RRM Methods

For many patients with endometriosis, laparoscopic surgery is the most effective treatment to alleviate severe chronic pelvic pain and improve quality of life. Because endometriosis is common among in...

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 devel...

Peipert et al. (1) claim that restorative reproductive medicine (RRM) originated as a political and religious movement with the purpose to limit access to in vitro fertilization (IVF). In so doing, th...

Introduction: Assisted reproductive technologies (ART) are widely used to address infertility; however, they are costly, associated with medical risks, and often yield suboptimal clinical outcomes. Na...

Recently, editorials have been published in reproductive medical journals that have misunderstood and misrepresented the origin and meaning of “restorative reproductive medicine” (RRM).1,2 This term w...

Objectives: Restorative reproductive medicine (RRM) is an emerging approach that can be used to treat infertility. Our goal was to compare RRM to IVF outcomes in 2019. Design: We conducted a retrospec...

Background: Knowledge of the fertile and infertile phases of the menstrual cycle can be applied to conceive or to avoid pregnancy. Fertility intentions and sexual behaviors during the fertile time may...

A one-day meeting was held as a pre-conference to the Catholic Medical Association Annual Educational event in 2024. A panel of eighteen physicians, scientists, and researchers involved in NFP work wa...

Background: Infertility affects around 17.5% of reproductive-aged individuals worldwide, posing significant personal and public health challenges. Although Medically Assisted Reproduction and Assisted...

Background: Fertility awareness-based methods (FABM) of family planning have increased in popularity in recent years. The effectiveness of various methods can vary substantially and can be user depend...

Background Reproductive hormones of the fertile window are often referenced to women in regular cycles, but this may not be representative of the hormonal profiles of women in different circumstances ...

Restorative reproductive surgery has emerged to become an exciting and promising field of surgery that can transform the way that we treat patients, especially regarding fertility. As a prime example ...

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 t...

Welcome to the Journal of Restorative Reproductive Medicine, the official journal of the International Institute for Restorative Reproductive Medicine! JRRM is a peer-reviewed, open-access medical jou...

PURPOSE: Prior studies in fresh embryo transfer IVF cycles have associated elevated serum progesterone level on day of ovulatory trigger, particularly if ≥ 1.5 ng/ml, with decreased pregnancy rates. A...

Fertility awareness-based methods (FABMs), also known as natural family planning (NFP), enable couples to identify the days of the menstrual cycle when intercourse may result in pregnancy ("fertile da...

BACKGROUND AND Objectives: Fertility awareness-based methods (FABMs) are evidence-based means of tracking observable biomarkers of a woman's fertility for the purpose of reproductive health monitoring...

Naltrexone (NTX) is a non-selective antagonist of opioid receptors, primarily used in the therapy of opioid and alcohol dependence. Low-dose naltrexone (LDN) exhibits antagonistic action against the o...

The fertility tracking of menstrual cycles during perimenopause with a quantitative hormone monitor is a novel undertaking. Women in regular menstrual cycles have been tracking their fertility using d...

Background Natural Procreative Technology (NaProTechnology) is a system of management of infertility and other reproductive health issues which requires the application of a woman’s observation and re...

For years, reproductive surgery was the mainstay of reproductive care. With the evolution and ultimate success of in vitro fertilization (IVF), reproductive surgery became an adjuvant therapy, indicat...

BACKGROUND AND Objectives: Knowledge and competency in the topics of reproductive health and family planning are important for primary care physicians. Given the high rates of unintended pregnancy, in...

PURPOSE: To assess efficacy of adjuvant dexamethasone during letrozole cycles for ovulation induction (OI) in women with letrozole-resistant polycystic ovary syndrome (PCOS). METHODS: We retrospectiv...

STUDY QUESTION: What is the feasibility of a prospective protocol to follow subfertile couples being treated with natural procreative technology for up to 3 years at multiple clinical sites? SUMMARY ...

BACKGROUND: Restorative reproductive medicine represents a comprehensive approach to subfertility (infertility and miscarriage) with investigations, diagnoses, and treatments combined with fertility c...

