Championing a little-known IVF alternative

Joseph Meaney and his wife Marie married in 2000 and expected babies to come along pretty quickly. But after a year without a pregnancy, the couple started looking around for some help with fertility issues. Most fertility doctors the couple visited only offered in vitro fertilization, which the Catholic couple objected to on religious grounds.

After meeting with specialists in multiple states, the Meaneys learned that Marie suffered from endometriosis, a condition caused by tissue growing outside the uterus. Joseph also needed surgery to treat a low sperm count.

“We ended up having to travel pretty long distances and pay a lot out of pocket to get the kind of healthcare that we wanted to receive,” said Meaney, who is now senior fellow of the National Catholic Bioethics Center.

Last month, two medical groups addressed U.S. lawmakers about treatment options for couples facing infertility: One championed IVF, while the other argued for restorative reproductive medicine (RRM), the kind of medical care the Meaneys had sought out. About 1 in 5 women of childbearing age struggle to get pregnant, but many women often assume IVF is their only option. Advocates for natural infertility care would like to change that misconception but say the fertility industry wrongly places RRM in a category of fake medicine.

Restorative reproductive medicine traces its roots to 1976, when Dr. Thomas Hilgers began developing the Creighton Model FertilityCare System. The diagnostic tool helps doctors monitor and pinpoint irregularities in a woman’s menstrual cycle. Today, RRM has become an umbrella term for an approach to infertility that addresses root causes. Physicians may use a variety of methods including the Creighton Model to assess patients.

Human IVF technology also made strides in the 1970s, with doctors delivering the first baby via IVF in 1978.

“Once IVF became successful, that’s where all the research and the big money went,” said Dr. Jean Golden-Tevald, an RRM specialist at MorningStar Family Health Center in Flemington, N.J. In the United States, the IVF market was valued at $5.9 million last year. Today, IVF makes up nearly 3% of U.S. births.

The procedure came under scrutiny when Alabama’s Supreme Court declared last year that embryos created via IVF should have the same legal protections as born children.

Following that ruling, then-presidential hopeful Donald Trump doubled down on support for IVF. Once back in office for his second term, President Trump issued an executive order pledging to “ensure reliable access to IVF treatment” and make the treatment “drastically more affordable.” In May, the administration reportedly considered enshrining IVF as an “essential health benefit” under the Affordable Care Act.

But the effort to subsidize IVF has hit some speed bumps. The Trump administration in April dismissed Centers for Disease Control and Prevention staffers responsible for collecting IVF data. In August, The Washington Post reported that the White House doesn’t plan to require insurance companies to cover the treatment, since the president doesn’t have that kind of unilateral authority—a mandate would likely have to come from or in conjunction with Congress. Legislators have introduced at least five bills to expand access to IVF this year, and 15 states mandate some form of insurance coverage for it.

On Sept. 16, the American Society for Reproductive Medicine hosted a congressional briefing to inform lawmakers about IVF—and warn them about the “limitations” of RRM.

That same day, less than half a mile away, the International Institute for Restorative Reproductive Medicine held its own congressional briefing to clarify “misinformation” and allow patients to share their experiences with RRM. Tracey Parnell, director of communications and development for the group, told WORLD it didn’t plan for its event to coincide with the pro-IVF society’s hearing. “We really wanted to make sure that the voices of our patients were heard, not just the professionals from these associations,” she said. “Patients need to know they have options.”

Conservatives have become increasingly critical of IVF. At least 1.5 million fertilized embryos are discarded every year, while the process results in only about 100,000 live births. “There is no procedure that has a 90% failure rate that is allowed to continue,” said Joseph Meaney.

The treatment is also expensive. Per round (also known as a cycle), the procedure can cost up to $30,000. Successful conception rates vary by a woman’s age, with women under 35 having a 54% success rate that drops to about 13% by age 41. Around 40% of embryo transfers result in live births, though younger women have a much higher chance of having healthy IVF babies.

Some health experts believe that IVF usually fails to address why a couple struggled with infertility in the first place. As MorningStar’s Golden-Tevald explains, a variety of problems—like hormonal imbalances, blockages in the fallopian tubes, or low sperm counts—can contribute to infertility. “Almost all the time it’s not just one thing,” she said.

Addressing the root causes of infertility leads to live pregnancies in about 37% of cases, according to Parnell’s organization. Women who opt for IVF are also three times more likely to deliver their babies prematurely compared with those who receive RRM care.

And even if couples don’t achieve pregnancy, they often appreciate having some answers. “Finding out maybe why this did not happen is comforting,” she said.

Still, Golden-Tevald believes RRM is widely mischaracterized. The American College of Obstetricians and Gynecologists, for example, has labeled RRM as a “nonmedical approach … focusing only on female patients.”

But Golden-Tevald argues that RRM addresses problems in men and women and is “completely” scientific. “We use all the tools and diagnostics that are just part of general medicine,” she said.

Some medical organizations, like the American Society for Reproductive Medicine, argue that IVF practitioners offer the same diagnostic services provided by RRM specialists.

But Emma Waters, a policy analyst at the Heritage Foundation and a contributor to WORLD Opinions, said that’s not accurate. “They are doing basic semen tests … basic hormonal panels,” she said. “Those basic tests or treatments don’t result in a clear understanding of what’s causing infertility. Their outcome is always the same, which is, ‘You need to go to IVF.’”

Waters believes that IVF and RRM aren’t opposing treatments. “The two can actually function in tandem with each other, recognizing that there are times and places when IVF may be the option a couple chooses to have a child,” she said. “And if they first prioritize optimizing their health, they’re actually setting themselves up for success.” For example, explained Waters, a couple might struggle with frequent miscarriages. Using RRM to address that issue might enable a woman to successfully carry an IVF embryo to term.

Waters expects the White House to issue an executive order about expanding access to infertility treatment, although she declined to speculate on the details. “What we certainly know is that restorative reproductive medicine aligns very closely with the Make America Healthy Again model, which is all about providing root cause care for patients,” said Waters.

But currently, most couples don’t have sufficient access to RRM or know that it exists. That’s why Waters helped to draft the RESTORE Act, legislation introduced in the House and Senate in May. The bill aims to fund RRM research, provide grant opportunities for aspiring RRM practitioners, and enable insurance companies to cover the cost of the care. Arkansas passed a similar bill in April.

Meaney said that if IVF had been their only option, he and his wife would have accepted infertility. But it didn’t come to that. In 2009, the Meaneys welcomed their daughter Thérèse.

As a bioethicist, Meaney finds it troubling that many couples aren’t always informed about their infertility treatment options. “They go to the doctor and the only thing they hear is like, ‘OK, well, we’ll make an appointment for you at the IVF clinic, because that’s all that we can do for you,’” said Meaney. “That’s just wrong.”