What is NeoFertility? How It Works, What Are NeoFertility's Success Rates?, and How to Find a Provider

What is NeoFertility

NeoFertility is a restorative reproductive medicine (RRM) approach developed by Dr. Phil Boyle that diagnoses and treats the underlying causes of infertility, recurrent miscarriage, and reproductive health disorders by restoring the body's natural cycle function rather than suppressing or bypassing it.

The name reflects the method's dual nature. "Neo" signals a new generation of restorative care, and "Fertility" describes the core goal: not a laboratory pregnancy, but a body returned to optimal reproductive function so that natural conception can occur. NeoFertility is built on the same founding principle as all RRM approaches: every reproductive health problem has a cause, and identifying and treating that cause produces better outcomes than bypassing the problem or masking its symptoms.

NeoFertility emerged from two decades of NaProTechnology practice. Dr. Boyle trained in NaProTechnology at the Saint Paul VI Institute and practiced it extensively before founding NeoFertility in 2016. What differentiated his new approach was a broadened diagnostic lens, one that incorporated autoimmune and immunological factors, androgen deficiency, endorphin pathways, and emerging evidence from outside the NaPro framework, alongside the cycle-based hormonal evaluation that NaProTechnology had established. NeoFertility operates within the RRM umbrella and is one of the most actively researched approaches in the field today.¹²³

How Does NeoFertility Treatment Work?

NeoFertility follows a structured, three-phase model. The process takes approximately four months to reach the conception phase, with conception typically occurring within twelve additional cycles once the cycle is optimized.¹⁴⁴

Phase 1: Assessment (Approximately 2 Months)

The goal of Phase 1 is to gather the diagnostic data needed to identify every correctable factor affecting fertility. This does not happen in a single appointment. It unfolds over one to two charted cycles, with bloodwork timed to the cycle events identified on the chart.¹⁵⁴

What happens in Phase 1:

• The couple is taught fertility charting by a trained NeoFertility Advisor, ideally using the ChartNeo app. Both partners' histories are taken in detail.
• The physician identifies the Day of Presumed Ovulation (DPO) from the chart. All blood tests are anchored to this event, not to a calendar date.
• Day 3 bloodwork covers the standard hormonal baseline: FSH, AMH, LH, TSH, progesterone, estradiol, and other indicators relevant to the patient's presentation.
• Mid-luteal testing is drawn on Day 7 post-ovulation to assess the quality of ovulation, targeting progesterone levels of 60 to 100 pmol/L and estradiol levels of 400 to 900 pmol/L.⁴
• Extended immunological testing may be ordered based on history: natural killer cell panels, food antibodies, chromosomal or blood clotting abnormalities, and markers of chronic endometritis.⁹
• DHEA and androgen levels are assessed, particularly in patients with recurrent miscarriage or poor follicle function.¹⁰
• An ultrasound follicle series confirms whether ovulation is occurring and whether follicle rupture is complete, a step many clinics omit.¹¹
• Male factor evaluation is standard: semen analysis and, when indicated, hormonal and immunological assessment of both partners.

A core principle of Phase 1 is that the diagnosis must be specific. "Unexplained infertility" is not an acceptable endpoint. In the Boyle et al. 2025 cohort of 187 NeoFertility patients, "unexplained infertility" dropped from 24% of presenting diagnoses to 1% after the full NeoFertility workup. Most of those cases had identifiable, treatable conditions that the standard evaluation had never investigated.¹⁶

Phase 2: Balancing the Cycle (Approximately 2 Months)

Phase 2 is the treatment phase. Every intervention is matched to a specific diagnostic finding and monitored cycle by cycle. Nothing is empiric. Nothing is generic.¹⁵

What Phase 2 may include:

• Ovulation induction medications (letrozole, clomiphene, or low-dose FSH) when ovulation is absent or insufficient, selected based on phenotype and patient history
• Progesterone support timed to the ovulatory event to optimize the luteal phase
• Estradiol evaluation and support when levels are suboptimal in the post-ovulatory phase
• Immune-modifying strategies for patients with elevated natural killer cells, autoimmune markers, or endorphin deficiency, often including low-dose naltrexone (LDN 4.5 mg nightly)
• DHEA supplementation when hypoandrogenemia is identified, both pre-conception and during early pregnancy when indicated
• Treatment of chronic endometritis with targeted antibiotic protocols
• Thyroid system optimization when thyroid dysfunction is contributing to cycle irregularity or miscarriage risk
• Metabolic interventions for insulin resistance and adrenal contributions to ovulatory dysfunction
• Dietary, nutritional, and psychological interventions where clinically relevant

