4,652 Americans just told federal regulators what kind of fertility care they actually want — and the answer caught Washington by surprise.
When the Department of Health and Human Services opened public comment on a proposed fertility benefit rule in May, nearly 5,000 people responded by the July 13 deadline. For context, 80 percent of federal rules draw 10 or fewer comments.
What they said was even more striking: 62 percent called for root-cause restorative reproductive medicine — not just IVF — to be covered and promoted in the final rule.
The proposal grew out of President Trump’s executive order on expanding access to IVF. But as the comment period unfolded, thousands of women shared stories of how restorative approaches — treating underlying conditions rather than bypassing the body — gave them answers traditional fertility clinics never offered.
“We believe that one is too many.”
One woman who miscarried was told by her OBGYN that standard care meant waiting until she miscarried three or more times before running tests. A friend referred her to a restorative reproductive medicine clinic, where detailed labs revealed hormone imbalances preventing healthy pregnancy. After treatment, her PCOS symptoms improved and she conceived naturally.
Another woman miscarried 16 days after telling her parents she was pregnant. Her OBGYN called it random. When she conceived again, she called an RRM clinic, unsure they would take her after only one loss. The clinic’s response: “We believe that one is too many.”
They monitored her pregnancy and supported her hormones when needed. She submitted her comment with her three-month-old daughter asleep in her arms.
A 31-year-old Ohio woman described spending over $3,000 out of pocket across 16 months on bloodwork and functional testing — spacing the tests out because she couldn’t afford them all at once. They revealed iron overload, poor stomach acid, mineral imbalances, and suboptimal thyroid function. None of it was caught by standard care.
The current insurance model isn’t built to cover these detailed, time-intensive approaches. Standard fertility care operates on the 15-minute appointment model. Root-cause medicine doesn’t.
Public surveys back up what the comment docket showed. A March 2026 survey by Carrot found 89 percent of women would prefer to try a less invasive option before IVF if it came with clinical guidance. Interest in metabolic health support topped every option at 85 percent — yet only 44 percent had ever had a single clinical conversation about metabolic health during their fertility journey.
A 2025 J.L. Partners poll found 79 percent of Americans want precision medicine that identifies and treats the root causes of infertility.
Restorative reproductive medicine treats infertility as a symptom, not a stand-alone disease. The approach asks: what underlying conditions are causing this, and how do we treat them?
In women, those conditions may include endometriosis, low progesterone, polyendocrine metabolic ovarian syndrome, or lifestyle factors. In men, common causes include low sperm count, motility issues, testosterone levels, and metabolic health problems.
RRM improves overall health for both partners, improves egg and sperm quality, reduces pregnancy and birth risks, reduces miscarriage rates, and enables couples to conceive naturally.
IVF bypasses the body to create embryos. It increases adverse health outcomes for mother and baby, leaves underlying conditions untreated, and has contributed to an estimated 1.5 million human embryos now frozen in the United States.
Madeleine Kearns, writing about her own NaProTechnology journey in The Free Press, described how surgery eliminated the chronic pelvic pain and agonizing periods she’d struggled with her entire adult life. Months later, she was pregnant. Her daughter turns 1 this week. She’s now 15 weeks pregnant with her second child.
The comment period has closed. The rule takes effect January 1, 2027. The requests before HHS regulators are clear: define infertility as a symptom of underlying conditions, name root-cause restorative care explicitly in the rule, ensure patients and employers understand all benefit options, and educate the public on fertility awareness-based methods and restorative reproductive medicine.
Nearly 5,000 Americans spoke. The question is whether Washington will listen.
