While the data above is comparable with RRM by live births over time, it is important to understand that the processes behind these statistics are categorically different. Every embryo transfer within that one year of IVF involves a tiny human being who will likely die before birth (the average live birth rate per embryo transfer from embryos created using the patient’s eggs is 49.1% to 24.4%). For every live birth from IVF, there are an unknown number of embryos who were discarded due to perceived abnormalities, were frozen indefinitely, or who died at other steps in the process. Each year in America, more tiny humans die through IVF than abortion.

In contrast, couples using RRM have one opportunity to conceive each month, twelve per year. Conception happens naturally in the mother’s body without the creation, sorting, storage, and transfer of multiple tiny children outside the womb.

In addition to not being an ethical minefield, RRM tends to be less expensive than IVF. According to Drs. Turczynski and Boyle, the cost of IVF can range from a base of $9,000 to as high as $60,000 to achieve a live birth (given additional cycles, genetic testing, etc.). They estimate that RRM can range from a base of $2,647 to $9,000.

Perhaps afraid of sharing government funds (and patients), organizations such as the American Society for Reproductive Medicine have tried to discredit RRM as “nonmedical,” ideological, and harmful. However, the IIRRM has convincingly countered these claims here and defended RRM’s place in the fertility conversation.

RRM does not promise easy fixes or happy endings, but neither does IVF. RRM offers answers instead of vague diagnoses, healing instead of artificial manipulation, and a significant possibility of giving birth to a child without the financial and ethical costs of IVF. As couples face some of the hardest decisions of their lives, they should be aware that they do not have to choose between IVF and a dead end. RRM is a third path that allows couples to pursue a family while honoring life and the God who gives it.