Phase 2 does not end when a treatment is prescribed. Response is verified. If progesterone is supplemented, mid-luteal blood tests confirm the levels are now in the optimal range. If ovulation induction is initiated, follicle ultrasound confirms a single mature follicle develops and ruptures completely. The goal is not to prescribe, but to verify the correction.¹¹

Phase 3: Allowing Conception (1 to 12 Cycles)

Phase 3 begins when the cycle is healthy, hormonal levels are in the optimal range, and follicle rupture has been confirmed by ultrasound. The couple is advised to conceive during the fertile window as identified on their chart. No laboratory is involved. No eggs are retrieved. No embryo is transferred.¹⁵

It is considered biologically normal for conception to take up to twelve cycles even after all correctable factors have been addressed. The goal of Phase 3 is to sustain twelve optimal cycles, providing the maximum opportunity for natural conception to occur. If conception has not occurred after six good cycles, surgical referral for laparoscopy is considered to identify or rule out endometriosis, which is frequently missed on standard imaging.¹⁷¹¹

Once pregnancy is achieved, monitoring continues. Progesterone and estradiol levels are tracked, and hormonal support is maintained as clinically indicated throughout early pregnancy. For patients with identified DHEA deficiency, DHEA supplementation continues during pregnancy to sustain optimal estradiol levels and reduce miscarriage risk.¹⁸¹⁰

The ChartNeo App

NeoFertility was developed alongside a dedicated digital charting platform: the ChartNeo app, co-founded by Dr. Phil Boyle. The app is a central tool in the NeoFertility workflow, functioning as the clinical interface between the patient, their fertility advisor, and the physician.¹

ChartNeo is method-agnostic. It supports the Creighton Model, Billings Ovulation Method, SymptoThermal Method, and Marquette Method, allowing women to track their preferred biomarkers within a single platform. Daily observations, medication records, and blood test results are entered in the app and are shareable directly with the NeoFertility clinic and treating physician. Charts can be printed as PDFs for clinicians unfamiliar with the system.⁶¹⁹

The app uses a "WWIT/WIT assessment routine" to guide consistent daily observations and determine fertile and infertile days with high accuracy. Independent clinical experience reports accurate peak day identification in approximately 90 to 95% of cycles. The ChartNeo app is HIPAA-compliant and GDPR-compliant, and patient data is never sold.²⁰⁶

For patients in the NeoFertility program, charting through ChartNeo is strongly recommended. The integration between app data and clinic records allows the physician to see the pattern of cycle response to treatment in real time across multiple cycles, not only at single-point consultations.

How Does NeoFertility Use Immune Treatment?

One of NeoFertility's most distinctive clinical contributions is its systematic approach to immunological causes of infertility and pregnancy loss. Where many fertility approaches either ignore immune factors or address them only after IVF failure, NeoFertility investigates them as a routine part of the Phase 1 workup for qualifying patients.

Natural Killer Cells

Elevated natural killer (NK) cell activity in the uterine lining has been associated with implantation failure and recurrent pregnancy loss. NK cells play an essential role in early pregnancy by supporting trophoblast invasion and placental development, but dysregulated or overactive NK cells can create an immune environment hostile to implantation. NeoFertility tests for NK cell abnormalities and, when elevated, applies immune-modifying strategies to bring activity into a range conducive to pregnancy.²¹²²⁹

Low-Dose Naltrexone (LDN)

Low-dose naltrexone (4.5 mg nightly) is an immune-modifying agent that Dr. Boyle applies routinely in patients with reduced egg reserve, suspected immune-mediated implantation failure, and clinical endorphin deficiency. LDN functions by transiently blocking opioid receptors, triggering a compensatory upregulation of endogenous endorphins, which in turn modulates immune function. The downstream effects include reduced NK cell activity, reduced inflammatory cytokine levels, and improved endometrial receptivity.¹²²³¹¹

