Arraztoa, J. A. (2025). Commentary On Infertility and Restorative Reproductive Medicine. Journal of Restorative Reproductive Medicine, 1, 1-5. https://doi.org/10.63264/7eg52623
Arraztoa JA. Commentary On Infertility and Restorative Reproductive Medicine. J Restorative Reprod Med. 2025;1:1-5. doi:10.63264/7eg52623
Arraztoa, José Antonio. "Commentary On Infertility and Restorative Reproductive Medicine." Journal of Restorative Reproductive Medicine, vol. 1, 2025, pp. 1-5.
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Restorative reproductive medicine targets the causes of infertility
A 2025 commentary argues that restorative reproductive medicine targets the causes of infertility by working with the body and caring for both partners. It cites an Irish study of 1,072 patients that estimated an adjusted live birth rate of about 5 in 10 (52.8%) at 24 months.
Key Findings
The commentary describes three pillars: protecting normal reproductive function, caring for the couple and the potential embryo, and educating and supporting patients through treatment.
In the Irish NaProTechnology cohort of 1,072 patients, 364 achieved pregnancies. The crude live birth rate was 25.5% at 24 months, adjusted to 52.8%.
The crude conception rate was 33.0% at 24 months, with an adjusted proportion of 64.8%. The cohort also had 13 twin pregnancies (4.6%).
In the Irish cohort, patients averaged 35.8 years of age and 5.6 years of infertility. In all, 76% had primary infertility, and 33% had tried assisted reproductive technologies before.
The multinational study reported an average of 4.7 different diagnoses per couple, and the author describes a dramatic reduction in the diagnosis of unexplained infertility across published outcome studies.
Interpretation
The paper is a commentary that gathers evidence around three pillars of restorative care. The outcome data come from a life table analysis of 1,072 patients treated by family physicians trained in NaProTechnology. NaProTechnology is a system of restorative reproductive medicine based on Creighton Model FertilityCare charting. The study authors note that actual effectiveness likely falls between the crude and adjusted proportions. The commentary also reports registry figures from RedLARA, the CDC, and the HFEA, which count outcomes per oocyte aspiration, retrieval, or embryo transfer.
RRM Context
Restorative reproductive medicine evaluates the causes of impaired fertility and treats them in step with the body's own cycle. Cycle charting, formalized within NaProTechnology by Dr. Thomas W. Hilgers, records ovulatory function and follows the response to treatment. Careful diagnosis supports the view that unexplained infertility means undiagnosed infertility, since each cause found becomes a target of care for both partners.
Our editorial summary of this paper, not the article's abstract.
Abstract
In 1972, a seminal article was published demonstrating that women, adequately trained, could detect the approach of ovulation in the fertile window of their menstrual cycle. It was demonstrated that the symptoms perceived by women at the vulva correlate closely with changes in steroid hormone levels associated with folliculogenesis and the luteal phase. The fertility charting performed by women trained to recognize vulvar symptoms associated with hormonal changes serves as an instrument for detecting potential pathologies and monitoring the effects of treatment These findings established the biological foundations of a tool of fertility awareness tracking that has facilitated the development of restorative reproductive medicine (RRM): an approach that can be applied to identify and treat the underlying causes of infertility/subfertility. Several core characteristics—or foundational pillars—of the RRM approach to fertility can be identified. These include: a commitment to respecting healthy physiological processes, comprehensive health care for both the couple and the potential embryo, and the provision of education and continuous support throughout the therapeutic process. This commentary aims to elucidate the interplay of these foundational pillars by drawing upon evidence from peer-reviewed biomedical literature. Finally, the challenges faced by RRM in strengthening its scientific foundations, engaging with the broader scientific community, and promoting the dissemination of this approach are described.
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