President Trump’s recent announcement that his administration intends to prioritize funding for Restorative Reproductive Medicine (RRM) rather than In Vitro Fertilization (IVF) has sparked intense debate. Congressional hearings have now begun on this issue, drawing attention not only from political commentators but also from physicians, fertility advocates, and patients nationwide.
As an OBGYN with more than three decades of experience, I welcome this discussion — but I also believe it must be grounded in medical evidence, compassion, and respect for women’s diverse fertility journeys. It’s essential to remember that the ultimate goal of both RRM and IVF is the same: to help couples achieve a healthy pregnancy and a healthy baby. The difference lies in the path each approach takes to reach that goal.
RRM and IVF differ fundamentally in philosophy and process, but both aim to help couples conceive.
RRM seeks to restore natural fertility by identifying and correcting the underlying causes of infertility, including hormonal, metabolic, structural, immunological, and inflammatory factors. It is personalized, holistic, and encourages patients to optimize lifestyle factors that enhance egg and sperm quality, reduce the risk of miscarriage, and improve long-term health outcomes for both mother and child.
By contrast, IVF bypasses many of these underlying issues. Eggs and sperm are combined in the laboratory rather than in the woman’s body, and blastocysts or embryos are transferred into the uterus. While IVF has helped millions conceive, it does not treat the root causes of infertility. It may carry higher medical risks — including ovarian hyperstimulation, multiple pregnancy, preterm birth, and certain long-term metabolic or cardiovascular complications in offspring.
RRM, on the other hand, allows fertilization to occur in vivo, within the natural environment of the woman’s body — respecting physiological timing and hormonal cues.
It’s worth recalling that when IVF was first introduced in the late 1970s, it was highly controversial. Many medical societies, religious organizations, and members of the public opposed it on ethical, social, or safety grounds. The world’s first IVF baby, Louise Brown, was born into a storm of media scrutiny and moral debate.
Over time, as evidence accumulated and outcomes improved, IVF became widely accepted and is now considered mainstream reproductive care. RRM today is at a similar crossroads — a field rooted in science, compassion, and precision that is misunderstood by some because it challenges existing paradigms. What was once seen as radical can, with time and evidence, become recognized as essential.
I would like to clarify that RRM practitioners are not opposed to IVF. In fact, many, like myself, are conventionally trained physicians who collaborate closely with IVF centers. I have referred numerous patients for IVF when it was the most appropriate path. These two approaches are complementary, not adversarial.
RRM may help many couples conceive naturally or improve their health before assisted reproduction, which, in turn, may improve IVF outcomes. For some, IVF remains the best or only option. For others, RRM offers a means to restore their fertility and overall well-being. True reproductive choice means access to both.
Unfortunately, recent statements by professional bodies such as the American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG) have contained misleading and inaccurate claims about RRM.
They have suggested that RRM “is simply fertility medicine minus key tools like IVF,” yet that RRM is not evidence-based — a contradiction that reflects misunderstanding rather than fact. RRM utilizes diagnostic precision, hormonal profiling, and targeted treatment, often supported by peer-reviewed studies that demonstrate improved outcomes in ovulation, implantation, and live birth rates.
Equally concerning is the claim that RRM subjects patients to unnecessary surgery. In reality, procedures such as diagnostic laparoscopy are used only when clinically indicated — often revealing treatable conditions like endometriosis or tubal scarring that conventional IVF workups may overlook.
ACOG mistakenly claims that RRM only treats women, somehow having missed the fact that Restorative Andrology is an integral part of RRM practice.
Finally, the notion that RRM practitioners are anti-IVF is simply false. Most of us believe in integration, not exclusion. We advocate for patient-centered fertility care, where each woman and couple can make informed choices aligned with their health, values, and circumstances.
The fertility crisis in the United States — and globally — demands that we pull out all the stops. Supporting RRM should not mean defunding IVF, nor should promoting IVF mean dismissing RRM. Each plays a role in ensuring that those who wish to become parents have every possible opportunity to do so safely and sustainably.
Congress now has an opportunity to move beyond ideological framing and instead champion comprehensive fertility care — one that includes restoration, prevention, and assisted reproduction.
Ultimately, RRM and IVF share a common goal: achieving a healthy pregnancy and a thriving child. Our policies should reflect that shared mission by supporting all medically sound, evidence-based, and compassionate approaches to building families.
- Boyle, P. C., Stanford, J. B., et al. “Restorative Reproductive Medicine: An Integrated and Evidence-Based Approach to Fertility.” Frontiers in Medicine, 2021.
- Practice Committee of the American Society for Reproductive Medicine. “Complications of Assisted Reproductive Technology.” Fertility and Sterility 2022;118(3): 457–476.
- Hilgers, T. W. “The Medical and Surgical Practice of NaProTECHNOLOGY.” Pope Paul VI Institute Press, 2019.
- Stanford, J. B., et al. “Outcomes from Treatment of Infertility with Natural Procreative Technology in an Irish General Practice.” Journal of the American Board of Family Medicine 2018;31(5): 805–812.
Dr Marina OBGYN