Research on LDN in reproductive medicine documents significant improvements in endometrial thickness, ovarian responsiveness, progesterone levels, and clinical pregnancy rates in women with immunological infertility and recurrent implantation failure. LDN also reduced NK cell counts and antinuclear antibody (ANA) levels in treated patients compared to controls, with LDN-treated women showing higher implantation and clinical pregnancy rates. LDN does not appear to harm fertility and may confer measurable benefit in conditions including PCOS and endometriosis through its neuroendocrine and anti-inflammatory mechanisms.²³¹²

DHEA and Androgen Deficiency

NeoFertility was among the first RRM practices to systematically evaluate DHEA and androgen levels as a routine part of the fertility workup and to publish on hypoandrogenemia as a contributory cause of recurrent miscarriage.²⁴¹⁰

DHEA is a precursor hormone that supports both egg quality pre-conception and estradiol production during early pregnancy. When DHEA levels are inadequate, the corpus luteum may not produce sufficient estradiol to sustain early pregnancy, increasing miscarriage risk. Research from Dr. Boyle's team at NeoFertility Dublin demonstrated that DHEA treatment during pregnancy dramatically improved low estradiol levels (p < 0.0001) and reduced miscarriage incidence from 45.5% to 17.5% (p = 0.038) in women with documented hypoandrogenemia. This research, published in peer-reviewed journals, received the Research Paper of the Year Award from the American Academy of FertilityCare Professionals in 2025.³²⁵¹⁰

A published case report from NeoFertility documented a successful live birth in a 30-year-old woman who had experienced five unexplained pregnancy losses, including a fetal demise at 24 weeks. Standard investigations at a specialized miscarriage clinic had returned normal results and she was advised to conceive again without treatment. NeoFertility identified significant hypoandrogenemia along with clinical endorphin deficiency and poor follicle function. Treatment with DHEA, LDN, and cycle-timed progesterone support resulted in a healthy singleton delivery at 36 weeks.²⁴¹⁰

What Conditions Does NeoFertility Treat?

NeoFertility treats a wide range of reproductive and gynecologic conditions by identifying and treating the underlying cause. The table below describes conditions and the NeoFertility approach. Every treatment plan is individualized based on charting data, diagnostic results, and clinical history. This information is educational, not prescriptive.

Recurrent Miscarriage

NeoFertility reports an 80% live birth success rate for women with recurrent miscarriage. This outcome reflects the multi-factorial diagnostic approach: NeoFertility does not stop at the first identified finding but investigates all potential contributors simultaneously, treating the full picture rather than a single variable.¹⁷

Standard miscarriage investigations often return normal results and offer no treatment. The NeoFertility workup extends to markers that standard panels omit: NK cell activity, food antibodies, DHEA and androgen levels, endorphin deficiency, and follicle quality confirmed by ultrasound. In NeoFertility's experience, the etiology of recurrent miscarriage is rarely a single factor. Multi-factorial diagnoses are the rule, not the exception.¹⁰

Low AMH and Reduced Ovarian Reserve

NeoFertility's approach to low AMH illustrates a fundamental difference from IVF. IVF clinics require multiple eggs per cycle to produce viable embryos. Low AMH means fewer follicles, fewer eggs, and worse IVF outcomes. The standard response is often to decline IVF or recommend donor eggs.¹⁷

NeoFertility requires only one follicle and one egg per cycle, because the goal is natural conception, not laboratory fertilization. This means patients with very low AMH remain candidates for treatment. NeoFertility has reported success in a 36-year-old woman with six years of infertility whose AMH was 0.07 pmol/L and FSH was 42 IU/L, values that would effectively exclude her from most IVF programs. She conceived on her first cycle of NeoFertility treatment.¹⁷

What Are NeoFertility's Success Rates?

NeoFertility has published outcome data across multiple cohorts and case series, primarily from Dr. Boyle's clinic in Dublin, Ireland.