Women of reproductive age need reliable and effective family planning methods to manage their fertility. Natural family planning (NFP) methods or fertility awareness-based methods (FABMs) have been in...

Background and Objectives: Women with androgenic Polycystic Ovary Syndrome (PCOS) have increased endometrial cancer risk that cyclic progesterone will prevent; it may also reverse PCOS's neuroendocrin...

Background: Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are hig...

NaProTECHNOLOGY – a chance for offspring or fraud? In the media space in Poland, you can meet the concept of Naprotechnology as an alternative to the in vitro procedure. Often, many myths and untruths...

While we agree with many of the points stated by Dyer et al. in their recent commentary inRBMO(Dyer et al., 2020), we believe their conclusions are focused too narrowly. Limiting the indicator of acce...

One aspect of the progressive secularization of biotechnology is the use of the by-products from abortion and the use of human embryos. These morally illicit cells and tissue create a significant mora...

This article considers one question: How does the Catholic Church guide infertile couples to exercise their right to build a family? Part One examines the principal tenets of Catholic social teaching ...

A special course on Marriage, the Family and Human Sexuality was established at Kenrick-Glennon Seminary in St. Louis so as to assist the seminarians in their better understanding of the Church's teac...

Identifying the return of fertility with cervical mucus observations is challenging during the postpartum period. Use of urinary measurements of estrogen and progesterone can assist in understanding t...

A one-day meeting of physicians, professional nurses, and scientists actively involved in Natural Family Planning (NFP) research was held to review the state of the science of NFP and consider future ...

Objectives: To determine the live birth rate for patients who chose to undergo treatment with Restorative Reproductive Medicine (RRM) after previous IVF (includes ICSI). To look at birth outcomes with...

This issue of Current Medical Research (CMR) includes studies that provide evidence that use of natural family planning (NFP) can be helpful for subfertile couples wishing to achieve a pregnancy, the ...

Natural family planning (NFP) methods have served many generations well, and in particular, the symptothermal or symptohormonal methods. The comparison of daily mucus and temperature records for indiv...

Objective: Explore potential relationships between preovulatory, periovulatory, and luteal-phase characteristics in normally cycling women. Design: Observational study. Setting: Eight European natural...

Aim: Gonadotropin stimulation is used as the second line of treatment in patients with thin endometrium following clomiphene citrate (CC) administration, which is associated with higher cost, multiple...

Objective: To determine the effectiveness of achieving pregnancy with focused intercourse in the fertile window identified using natural fertility indicators. Methods: 24-cycle prospective effectiven...

CONTEXT: The Creighton Model FertilityCare(TM) System (CrM) is a standardized approach for educating women about the biomarkers of their fertility. Couples can use this information for timing intercou...

OBJECTIVE: Traditional medical school curricula have not addressed fertility awareness-based methods (FABMs) of family planning. The objective of this study was to assess (1) 3-year medical students' ...

Purpose: To analyze cumulative pregnancy rates of subfertile couples after fertility awareness training. Methods: A prospective observational cohort study followed 187 subfertile women, who had recei...

The topic of how the menstrual cycle is a vital sign which could signal pathophysiologic process has received considerable attention in the past decade. The current recommendations of various academic...

Purpose: The aims of this study were to determine and compare extended use-effectiveness of an online nurse-managed fertility education service program among women (and subgroups of women) seeking to ...

Various fertility indicators are used by natural family planning methods to identify the fertile and infertile phases of a woman's menstrual cycle: mucus observations, cycle-day probabilities, basal b...

Introduction: The length of periodic abstinence, due to overestimation of the fertile phase of the menstrual cycle, is often a cause for dissatisfaction, discontinuation, and user error with natural f...

This document reviews surgical options for achieving patency in obstructed fallopian tubes and the factors that must be considered when deciding between surgical repair and IVF. This document replaces...

Introduction: Luteal phase deficiency (LPD), while commonly observed and managed in stimulated in-vitro fertilisation cycles, is a more contentious phenomenon in natural cycles. The challenge arises i...

