In my policy work, and in my efforts to help the Church think biblically about infertility, I often speak with couples struggling to conceive. Many are not comfortable pursuing IVF, whether for reasons of conscience or cost, but they feel trapped, as if declining IVF means giving up on having children altogether. When I ask whether they have worked with a doctor trained in restorative reproductive medicine (RRM), through approaches such as NaProTechnology, NeoFertility, or FEMM, the answer is usually some version of “our OB-GYN is Catholic” or “we met with a holistic medicine doctor.”

In short, no. That answer captures a national problem: Infertility diagnoses almost always have a findable, treatable cause, yet most fertility clinics move American couples into IVF before they are sufficiently treated.

Indeed, while a pro-life OB-GYN or an integrative practitioner may share a couple’s values or improve their overall health, neither is trained in the specific RRM protocols that diagnose and treat infertility. Nor is RRM merely diet and lifestyle changes, as some assume. This confusion is widespread, from The New York Times to evangelical Christians, and it leaves many couples believing their only real options are IVF or prayer alone.

The fertility industry only adds to the confusion. Groups such as the American Society for Reproductive Medicine (ASRM) have dismissed restorative medicine as mere ideology while also insisting that standard fertility clinics already provide the same thorough diagnostic care before recommending IVF. Either root cause care is fake medicine, they say, or clinics already provide it. Both cannot be true. A study published in early July suggests that neither claim reflects the care couples actually receive.

The study, published in the Journal of Restorative Reproductive Medicine, drew on a national claims database covering roughly five million commercially insured patients. Researchers identified men and women who were diagnosed with infertility and went on to pursue IVF, then asked whether those patients had first received the evaluations and treatments that ASRM recommends. The benchmark, in other words, was not restorative medicine’s standard but the industry’s own.

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The findings were sobering. Within nine months of diagnosis, 70% to 85% of patients had begun IVF, while adherence to many recommended evaluations and treatments remained below 40 percent, and several below 15. The gaps were widest for men. Fewer than 8 percent had completed the two semen analyses that form the foundation of a male evaluation, and among couples suffering recurrent pregnancy loss, just 3 percent of male partners received the recommended DNA fragmentation testing. Women fared little better: Only a third of women with polycystic ovary syndrome received the first-line drug therapy, and barely one in ten with symptoms suggesting endometriosis received the laparoscopy needed to diagnose it.

It would be one thing if these underlying conditions were incidental to the diagnosis of infertility, but this couldn’t be further from the truth. Infertility is not a standalone disease but a symptom of underlying conditions in the woman and/or man’s body, such as endometriosis, Polyendocrine Metabolic Ovarian Syndrome (PMOS), thyroid dysfunction, hormonal imbalances, low sperm count, low sperm motility, or varicoceles.

IVF, by contrast, bypasses the bodies of the man and woman. Eggs and sperm are retrieved and fertilized in a lab to create human embryos; each embryo is then graded, and in roughly 40 percent of cases eugenically tested for the sex, health, or predicted traits of the child, before transfer into the woman’s body. All of this happens whether anyone ever learns why the couple could not conceive. Given how often full diagnostic workups fail to happen, it is little wonder that up to 30 percent of infertility cases are labeled “unexplained.”

Restorative reproductive medicine follows a completely different trajectory. A doctor trained in NaProTechnology, NeoFertility, or FEMM begins with a thorough evaluation of both partners, including diagnostic cycle charting, hormone panels, ultrasounds, semen analyses, and, where needed, exploratory surgeries. From there, the doctor treats those conditions directly, removing the barriers to natural conception, whether it’s medication to restore ovulation, progesterone to sustain pregnancy, the correction of a thyroid disorder, or surgery for endometriosis or varicocele. By treating root causes, restorative care can improve egg and sperm quality, reduce the risk of miscarriage, and leave husband and wife healthier regardless of whether a child ever comes.

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On the whole, such root cause care costs a fraction of a single IVF cycle, has success rates that rival IVF in published studies, and frees couples to conceive multiple times without having to restart a costly and invasive procedure.

Many Americans want this kind of care, and lawmakers are starting to notice, too. After President Trump initially campaigned on enacting an “IVF mandate,” the administration adjusted course to create an optional “excepted fertility benefit.” Put simply, it is a new category of standalone insurance coverage that employers may choose to offer, built around IVF, restorative care, or both. Before a rule like this takes effect, federal law requires the government to invite written feedback from the public, in the form of a public comment period that I wrote about for WORLD Opinions. Most comment periods attract fewer than 10 submissions. This one drew more than 4,600, and initial analyses found that 62 to 75 percent explicitly called for restorative reproductive medicine or root cause care in the diagnosis and treatment of infertility.

Rising public awareness of root cause care points toward a future where couples who are struggling with infertility can receive treatments that are truly innovative, life-affirming, and restorative. The problem isn’t a lack of faith in the goodness of God, but a lack of information about what options Christians may steward that honors their bodies and life from the moment of conception.