Restoration, Treatment, and Time: Why Restorative Reproductive Medicine Is a First, But Not the Only, Tool in Comprehensive Fertility Care

Many patients searching for answers about infertility encounter Restorative Reproductive Medicine (RRM). At its core, RRM focuses on identifying and treating underlying factors that may affect fertility, including hormonal health, ovulation, thyroid disease, nutrition, metabolic health, and lifestyle factors.

These are important goals.

In fact, restorative reproductive medicine is already practiced every day by primary care physicians, OB-GYNs, reproductive endocrinologists, reproductive urologists, nutritionists, and other healthcare professionals. Understanding root causes and optimizing health are foundational parts of good medical care.

The question is not whether restoration has value.

The question is whether restoration alone is sufficient for every patient.

Why Comprehensive Fertility Care Includes More Than Restoration

Some patients conceive after addressing ovulation, thyroid disease, nutrition, or other underlying conditions.

Others need additional tools.

A patient with blocked fallopian tubes may need IVF. A patient with azoospermia may need a reproductive urologist. A patient with premature ovarian insufficiency may need donor eggs. Some patients need donor sperm, a gestational carrier, fertility preservation, or advanced laboratory technologies.

And some hopeful parents, including many LGBTQ+ individuals and couples, are not seeking to restore a reproductive pathway at all. They are building a family through donor conception, gestational carriers, or other assisted reproductive technologies.

A comprehensive fertility center exists to serve all these family-building paths.

Every Patient Deserves Access to Every Appropriate Tool

Patients come to fertility care with different diagnoses, timelines, beliefs, and goals.

Some wish to pursue the least invasive approach possible.

Some want to move quickly because time is limited.

Some have religious or ethical beliefs that shape which treatments they are comfortable pursuing.

Others want access to every available option.

The role of a fertility specialist is not to decide which values a patient should hold. The role of a fertility specialist is to provide accurate information, evidence-based recommendations, and a safe space for patients to make decisions aligned with their own goals and beliefs.

For some patients, restorative approaches may be enough.

For others, restoration is one part of a larger plan.

The best fertility care is not about choosing restoration or reproductive technology. It is about understanding when each tool is most likely to help and ensuring every hopeful parent has access to the care that best supports their vision for building a family.

Time Matters

Fertility differs from many areas of medicine because time changes biology. Reproductive potential declines with age. Egg quantity and quality decrease, miscarriage rates increase, and age and health can affect sperm quality and reproductive outcomes as well. The question is not whether restorative approaches have value. The question is whether they can help a patient achieve their family-building goals within the time available.

Patients deserve an honest assessment of their diagnosis, prognosis, and options so they can pursue restoration when appropriate while preserving timely access to additional treatments when needed.

The goal is not a particular treatment. The goal is helping people build the families they hope for in a way that is medically sound, emotionally supportive, and aligned with their values, beliefs, diagnosis, timeline, and family-building needs. Some patients may achieve that through restoration alone. Others may require reproductive surgery, IVF, donor conception, a gestational carrier, or other assisted reproductive technologies. Comprehensive fertility care ensures every hopeful parent has access to the tools most likely to help them achieve their vision of family.

References

Stanford JB, Parnell TA, Boyle PC. Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study. BMC Pregnancy Childbirth. 2021;21:495.

American Society for Reproductive Medicine Center for Policy and Leadership. Following the Science: An Evidence-Based, Science-Driven Response to Infertility. Washington, DC: ASRM; 2025.

American Society for Reproductive Medicine. Just the Facts: "Restorative Reproductive Medicine" and "Ethical IVF" Are Misleading Terms That Threaten Access. ASRM Fact Sheet. 2025.

Ethics Committee of the American Society for Reproductive Medicine. Access to fertility services by transgender and nonbinary persons. Fertil Steril. 2021.

Peipert BJ, et al. The illusion of reproductive choice: how restorative reproductive medicine violates reproductive autonomy and informed consent. Fertil Steril. 2025.

Susannah Copland, MD, MSCR is a board-certified fertility specialist and co-founder of Atlantic Fertility in Raleigh, NC. She trained at Mayo Clinic School of Medicine, completed her residency at Magee-Women's Hospital, and pursued her fellowship in Reproductive Endocrinology & Infertility at Emory University, where she also earned a Master of Science in Clinical Research.