I sent the comments below for consideration on a Federal rule attempting to clarify the definition of infertility as it relates to coverage for federal fertility benefits…and I also wanted to send it to YOU!

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My experience has taught me that infertility is often not the primary problem—it is a symptom of underlying disease. Fertility care should not begin by asking only, “How can we achieve pregnancy?” It should first ask, “Why isn’t the body functioning as it was designed?” That question changed the course of my life.

I entered conventional fertility medicine because I was told reproductive endocrinologists were the specialists who treated endometriosis and other complex reproductive disorders. I entered that system seeking treatment for disease, not reproductive technology.

Instead, over nearly five years, the focus of my care gradually shifted away from investigating my health and toward assisted reproductive technology. In my experience, artificial reproductive technology was not an investigative medical approach. Rather than diagnosing and treating the conditions affecting my reproductive health, my care largely centered on overriding my body’s infertility without identifying its cause. After confirming that my fallopian tubes were open, there was very little investigation into my ongoing women’s health concerns.

During those years, my symptoms worsened after hormonal birth control was discontinued, and I developed increasingly frequent ovarian cysts. I was repeatedly told they were simply a normal part of women’s cycles. My underlying hormone deficiencies, including low progesterone, went undiagnosed and untreated. As a result, I did not receive progesterone support during my first pregnancy, which later became high risk. My endometriosis, autoimmune disease, and other chronic health concerns also went largely unrecognized. Although I entered that system seeking treatment for disease, I left without understanding the root causes of my illness.

After my husband’s fertility evaluation, we were told by an IVF clinic that it would take a miracle for us to have a baby based on his test results alone. In the same conversation, we were encouraged to begin assisted reproductive technology with a payment plan. We spent more than a year trying to conceive naturally. Despite seeing multiple physicians, we were never offered meaningful treatment for my health or our shared fertility—only IUI as a workaround to our unexplained infertility. Throughout those years, the only solutions presented to us were procedures designed to produce a pregnancy. No one offered an explanation for why we were infertile or a plan to restore our health.

Everything changed when we found physicians practicing Restorative Reproductive Medicine.

For the first time, someone asked why.

Through careful cycle charting, hormone evaluation, and surgery, they diagnosed significant endometriosis that had gone unrecognized despite years of symptoms and a previous surgery. They identified my low progesterone, treated it with cycle-specific supplementation, and my recurrent ovarian cysts resolved. Because they had identified my risk factors, they proactively supported my cycles and hormone needs to reduce my risk of miscarriage rather than waiting until I had experienced the loss of a pregnancy. They also treated my thyroid disease, autoimmune disease, and other chronic conditions as interconnected aspects of my health rather than isolated problems.

After receiving teaching about charting and treatment through Restorative Reproductive Medicine, we conceived our second child completely naturally. We are now pursuing another pregnancy with a much clearer understanding of my health, my diagnoses, and the factors affecting my fertility. Whether or not we conceive again, RRM has fundamentally improved my health because it continues to identify and treat the diseases affecting my body.

That is why I believe Restorative Reproductive Medicine should be recognized as distinct within federal fertility benefits. I entered the fertility system seeking healthcare for disease. What I largely found were procedures designed to override infertility rather than investigate it. Restorative Reproductive Medicine finally provided the medical care I had been searching for.

RRM is not simply another approach to helping people have babies. It is restorative medicine. It investigates and treats the underlying causes of female and male infertility while also caring for patients throughout adolescence, infertility, pregnancy, recurrent pregnancy loss, menopause, and other reproductive health conditions. By restoring health rather than bypassing disease, its benefits extend far beyond achieving pregnancy.

Current benefit structures often fail to distinguish between medical care that restores health and procedures that bypass underlying disease. Those are fundamentally different goals. For women with endometriosis, ovarian stimulation may increase symptoms because it does not treat the underlying disease. When restoring health is not the priority, opportunities to diagnose disease, prevent complications, and improve long-term health can be missed. Benefits that support diagnosing and treating disease provide lifelong health benefits that extend far beyond fertility alone.

Unfortunately, physicians trained in Restorative Reproductive Medicine are extraordinarily difficult to find, and many do not accept insurance because this model of care has not been adequately recognized within existing benefit structures. My own treatment has required significant travel and substantial out-of-pocket expense simply to receive comprehensive medical care. Expanding insurance coverage would remove one of the greatest barriers preventing women and men from receiving effective treatment for chronic reproductive disease. The shortage of physicians trained in Restorative Reproductive Medicine is so significant that I personally support a nonprofit organization dedicated to training and equipping physicians and nurses in this model of care. That shortage itself illustrates how urgently this field needs broader recognition and support.

I respectfully encourage the Departments of Treasury, Labor, and Health and Human Services to explicitly recognize Restorative Reproductive Medicine in the final rule. Patients deserve access to healthcare that investigates disease, restores normal function whenever possible, and improves lifelong health—not simply healthcare that helps them overcome infertility.

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If you are reading this and realizing that you haven’t received proper medical care, please check out my page to find out more about how RRM and learning about your health and fertility can actually help you to heal. Your best health is your best fertility. Even if you don’t have a baby, you have better health and that is a gift at any age!