Just the Facts: “Restorative Reproductive Medicine” and “Ethical IVF” are Misleading Terms That Threaten Access

As advocates for evidence-based fertility care, we implore policymakers to uphold the integrity of our healthcare system by protecting access to proven treatments like IVF. It is crucial to be vigilant against misleading terminology, such as “Restorative Reproductive Medicine” (RRM) and “Ethical IVF,” Which can be used to promote ideologically driven restrictions that could limit patient care.

Despite strong public support for in vitro fertilization (IVF)—67% of Americans favor mandatory insurance coverage for the procedure (Krewson, 2024)—these labels are intended to mask restrictive policies that could relegate patients to antiquated, unnecessary treatments, and delay or deny effective and time-sensitive interventions.

What Is RRM? A Rebranding of Standard Medical Practice

What distinguishes RRM is not medical practice but ideology. It typically excludes IVF and related treatments on moral or religious grounds, not clinical evidence. Its proponents create a false narrative that standard fertility care skips proper diagnosis or healing, when in fact, it is based on precisely those principles.

RRM is not a distinct specialty or a new concept. It repackages what fertility doctors already do for every patient:

• Thorough diagnostic workups (e.g., hormone tests, imaging, semen analysis)
• Treatment of underlying conditions like PCOS, endometriosis, or thyroid dysfunction
• Individualized care before moving to assisted technologies like IVF
  
  

In short, RRM (and any variation thereof, including so-called “in ventre fertilization”) is simply fertility medicine minus key tools like IVF, which, for some, represents the only way to build a family.

Fertility Care Is Ethical

Similarly, the term “ethical IVF” is often used as a political tool to justify limiting standard practices like genetic testing or embryo creation. These restrictions can reduce success rates and raise costs, particularly harming older patients, LGBTQ+ individuals, and single parents. It's important to consider the ethical implications of such restrictions and their impact on those seeking to build their families.

The American Society for Reproductive Medicine (ASRM) plays a central role in shaping the ethical standards that guide reproductive medicine practice in the United States and internationally. Through its Ethics Committee, which is comprised of medical professionals, bioethicists, lawyers, and others, ASRM issues evidence-based guidance on a wide range of complex issues, including embryo disposition, third-party reproduction, fertility preservation, and access to care.

ASRM’s Practice Committee, a multidisciplinary group of experts dedicated to promoting evidence-based practices in reproductive medicine, published a comprehensive practice document titled “Optimizing Natural Fertility: A Committee Opinion” (Practice Committee of the American Society for Reproductive Medicine, 2022). This guideline offers evidence-based recommendations for clinicians advising individuals or couples attempting to conceive without known infertility issues. It covers key factors influencing natural fertility, including age-related fertility decline, timing and frequency of intercourse, ovulation monitoring, and lifestyle considerations (such as smoking, alcohol, and caffeine intake).

ASRM’s guidelines are a testament to its commitment to patient-centered care. By grounding its recommendations in medical science and bioethical analysis, ASRM ensures that reproductive care remains ethically sound and responsive to the needs of individuals seeking to build their families. This approach provides reassurance to patients and underscores the importance of their autonomy in the decision-making process.

Reproductive Health Care–Including IVF–Is Inherently Restorative and Ethical

As legislative bodies consider policies affecting access to fertility treatment, it's essential to rely on clinical evidence and professional standards, not branding efforts that obscure the high-quality, restorative care already provided by reproductive medicine specialists.

IVF has been a transformative medical advancement since its inception, nearly five decades ago, offering hope to millions facing infertility, a condition recognized by both the World Health Organization and the American Medical Association. Its discovery garnered a Nobel Prize, with the committee acknowledging the medical procedure as a "beacon of hope" for infertile individuals across the globe. In February 2025, President Trump issued an Executive Order directing the Domestic Policy Council to develop policy recommendations to protect access to IVF treatments and reduce associated costs. As debates continue, it's crucial to distinguish between political rhetoric and the medical realities of IVF.

Medical advancements often face initial skepticism and apprehension. The first heart transplant in 1967, now standard practice, was met with a mix of wonder and concern, sparking ethical debates. Similarly, procedures like organ donation, C-sections, and blood transfusions, once controversial, are now widely accepted in medical practice. IVF, once doubted, has evolved into cutting-edge medical care, with approximately 2% of annual U.S. births attributed to IVF and other forms of ART (CDC, National ART Surveillance System). Over one million babies have been born in the U.S. through IVF since its inception nearly fifty years ago.

The ongoing efforts by ideological opponents of reproductive healthcare need to be seen for what they are—ideological and political arguments, not medical and scientific facts. This underscores the need for policies grounded in medical evidence and patient-centered care. While ethical considerations are vital, they should not override the autonomy of individuals seeking to build families through proven medical treatments.