Purpose: To determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy. STUDY DESIGN AND Methods: Using an...

INTRODUCTION: Natural family planning (NFP) methods are effective for contraception with proper and consistent use. However, only 1% of patients at federally funded Title X family planning clinics sel...

The diminished role of tubal surgery in infertile women following widespread access to IVF is now being reviewed as more patients and surgeons today consider tubal surgery as an effective alternative ...

Objective: To evaluate the efficacy, knowledge of fertility, and acceptability of a web-based natural family planning (NFP) education and service program. Design: A 6-month repeated measure longitudin...

Description: Infertility is usually a consequence of multiple chronic conditions rather than a single acute condition. We propose that it is erroneous to apply acute medical interventions to a conditi...

Relatively few Catholic couples in the United States use modern methods of natural family planning (NFP). So too, few Catholic physicians and health professionals prescribe the use of NFP methods for ...

Purpose: To determine the effectiveness of the Marquette Method (MM) of natural family planning (NFP) as a method of avoiding pregnancy. STUDY DESIGN AND Methods: This was a 12-month retrospective ev...

Calendar-based methods are not usually considered effective or useful methods of family planning among health professionals. However, new "high-" and "low"-tech calendar methods have been developed, w...

Nurses and other health care professionals often have little knowledge of methods of natural family planning (NFP) and do not readily prescribe natural methods for their patients. One reason for this ...

NaProTECHNOLOGY (Natural Procreative Technology) is defined as a women's health science that monitors and cooperates with the menstrual and fertility cycles to identify, evaluate, and treat gynecologi...

NaProTECHNOLOGY applies the standardized biomarkers of the Creighton Model FertilityCare System to identify the specific pathophysiological causes of infertility in each couple, then directs targeted ...

The structured protocols used to train and certify FertilityCare Practitioners (FCPs) in the uniform delivery of CrMS instruction are detailed, covering the sequence of follow-up sessions, the use of ...

Early pregnancy loss encompasses biochemical pregnancy, embryonic demise, and missed abortion, each distinguished by specific hormonal profiles and ultrasound criteria within the NaProTECHNOLOGY surve...

The content and sequence of the introductory and follow-up instructional sessions that constitute the formal CrMS education series are outlined, covering observation technique, recording conventions, ...

NaProTECHNOLOGY uses the Peak Day of the Creighton Model chart — the last day of the most fertile-type cervical mucus — as the reference point for dating conception, providing a biologically grounded ...

Hilgers presents a refined classification of follicular and luteal phase deficiencies grounded in the integration of CrMS mucus pattern characteristics, cycle-phase-targeted estradiol and progesterone...

Cumulative pregnancy and live birth data from the Pope Paul VI Institute document NaProTECHNOLOGY outcomes across diagnostic categories including unexplained infertility, endometriosis, PCOD, and tuba...

The FertilityCare Practitioner (FCP) is the trained educator and coach who teaches the Creighton Model FertilityCare System to clients, standardizes charting methodology, and serves as the primary dat...

The philosophical and ethical foundation of NaProTECHNOLOGY is examined through the lens of a "new humanism" that affirms the dignity of women, couples, and the unborn by working within — rather than ...

Patients who have undergone multiple failed IVF cycles and are counseled to abandon fertility treatment represent a significant NaProTECHNOLOGY cohort in whom undiagnosed correctable pathology — inclu...

Adaptations of CrMS instruction for physiologically distinct reproductive states — including breastfeeding, post-hormonal contraceptive use, long or irregular cycles, and premenopause — are described ...

Structured postoperative management following PEARS procedures addresses wound care, pain control, early ambulation, hormonal support, and surveillance for complications including bleeding, infection,...

Preconceptional optimization using CrMS cycle data establishes hormonal baselines, identifies correctable pathologies, and guides targeted supplementation before conception is attempted. Systematic pr...

