In “How to Make American Babies Again” (op-ed, April 30), Leonard Lopoo promotes a costly, one-size-fits-all solution to declining birth rates (in vitro fertilization) while ignoring a deeper question: Why are so many couples struggling with infertility in the first place?

Infertility isn’t a standalone disease—it is a symptom of other underlying reproductive health diseases. One in six couples struggles to conceive or carry to term, and in most cases, this stems from four or more reproductive health conditions, such as endometriosis, PCOS or male-factor infertility.

IVF bypasses these issues without healing them. The treatment can cost between $12,000 and $30,000 per cycle and has a higher rate of costly compilations. On average, it requires 2½ cycles before a couple achieves a live birth, if at all, with an overall failure rate of 76% according to 2021 data.

Instead of pushing IVF mandates, we should invest in restorative reproductive medicine (RRM): a scientific approach that identifies, diagnoses and treats the root causes of infertility to restore reproductive health. RRM can decrease miscarriage rates, balance hormone levels and optimize a woman’s body to support a child in utero. It is holistic care that considers the whole person: her reproductive health conditions, partner, metabolic and hormonal health, environmental exposures and long-term family planning goals.

As we have seen with patients, RRM succeeds even after IVF has failed, at a fraction of the cost, especially across multiple pregnancies. One study published in 2024 found that 40% of couples previously diagnosed with infertility conceived naturally after undergoing RRM-based treatments compared with a 24% success rate with IVF. Another 2018 study found that 32.1% of women who had an average of two failed IVF cycles conceived naturally following targeted medical interventions with RRM.

Such treatments may improve the overall birth rate by enabling couples to naturally have as many children as they want without relying on the costly process of IVF each time. The real choice isn’t coverage mandates or baby bonuses—it’s whether we continue to bypass infertility or invest in treatments that heal the underlying conditions in women and men.