2015 clinic cohort (412 couples):²⁶²⁷

• Female average age: 37
• 21% had previously attempted IVF
• Crude live birth rate: 32%
• Life-table adjusted live birth rate at 24 months: 53.6% (Life Table Analysis accounts for couples who discontinued treatment before completing all cycles; the crude rate was 32%)
• Multiple pregnancy rate: less than 1%
• Preterm delivery rate: 4.2%
• Low birth weight: 5% (under 2,500 g); 1.6% (under 1,500 g)
• Average birth weight: 7 lbs 7 oz

2019 clinic cohort, Boyle et al. (2025), Journal of Restorative Reproductive Medicine:³¹⁶

• 187 couples treated at NeoFertility Dublin
• Crude live birth rate: 41%
• Conception rate: 52%
• Singleton prematurity: 4.0% (compared to 11.8% CDC data for IVF singletons; 14.4% in SART-reported IVF singletons). These are observational comparisons between different patient populations.
• Multiple pregnancy rate: 2.5%
• Average time to conception: 12 months
• "Unexplained infertility" diagnosis: dropped from 24% to 1% after full RRM workup
• Benchmarked against HFEA (UK) IVF data: 24% live birth rate; CDC (USA): comparable metrics

This paper was the first published head-to-head comparison of RRM outcomes alongside IVF data from mandatory national reporting registries.¹⁶

After failed IVF, Boyle et al. (2018), Frontiers in Medicine:⁴

• 403 couples with an average of 2.1 prior IVF attempts
• Life-table live birth rate: 32.1% through natural conception after RRM treatment
• Of 74 live births: 92% born at 37 weeks or later; only 1 twin (1.4%)

These outcomes are achieved through natural conception, meaning without egg retrieval, embryo culture, or transfer. The obstetric safety profile reflects this: singletons conceived naturally do not carry the procedure-associated prematurity and low birth weight risks documented in IVF singleton pregnancies.²⁶

NeoFertility vs. IVF

NeoFertility and IVF answer different questions.

IVF asks: How do we achieve a pregnancy?

NeoFertility asks: Why can't this couple conceive, and what can be treated?

The difference in starting question produces entirely different evaluations, treatments, and long-term outcomes. IVF bypasses the reproductive system. Whether the woman has a luteal phase defect, undiagnosed DHEA deficiency, or elevated NK cell activity does not change the IVF procedure. NeoFertility is built on a different premise: the body's function is the target.

After Failed IVF

NeoFertility is a legitimate path for couples who have already experienced IVF failure. IVF does not typically diagnose the underlying condition. After IVF fails, that condition remains. NeoFertility investigates it.

Boyle et al. (2022) documented a successful natural conception in a couple with 16 years of infertility, three recurrent miscarriages, and eight failed IVF and ICSI embryo transfers. The NeoFertility evaluation identified and treated conditions the IVF pathway had never investigated. A healthy singleton pregnancy followed. Among the broader cohort of 403 couples who had undergone an average of 2.1 prior IVF cycles, NeoFertility achieved a 32.1% live birth rate through natural conception.¹¹⁶⁴

Who is NeoFertility For?

NeoFertility is appropriate for any couple or individual who wants to understand and treat the underlying causes of their reproductive health problems.

• Couples with unexplained infertility who have received no diagnosis after a standard workup
• Couples who have experienced one or more IVF failures and want to know why
• Women or couples with recurrent miscarriage who have been told "all tests are normal"
• Women with low AMH who have been told donor eggs are their only option
• Women with PCOS who want their underlying condition identified and treated
• Women with endometriosis who want the disease addressed, not masked
• Couples where the male partner has abnormal semen parameters and a treatable cause has not been investigated
• Women with suspected immune-mediated infertility or implantation failure
• Women with cycle irregularity, painful periods, or hormonal symptoms that have not been fully investigated
• Couples who prefer natural conception and want to understand what is preventing it

Do I Need to Be Religious?

No. NeoFertility was founded by a physician trained at a Catholic institution, but the clinical protocols are grounded in reproductive physiology. NeoFertility treats patients of all faiths and none, drawing on both scientific evidence and a view of the human person that values working with the body's design. Patients seek NeoFertility because they want cause-directed care and natural conception, not because of institutional affiliation.²⁸

NeoFertility After Recurrent IVF Failure

For couples who have been through multiple failed IVF cycles, NeoFertility offers something the IVF process typically does not: an investigation into why. IVF as practiced in most clinics does not diagnose the underlying condition. It attempts to bypass it. When IVF fails, the condition that prevented natural conception is still present and unaddressed.