Endometriosis impairs fertility through direct mechanical distortion of pelvic anatomy, peritoneal inflammatory mediators, and hormonal micro-environment alterations that reduce implantation potential...

Escalating rates of contraceptive use, abortion, divorce, child abuse, teenage pregnancy, and out-of-wedlock births over the preceding four decades are documented as interconnected indicators of syste...

Deep infiltrating endometriosis involving the rectosigmoid, appendix, and small bowel is addressed through gynecologist-performed PEARS techniques that include superficial disc excision, appendectomy,...

The Creighton Model's standardized daily vulvar observation system -- recording discharge color, consistency, quantity, and sensation -- allows chronic pathological discharges (persistent yellow or cl...

Endometriosis recurrence after surgical excision remains a clinical reality driven by residual ectopic implants, persistent hormonal milieu favoring re-seeding, and incomplete initial resection. NaPro...

Hilgers distinguishes isomolecular hormones -- molecules structurally identical to endogenous estradiol and progesterone -- from heteromolecular artimones, his term for synthetic analogues such as med...

Methodologically rigorous effectiveness data for the CrMS are presented, including method-effectiveness and use-effectiveness rates for pregnancy avoidance drawn from prospective cohort studies, demon...

Chronic pelvic pain and dysmenorrhea in reproductive-age women most commonly reflect undertreated endometriosis, adenomyosis, ovarian dysfunction, or pelvic adhesive disease rather than psychosomatic ...

Compounding pharmacists prepare individualized hormone formulations — including HCG, progesterone, and thyroid preparations — that are central to NaProTECHNOLOGY treatment protocols, where standardize...

Chronic anovulation and progesterone or estradiol deficiency identified through CrMS charting represent periods of suboptimal bone accrual in women of reproductive age, because both estradiol and prog...

Distal tubal occlusion — including hydrosalpinx, fimbrial agglutination, and peritubal adhesions — is a correctable cause of tubal-factor infertility amenable to salpingoneostomy, fimbrioplasty, and a...

Postpartum depression in susceptible women is linked to abrupt postpartum progesterone withdrawal following the high-progesterone state of pregnancy, particularly in those with prior PMS, luteal phase...

Serum estradiol and progesterone assays vary substantially across laboratories because of differences in antibody specificity, calibration standards, detection platforms, and quality-control practices...

CrMS charting features -- Peak day definition, pre-Peak mucus quality and duration, post-Peak phase length, and premenstrual spotting -- are systematically compared against sonographic and endocrine f...

Family physicians trained in NaProTECHNOLOGY serve as primary coordinators of medical management — prescribing targeted hormone support, monitoring biomarker trends, and triaging surgical referrals — ...

Laser adhesiolysis protocols address peritubal, periovarian, and cul-de-sac adhesions using CO2 laser energy applied under direct near-contact visualization, with attention to underlying anatomy and v...

Cooperative progesterone and estrogen replacement therapy administers bioidentical hormones in precise synchrony with the woman's CrMS-identified Peak day -- beginning progesterone at P+2 or P+3 and c...

Selective hysterosalpingography combined with transcervical fallopian tube catheterization allows both precise diagnosis and non-surgical correction of proximal tubal occlusion, distinguishing true an...

A systematic framework for managing patient cases within the CrMS-NaProTECHNOLOGY system is presented, addressing how FCPs and medical consultants collaborate to identify abnormal chart patterns, init...

Physiological and psychological stress disrupts hypothalamic GnRH pulsatility via CRH-cortisol pathways, producing downstream impairments in LH and FSH secretion that manifest as anovulation, delayed ...

Pelvic adhesions from prior infection, surgery, or endometriosis restrict tubal motility, occlude the fimbriae, and distort ovarian-tubal relationships, constituting a primary mechanical barrier to na...

Family physicians are optimally positioned to introduce NaProTECHNOLOGY to patients presenting with infertility, irregular cycles, or recurrent pregnancy loss during routine primary care, enabling ear...

Postoperative pelvic adhesions are a leading cause of secondary infertility, chronic pain, and bowel obstruction following gynecologic surgery, making adhesion prevention a primary surgical quality me...

