Rates of infertility continue to rise, with one in six American couples struggling to have children. For years, they have brought their questions to a system built to manage symptoms, not truly diagnose and treat the underlying causes. This year, for the first time, the federal government asked them a question instead: What kind of care do you want? Nearly 5,000 Americans answered.
In May, the Departments of Health and Human Services, Labor, and the Treasury proposed an “excepted fertility benefit”: an optional, fully customizable benefit that employers could offer alongside a major medical plan, much the way dental and vision coverage works today. The proposal grew out of President Trump’s executive order on expanding access to IVF, but as calls for root-cause restorative care grew louder, the rule’s scope grew with them. As proposed, covered services must be for the “diagnosis, mitigation, or treatment of infertility or infertility-related reproductive health conditions,” many of them written into the text of the rule itself.
When the comment period closed on July 13, the docket held 4,652 comments. For context, about 80 percent of federal proposed rules draw 10 or fewer. By two preliminary AI-assisted counts, at least 62 percent called for greater access to root-cause care, including fertility awareness-based methods, body literacy, treatment of underlying reproductive health conditions, and asked that restorative reproductive medicine (RRM) be named and promoted in the final rule.
The Personal Stories Within Each Comment
What is so striking, however, is that these thousands of comments did not merely call for restorative reproductive medicine. They were also filled with personal stories from patients about how this approach enabled them to heal their bodies, conceive naturally, and live healthier, fuller lives than they would have relying on traditional IVF protocols.
One woman struggling with miscarriages was told by her OBGYN that standard care meant they would not run tests until she miscarried three or more times. (Notably, the American Society for Reproductive Medicine, following this comment period, updated their recommended guidance on this point.) It was only when a friend referred her to an RRM clinic did doctors run detailed labs and found several hormone levels preventing her body from sustaining a healthy pregnancy. After a few cycles of medication and supplements, her levels stabilized, her PMOS (formerly PCOS) symptoms improved, and she conceived a healthy baby.
Another woman shared how she miscarried 16 days after telling her parents she was pregnant. While her OBGYN assured her that it was a one-in-four random occurrence, she wasn’t convinced. When she conceived a second time, she called an RRM clinic, unsure they would even take her since one loss wasn’t the “pattern” a traditional clinic would have required. “We believe that one is too many,” the RRM clinic told her. They monitored her pregnancy and supported her hormones when her body needed it. She wrote her comment, she said, with her three-month-old daughter asleep in her arms.
Sadly, the current health insurance system model is not built to cover the costs of these detailed and time-intensive approaches to treating infertility, which go far beyond the typical “15-minute appointment” model. A 31-year-old woman in Ohio described the cost of finding answers on her own. A NaProTechnology diagnosis of ovulatory dysfunction helped her conceive her first child after two years of trying; the medications her OBGYN prescribed afterward did nothing. Hoping for more children, she has spent over $3,000 out of pocket across 16 months on bloodwork and functional testing, spacing the tests out because she cannot afford them all at once. They revealed iron overload driving inflammation, poor stomach acid impairing absorption, mineral imbalances, and a suboptimal thyroid, none of it caught by standard care. “Paying for root-cause solutions,” she wrote, “is the only hope we have remaining to grow our family.”
Recent Surveys Said the Same Thing
Comments like these, and thousands more, are why public comment periods matter: they are a rare opportunity when ordinary citizens, not lobbyists and special interest groups, speak directly to federal regulators.
As 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, and 78 percent said better information alone would make them more likely to pursue non-IVF options. Interest in metabolic health support topped every option surveyed at 85 percent, and yet only 44 percent had ever had a single clinical conversation about metabolic health in their entire fertility journey.
A 2025 J.L. Partners poll found the same thing: 79 percent of Americans want precision medicine that identifies and treats the root causes of infertility, and 89 percent said couples should be able to tailor treatment to their individual health.
The medical approaches within RRM, such as Natural Procreative Technology, FEMM, and NeoFertility, have been around for decades; the political movement behind them is much newer.
What has made it catch on so quickly is its premise: infertility is not a stand-alone disease but a symptom of underlying conditions, and treatment means asking what those conditions are and not stopping until there are treatable answers. In women, these conditions may include endometriosis, low progesterone, polyendocrine metabolic ovarian syndrome (PMOS), or lifestyle factors. For men, common conditions include low sperm count, motility, or quality, testosterone levels, metabolic health, and much more.
RRM is the only approach that improves the overall health of both the man and the woman, improves egg and sperm quality, reduces pregnancy and birth risks, reduces miscarriage, and enables couples to bear children naturally.
IVF, by contrast, bypasses the body to create human embryos. In the process, it increases adverse health outcomes for mother and baby, leaves the couple’s underlying health untreated, and has contributed to an estimated 1.5 million human embryos now frozen in the United States alone.
Madeleine Kearns, writing about her own NaProTechnology journey in The Free Press, shared, “When I sought out RRM, I wanted my body to be as healthy as possible. After my surgery, I found that the chronic pelvic pain I’d struggled with my entire adult life, and the agonizing periods, were gone. And a couple of months later, I found out I was pregnant with my daughter, who turns 1 this week. As of now, I am 15 weeks pregnant with her baby sibling.”
The comment period has closed, and the rule is set to take effect on Jan. 1, 2027. As the departments draft the final language, the requests before them are clear: define infertility as a symptom of underlying conditions, name and explain root-cause restorative care explicitly in the rule, ensure patients and employers fully understand the benefit options before them, and educate the public on fertility awareness-based methods, body literacy, and restorative reproductive medicine. Regulators, you can take it from here.
