Infertility affects 1 in 6 people globally (and up to a third of physicians) and is recognized by the World Health Organization and the American Medical Association as a disease. Since 1978, the development of assisted reproductive technology (ART), which is defined as fertility treatments in which gametes or embryos are handled in vitro, has made it possible to overcome otherwise insurmountable barriers to conception and has led to the birth of more than 10 million children worldwide.
restorative reproductive medicine critique JAMA viewpoint, RRM versus assisted reproductive technology fertility treatment, Liao Kallen false promise restorative reproductive medicine, natural medicine fertility treatment access restriction, NaProTECHNOLOGY critique evidence-based fertility care, RRM ideology restricting IVF access policy, restorative reproductive medicine natural fertility claims debate, assisted reproductive technology versus restorative medicine ethics, fertility treatment access restriction religious ideology, NaProTECHNOLOGY effectiveness claims JAMA critique
PMID 41405900 41405900 DOI 10.1001/jama.2025.22841 10.1001/jama.2025.22841
Cite this article
Liao C, Himel R, & Kallen AN (2026). The False Promise of Restorative Reproductive Medicine-Restricting Access to Care in the Name of "Natural" Medicine. JAMA, 335(3), 211-212. https://doi.org/10.1001/jama.2025.22841
Liao C, Himel R, Kallen AN. The False Promise of Restorative Reproductive Medicine-Restricting Access to Care in the Name of "Natural" Medicine. JAMA. 2026;335(3):211-212. doi:10.1001/jama.2025.22841
Liao C, et al. "The False Promise of Restorative Reproductive Medicine-Restricting Access to Care in the Name of "Natural" Medicine." JAMA, vol. 335, no. 3, 2026, pp. 211-212.
Endometriosis has been associated with an increased risk of ovarian cancer; however, the associations between endometriosis subtypes and ovarian cancer histotypes have not been well-described. To evaluate the associations of endometriosis subtypes with incidence of ovarian cancer, both overall and by histotype. DESIGN, SETTING, Population-based cohort study using data from the Utah Population Database. The cohort was assembled by matching 78 893 women with endometriosis in a 1:5 ratio to women without endometriosis. Endometriosis cases were identified via electronic health records and categorized as superficial endometriosis, ovarian endometriomas, deep infiltrating endometriosis, or other. Estimated adjusted hazard ratios (aHRs), adjusted risk differences (aRDs) per 10 000 women, and 95% CIs for overall ovarian cancer, type I ovarian cancer, and type II ovarian cancer comparing women with each type of endometriosis with women without endometriosis. Models accounted for sociodemographic factors, reproductive history, and past gynecologic operations. In this Utah-based cohort, the mean (SD) age at first endometriosis diagnosis was 36 (10) years. There were 597 women with ovarian cancer. Ovarian cancer risk was higher among women with endometriosis compared with women without endometriosis (aHR, 4.20 [95% CI, 3.59-4.91]; aRD, 9.90 [95% CI, 7.22-12.57]), and risk of type I ovarian cancer was especially high (aHR, 7.48 [95% CI, 5.80-9.65]; aRD, 7.53 [95% CI, 5.46-9.61]). Ovarian cancer risk was highest in women with deep infiltrating endometriosis and/or ovarian endometriomas for all ovarian cancers (aHR, 9.66 [95% CI, 7.77-12.00]; aRD, 26.71 [95% CI, 20.01-33.41]), type I ovarian cancer (aHR, 18.96 [95% CI, 13.78-26.08]; aRD, 19.57 [95% CI, 13.80-25.35]), and type II ovarian cancer (aHR, 3.72 [95% CI, 2.31-5.98]; aRD, 2.42 [95% CI, -0.01 to 4.85]). Ovarian cancer risk was markedly increased among women with ovarian endometriomas and/or deep infiltrating endometriosis. This population may benefit from counseling regarding ovarian cancer risk and prevention and could be an important population for targeted screening and prevention studies.
Neural tube defects are among the most common congenital malformations in the US, with an estimated 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folic acid supplementation. Persons who are planning to or could become pregnant.Evidence AssessmentThe USPSTF concludes that, for persons who are planning to or could become pregnant, there is high certainty that folic acid supplementation has a substantial net benefit to prevent neural tube defects in their offspring.RecommendationThe USPSTF recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid. (A recommendation)