ASRM Letter to the International Institute for Restorative Reproductive Medicine (IIRRM)
September 10, 2025
Dr. Phil Boyle, President, and Colleagues
International Institute for Restorative Reproductive Medicine (IIRRM)
1 Sansome Street, Suite 3500
San Francisco, CA 94104
Dear Drs. Boyle, Stanford, Parnell, Carpentier, Arraztoa, Horodenchuk, and McCarthy,
Thank you for your recent communication and statement regarding Restorative Reproductive Medicine (“RRM”). The American Society for Reproductive Medicine (ASRM) shares your commitment to improving reproductive health outcomes and welcomes respectful dialogue grounded in clinical evidence and patient-centered care.
We recognize the dedication of physicians who focus their practice on “RRM,” and your commitment to expanding knowledge of the underlying causes of infertility. Reproductive endocrinology and infertility specialists (REIs) share this passion: a significant proportion of their seven years of subspeciality training, including three years of fellowship, is devoted to investigating these etiologies. We also acknowledge that some patients find value in working with “RRM practitioners,” and that collaborative research has enhanced understanding of fertilityawareness-based methods.
Our concern lies not in the medical concepts themselves but in labeling “RRM” as distinct from standard reproductive endocrinology. REIs routinely educate on, diagnose, and treat hormonal disorders, menstrual dysfunction, endometriosis, male factor infertility, and other reproductive conditions, often correcting underlying dysfunctions to enable a healthy pregnancy. At the same time, we recognize that assisted reproductive technologies (ART), including in vitro fertilization (IVF), may be necessary – and our training equips us to provide the full spectrum of care.
We are particularly concerned that “RRM” is increasingly promoted in political, religious, and legislative arenas in ways that threaten access to IVF and other evidence-based treatments. Despite your assertion to the contrary, there is ample evidence that proponents of “RRM” in the U.S. policy environment are working to elevate these preliminary treatments as the preferred fertility treatment while restricting access to IVF, contraceptive care, and fertility preservation.
Patients deserve complete, unbiased information about all medically appropriate pathways to parenthood. That includes evidence-based approaches that align with “RRM” when appropriate and assisted reproductive technologies, such as IVF, which has decades of clinical success and remains the standard of care for treatment of many causes of infertility. Positioning non-assisted methods as a universal first-line treatment risks harmful delays for patients with diminished ovarian reserve, tubal factor infertility, severe male factor infertility, or other diagnoses where IVF is the standard of care.
While you cite studies comparing cycle tracking and fertility awareness-based methods to IVF, the research lacks the scope, standardization, and independent validation necessary to claim equivalency. There is no question that the likelihood of live birth is highest when IVF is employed in most situations. The American Society for Reproductive Medicine is committed to rigorous scientific inquiry, and we would welcome high-quality, peer-reviewed studies that meet established standards.
We issued recent statements not to dismiss the underlying practices being labeled “RRM,” but to ensure that patients receive accurate information about the relative efficacy, defined by the likelihood that a treatment will lead to having a baby, cost, and accessibility of treatments. We agree that infertility often reflects broader health issues, and we support comprehensive evaluation and treatment of underlying conditions as standard evaluation and initial practice. However, we will continue to oppose any policy that limits IVF access or prioritizes one philosophy of care at the expense of patient autonomy.
ASRM is a global multidisciplinary organization dedicated to “leading the advancement of reproductive medicine through evidence-based ethical practice, education, research, and advocacy.” We appreciate your outreach, have reviewed your materials, and invite you to join our society to contribute to education and research across the full spectrum of reproductive care. We remain open to dialogue and collaboration that places patient wellbeing, scientific integrity, and reproductive freedom at the center of care.
Sincerely,
Jared Robins, MD, MBA
CEO
Elizabeth Ginsburg, MD
President
Dr. Phil Boyle, President, and Colleagues
International Institute for Restorative Reproductive Medicine (IIRRM)
1 Sansome Street, Suite 3500
San Francisco, CA 94104
Dear Drs. Boyle, Stanford, Parnell, Carpentier, Arraztoa, Horodenchuk, and McCarthy,
Thank you for your recent communication and statement regarding Restorative Reproductive Medicine (“RRM”). The American Society for Reproductive Medicine (ASRM) shares your commitment to improving reproductive health outcomes and welcomes respectful dialogue grounded in clinical evidence and patient-centered care.
We recognize the dedication of physicians who focus their practice on “RRM,” and your commitment to expanding knowledge of the underlying causes of infertility. Reproductive endocrinology and infertility specialists (REIs) share this passion: a significant proportion of their seven years of subspeciality training, including three years of fellowship, is devoted to investigating these etiologies. We also acknowledge that some patients find value in working with “RRM practitioners,” and that collaborative research has enhanced understanding of fertilityawareness-based methods.
Our concern lies not in the medical concepts themselves but in labeling “RRM” as distinct from standard reproductive endocrinology. REIs routinely educate on, diagnose, and treat hormonal disorders, menstrual dysfunction, endometriosis, male factor infertility, and other reproductive conditions, often correcting underlying dysfunctions to enable a healthy pregnancy. At the same time, we recognize that assisted reproductive technologies (ART), including in vitro fertilization (IVF), may be necessary – and our training equips us to provide the full spectrum of care.
We are particularly concerned that “RRM” is increasingly promoted in political, religious, and legislative arenas in ways that threaten access to IVF and other evidence-based treatments. Despite your assertion to the contrary, there is ample evidence that proponents of “RRM” in the U.S. policy environment are working to elevate these preliminary treatments as the preferred fertility treatment while restricting access to IVF, contraceptive care, and fertility preservation.
Patients deserve complete, unbiased information about all medically appropriate pathways to parenthood. That includes evidence-based approaches that align with “RRM” when appropriate and assisted reproductive technologies, such as IVF, which has decades of clinical success and remains the standard of care for treatment of many causes of infertility. Positioning non-assisted methods as a universal first-line treatment risks harmful delays for patients with diminished ovarian reserve, tubal factor infertility, severe male factor infertility, or other diagnoses where IVF is the standard of care.
While you cite studies comparing cycle tracking and fertility awareness-based methods to IVF, the research lacks the scope, standardization, and independent validation necessary to claim equivalency. There is no question that the likelihood of live birth is highest when IVF is employed in most situations. The American Society for Reproductive Medicine is committed to rigorous scientific inquiry, and we would welcome high-quality, peer-reviewed studies that meet established standards.
We issued recent statements not to dismiss the underlying practices being labeled “RRM,” but to ensure that patients receive accurate information about the relative efficacy, defined by the likelihood that a treatment will lead to having a baby, cost, and accessibility of treatments. We agree that infertility often reflects broader health issues, and we support comprehensive evaluation and treatment of underlying conditions as standard evaluation and initial practice. However, we will continue to oppose any policy that limits IVF access or prioritizes one philosophy of care at the expense of patient autonomy.
ASRM is a global multidisciplinary organization dedicated to “leading the advancement of reproductive medicine through evidence-based ethical practice, education, research, and advocacy.” We appreciate your outreach, have reviewed your materials, and invite you to join our society to contribute to education and research across the full spectrum of reproductive care. We remain open to dialogue and collaboration that places patient wellbeing, scientific integrity, and reproductive freedom at the center of care.
Sincerely,
Jared Robins, MD, MBA
CEO
Elizabeth Ginsburg, MD
President
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