Women with persistent or continuous vaginal discharges — including those from chronic cervicitis, hormonal imbalance, or other gynecologic sources — present a distinct charting challenge, and this cha...

Recurrent spontaneous abortion is examined through a systematic NaProTECHNOLOGY diagnostic framework that includes hormonal, anatomical, immunological, and infectious etiologies identified via CrMS cy...

Serial progesterone measurement timed to the luteal phase and early pregnancy using CrMS Peak Day-referenced protocols reveals luteal insufficiency and early placental progesterone inadequacy that are...

OBJECTIVE: The purpose of this study was to evaluate the effect of prophylactic vaginal progesterone in decreasing preterm birth rate in a high-risk population. STUDY DESIGN: A randomized, double-bli...

In an otherwise excellent editorial that appeared in this journal concerning the problems created by failure of the Health Insurance Industry to provide coverage for infertility, the author, a noted a...

A Belgian pilot-study conducted in the framework of the prospective European multi-center study (University of Düsseldorf) tried to establish the use-effectiveness (a sine qua non condition for its ac...

OBJECTIVE: To verify the occurrence of preferential distribution of vaginally administered progesterone to the uterus compared with extrapelvic regions in vivo and in humans. DESIGN: Prospective clin...

Patients suffering from normogonadotrophic anovulation and infertility are initially treated with clomiphene citrate. Those who do not respond to clomiphene citrate usually receive gonadotrophin treat...

Despite the recognized benefits for clients and programs of providing natural family planning (NFP) services, few family planning programs offer NFP and few provide fertility awareness education. Furt...

Natural methods of fertility regulation are acceptable in most cultures. Many couples worldwide do not wish to use contraceptives or do not have access to them but wish to limit their family size or l...

Objective: To evaluate whether the efficacy of naltrexone administration in patients with hypothalamic amenorrhea correlates to the response to an acute naloxone test. Design: Thirty patients with hyp...

OBJECTIVE: Vaginal progesterone suppositories are an accepted treatment for infertility attributed to luteal phase defects. Although oral micronized progesterone may be preferable to suppositories for...

good of all, and above all, for the protection of the weak."2I submit that, no matter how appealing a marketplace model may seem for the NHS, it is a business model.As such the destruction of either p...

Studies to evaluate use-effectiveness and cost-effectiveness of natural family planning (NFP) were conducted in Liberia and Zambia. The Liberian programme provided uni-purpose NFP services to 1055 cli...

An improved delivery method to achieve sustained physiological P levels would be useful. Based on this single-dose pharmacokinetic study, micronized P prepared in a nonliquefying vaginal cream holds p...

A study of the knowledge, perceptions, and behavioral intentions of physicians regarding periodic abstinence (PA) methods was undertaken in Mauritius, Peru, the Philippines, and Sri Lanka. Most respon...

A deficiency in follicle stimulating hormone (FSH) levels during the early follicular phase of the menstrual cycle has been shown to result in luteal phase defect (LPD). A short course of human urinar...

The bioavailability of micronized progesterone (P) was studied by measuring sequential serum P concentrations after a single bolus of 50-200 mg P given sublingually, orally (capsule and tablet), vagin...

A study was designed to see if the use of prophylactic progesterone vaginal suppositories (PVS) reduced the risk of spontaneous abortions in women with a history of at least one spontaneous abortion. ...

There is no information available about the effect of iron in formula on the development of gastrointestinal humoral immune response in early human infancy. We compared standard Enfamil to iron-fortif...

In previous studies it could be demonstrated that in severe hypothalamic amenorrhea, which is associated with absent or deficient hypothalamic secretion of Gn-RH, ovarian function could be restored by...

NFP (natural family planning) has replaced the term of rhythm method in the last decade as a designation for those methods of fertility regulation based on periodic abstinence. A graph presents the sy...

The ovulation method of natural family planning is described in detail as taught in the ovulation method centers with an account of its development in Australia and the underlying philosophy. Hormonal...