Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study

Abstract

Background Restorative reproductive medicine (RRM) seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. Many components of RRM are highly suitable for primary care practice. We studied the outcomes amongst couples who received restorative reproductive medicine treatment for infertility in a primary care setting. Methods Two family physicians in Massachusetts trained in a systematic approach to RRM (natural procreative technology, or NaProTechnology) treated couples with infertility. We retrospectively reviewed the characteristics, diagnoses, treatments, and outcomes for all couples treated during the years 1989 to 2014. We compared pregnancy and live birth by clinical characteristics using Kaplan-Meier analysis. We employed the Fleming-Harrington weighted Renyi test or the logrank test to compare the cumulative proportion with pregnancy or with live birth. Results Among 370 couples beginning treatment for infertility, the mean age was 34.8 years, the mean prior time trying to conceive was 2.7 years, and 27% had a prior live birth. The mean number of diagnoses per couple was 4.9. Treatment components included fertility tracking with the Creighton Model FertilityCare System (80%); medications to enhance cervical mucus production (81%), to stimulate ovulation (62%), or to support the luteal phase (75%); and referral to female laparoscopy by a surgeon specializing in endometriosis (46%). The cumulative live birth rate at 2 years was 29% overall; this was significantly higher for women under age 35 (34%), and for women with body mass index < 25 (40%). There were 2 sets of twins and no higher-order multiple gestations. Of the 63 births with data available, 58 (92%) occurred at term. Conclusions Family physicians can provide a RRM approach for infertility to identify underlying causes and promote healthy term live births. Younger women and women with body mass index < 25 are more likely to have a live birth.

Fertility Awareness-Based Methods for Family Planning and Women’s Health: Impact of an Online Elective

“…In addition, we integrated live case studies facilitated by leading experts in the field of restorative reproductive medicine (RRM), which seeks to identify and correct underlying causes and factors contributing to infertility and reproductive dysfunction. 4,24 To further enhance the students' clinical experiences, we coordinated online clinical observations with fertility educators and telemedicine visits with clinicians trained in FABMs.…”

A termékenységtudatosságon alapuló módszerek lehetőségei a családtervezésben

“…A reprodukció helyreállításában képzett klini kusok számára eszközként is szolgálhatnak a meddőség vagy a habituális vetélés több alapvető okának feltárá sához és kezeléséhez [8,13]. Számos tanulmány doku mentálja a termékenységtudatossági módszerek alkalma zásának eredményeit a meddőség kezelésére, akár orvosi beavatkozással, akár anélkül [8,22,[48][49][50][51]. A tanulmá nyok részletes elemzése vagy kritikus áttekintése meg haladja e cikk kereteit, tekintettel a folyóirat multidisz ciplináris jellegére.…”

Restorative Reproductive Medicine: An Emerging New Treatment Process and a Prerequisite to Assisted Reproductive Technology for Treatment of Infertility.

“…When these chronic issues are identified and treated, fertility can return without the need for more invasive assisted reproductive technology (ART). The process of RRM treats infertility as a chronic illness requiring multiple and sustained interventions over time [2,3]. Restorative treatments are guided with the help of "specialised cycle tracking of fertility biomarkers" such as bleeding, cervical mucus, and basal body temperature [4].…”