NeoFertility begins from the beginning, with a thorough workup including immune markers, androgen panels, and follicle function confirmation that IVF programs typically do not perform. For 32.1% of couples who had already failed an average of 2.1 IVF cycles, that workup led to natural conception after treatment.⁴

How Much Does NeoFertility Cost?

NeoFertility costs substantially less than IVF, and the gap widens significantly when IVF costs are calculated over multiple cycles.

IVF in the United States costs $15,000 to $30,000 per cycle, and most couples need two to three cycles to achieve a live birth, bringing average total spending to $40,000 to $60,000 or more. NeoFertility at the Dublin clinic offers a Standard Treatment Plan at €2,000, with a 100% Refund Treatment Plan available at a higher fee for qualifying patients.²⁸

Because NeoFertility treats diagnosed medical conditions, many components of the workup and treatment can be submitted to standard health insurance using diagnostic and treatment codes: hormonal testing ordered for a documented condition such as PCOS, laparoscopic excision for confirmed endometriosis, progesterone support for luteal phase deficiency. This billing structure differs from IVF, which is typically classified as elective fertility treatment and covered only in states with specific mandates.²⁸

The policy landscape is also shifting. Arkansas became the first U.S. state to mandate insurance coverage for restorative reproductive medicine in 2025, and the RESTORE Act (H.R. 3589) was introduced in Congress to expand access to RRM approaches. NeoFertility patients in the United States stand to benefit directly from these developments.

How to Find a NeoFertility Provider

The first step in NeoFertility care is learning fertility charting. NeoFertility clinicians rely on a detailed, well-charted cycle to time blood tests, evaluate treatment response, and guide each phase of care. Charting before or concurrent with beginning treatment is essential.

Start with ChartNeo

The ChartNeo app is the primary charting tool for NeoFertility patients. It is available on iOS and Android and supports multiple charting methods. A trained NeoFertility Advisor teaches the observations and guides the first few months of charting. Within the ChartNeo app, there is a map of certified advisors and affiliated clinics.²⁰

Find a NeoFertility-Trained Physician

• NeoFertility Clinical Mastery Program: Clinicians trained through this program have completed NeoFertility's formal training curriculum, including CME-eligible modules on diagnostic protocols, immune modifying strategies, and ChartNeo integration.⁷
• FACTS-NeoFertility Medical Consultant Training: A joint training program between FACTS About Fertility and NeoFertility, offered to family clinicians, NPs, and PAs. Covers infertility, recurrent miscarriage, and at-risk pregnancy management using NeoFertility protocols.⁸
• IIRRM Provider Directory: The International Institute for Restorative Reproductive Medicine maintains a broader referral network of RRM-trained clinicians at iirrm.org. When contacting a provider, ask specifically about NeoFertility or NeoFertility Clinical Mastery Program training.¹
• Telehealth: NeoFertility is well-suited to telehealth delivery. Initial consultations, protocol review, and ongoing monitoring can be conducted remotely when combined with local lab work and ultrasound. NeoFertility Dublin has treated international patients through this model.²⁸

Questions to Ask When Choosing a Provider

Before scheduling, ask:

• Have you completed the NeoFertility Clinical Mastery Program or FACTS-NeoFertility Medical Consultant Training?
• Do you use ChartNeo for patient tracking and integration?
• Do you routinely test for NK cells, DHEA, and androgen levels as part of your workup for recurrent miscarriage?
• Do you evaluate both partners from the initial consultation?
• Do you continue hormonal monitoring and support into early pregnancy?
• Do you offer telehealth for ongoing monitoring?

NeoFertility Research and Training

NeoFertility has an active and growing research output, primarily from the Dublin clinic. Key published work includes:

• Boyle et al. (2025), Journal of Restorative Reproductive Medicine: First head-to-head comparison of RRM outcomes versus IVF, 187-couple cohort, 41% crude live birth rate¹⁶
• Boyle, Pandalache, and Turczynski (2024), Frontiers in Medicine: DHEA treatment for hypoandrogenemia in recurrent miscarriage; first peer-reviewed paper on DHEA during pregnancy for reducing miscarriage risk in women with low estradiol²⁴¹⁰
• Boyle et al. (2022), Journal of Medical Case Reports: Successful natural conception after 16 years of infertility and eight failed IVF/ICSI transfers¹⁶
• Boyle et al. (2018), Frontiers in Medicine: Healthy singleton pregnancies through RRM after failed IVF, 403-couple cohort, 32.1% life-table live birth rate⁴

NeoFertility training is available to medical professionals through two primary pathways. The NeoFertility Clinical Mastery Program is a comprehensive online program with 15+ CME credits, covering foundational RRM, diagnostic protocols, immune-modifying strategies, the psychology of conception, and ChartNeo integration. It includes ongoing clinical support through monthly case studies with Dr. Boyle and colleagues, a Clinical Resource Library, and access to the NeoFertility Medical Forum. The FACTS-NeoFertility Medical Consultant Training is a 10-week live online course offered jointly with FACTS About Fertility for clinicians, NPs, and PAs seeking systematic training in NeoFertility protocols, including specific modules on low AMH, male infertility, and at-risk pregnancy management.⁸⁷

Frequently Asked Questions

What is NeoFertility?

NeoFertility is a restorative reproductive medicine approach developed by Dr. Phil Boyle in Dublin, Ireland that diagnoses and treats the underlying causes of infertility and recurrent miscarriage. Rather than bypassing reproductive problems, NeoFertility investigates why the couple is not conceiving and corrects the conditions found, allowing natural conception to occur.²⁸

What makes NeoFertility different from standard fertility treatment?

Standard fertility treatment typically involves suppressing or bypassing reproductive function with medications or IVF. NeoFertility investigates what is causing the problem and treats it. Bloodwork is timed to the individual's cycle, not a calendar date. Both partners are evaluated. Immune markers, androgen levels, and follicle function are assessed. Treatment is matched to the specific findings.⁴²⁸

Does NeoFertility work for women with low AMH?

Yes. Because NeoFertility requires only one follicle per cycle for natural conception, low AMH does not disqualify a patient the way it does for IVF. NeoFertility has reported success in patients with AMH as low as 0.07 pmol/L, values typically considered incompatible with IVF.¹⁷

Can NeoFertility help after failed IVF?

Yes. IVF does not diagnose or treat the underlying condition. After IVF fails, the condition that prevented natural conception is still present. NeoFertility identifies it. In a cohort of 403 couples with an average of 2.1 prior failed IVF cycles, NeoFertility achieved a life-table live birth rate of 32.1% through natural conception.⁴

What is the success rate for NeoFertility?

The 2015 Dublin clinic cohort of 412 couples reported a 32% crude live birth rate and a 53.6% life-table adjusted rate at 24 months, which accounts for couples who discontinued before completing treatment. The 2019 cohort published in Boyle et al. (2025) reported a 41% crude live birth rate. Results depend on age, diagnosis, and individual factors.²⁶¹⁶

Is NeoFertility only available in Ireland?

No. NeoFertility training has expanded internationally through the NeoFertility Clinical Mastery Program and FACTS-NeoFertility Medical Consultant Training, with trained providers practicing in the United States and other countries. Telehealth options extend access further for patients who cannot access a local provider.⁷⁸

Do I have to be a certain religion to use NeoFertility?

No. NeoFertility is evidence-based medicine available to patients of all faiths and none. The approach works because it is grounded in reproductive physiology, not theology.²⁸

What is the ChartNeo app?

ChartNeo is a fertility charting app co-developed by Dr. Phil Boyle that supports multiple charting methods and integrates with NeoFertility clinical care. It allows patients to record daily biomarkers, track medications, log blood test results, and share cycle data directly with their physician and fertility advisor. It is HIPAA-compliant and available on iOS and Android.⁵⁶

What does NeoFertility do differently for recurrent miscarriage?

NeoFertility evaluates a broader set of potential causes than standard miscarriage workups, including NK cells, food antibodies, DHEA and androgen levels, endorphin deficiency, and follicle quality. The etiology is frequently multi-factorial. NeoFertility reports an 80% live birth success rate for women with recurrent miscarriage.⁹¹⁷