What is restorative reproductive medicine (RRM)?
Restorative reproductive medicine (RRM) is a specialized field of medicine that focuses on identifying the underlying health conditions that contribute to reproductive dysfunction and suboptimal reproductive health, treating them to restore the natural functions of the reproductive system. Unlike conventional approaches that use treatments that suppress normal physiology to deal with dysfunction, RRM seeks to work with the body, treating reproductive abnormalities, not by bypassing the body’s processes but by diagnosing, understanding, and addressing underlying health concerns. This approach improves overall wellness and restores reproductive abilities such as fertility.
How does RRM work?
1. Fertility Charting and Tracking
RRM often begins with observing and charting a woman’s menstrual cycle, paying attention to patterns in mucus production, hormone patterns, bleeding, and other cycle characteristics. This tracking reveals different phases and potential abnormalities in the reproductive cycle. The patterns can be interpreted much like an ECG (electrocardiogram) to help identify potential conditions and issues of concern. This information can be used to time investigations to the individuals’ hormonal cycle, and to guide timing of interventions and medications, as well as empower the couple to know optimal times for intercourse. Changes in the cycle tracking act as a form of biofeedback to assess efficacy of treatments.
2. Male Factor
Restorative andrology, is a branch of RRM focusing on the reproductive health concerns of men, recognizing that new research has identified that abnormal semen analysis is not only associated with difficulty getting pregnant but with long term health issues, leading to poorer quality of life and earlier mortality. The goal of RRM treatment for men is the same…identify and treat underlying abnormalities, restoring health and improving reproductive function and fertility.
3. Diagnosis and Testing
RRM practitioners conduct specific medical tests, like ultrasounds and blood tests, to confirm observations in the cycle charting. Screening for conditions like polycystic ovarian syndrome (PCOS), thyroid dysfunction, and endometriosis is common to identify underlying health concerns that may impact fertility. We also manage restorative andrology and work with male-factor infertility and reproductive health, identifying and optimizing the health of the male whether the goal is improved health, wellness or family.
4. Personalized Treatment Plans
RRM uses a multi-factorial and often multi-disciplinary approach. Treatment plans are tailored to the individual or couple, aiming to restore normal hormonal functions and correct any abnormalities found. Treatments for example may include personalized hormone therapies, ovulation induction, luteal phase normalization, other medications, supplements, surgery and lifestyle adjustments. RRM team members may include cycle charting educators, nurses, navigators, dietician and nutritional experts, activity, sleep, lifestyle coaches and others.
5. Conditions RRM treats
RRM does not just address infertility, recurrent miscarriage and pregnancy; it can also help manage and improve various reproductive and gynaecological conditions including:
- Infertility (in men, women, or both)
- Recurrent miscarriage
- Ovarian cysts and endometriosis
- Polycystic ovary syndrome (PCOS)
- Irregular cycles
- Hormone imbalances (in both men and women)
- Premenstrual dysphoric disorder (PMDD)
- Heavy Menstrual Bleeding (Menorrhagia) / Painful Periods (Dysmenorrhea)
- Postpartum depression
- Low ovarian reserve and low AMH
- Premature birth risk/preterm birth
- Chronic fatigue
- Hormonal Imbalances
- Adolescent and postmenopausal health
- Perimenopause and menopause
- and more...
Frequently Asked Questions
"What is the International Institute for Restorative Reproductive Medicine (IIRRM)? "
The IIRRM is the professional society representing RRM health professionals and allied health team members. It promotes excellence in evidence-based restorative reproductive medicine, setting the standards for the profession. It has active research and educational activities to accomplish these objectives. It is a Charitable Incorporated Organisation (CIO), based out of London, England with members and affiliated organizations throughout the world. It has achieved recognised status as an Institute in the UK which is a protected term used only for organisations that “undertake research at the highest level, or are professional bodies of the highest standing”.
" What is restorative reproductive medicine? "
Restorative reproductive medicine is a specialized field of medicine which diagnoses and treats underlying health conditions contributing to reproductive dysfunction and suboptimal reproductive health, addressing factors critical to improving wellness and fertility. RRM seeks to cooperate with and restore the normal physiology and anatomy of the human reproductive system. It does not employ methods that are inherently suppressive, circumventive or destructive. This approach respects the integrity of the human person and the right of women and men to have access to reproductive health care that respects their right to understand and cooperatively manage their own fertility, with appropriate medical assistance.
" What is restorative reproductive health? "
Sometimes RRM is only thought of in terms of medical conditions, but it also supports and promotes restorative reproductive health which includes empowering women and men to know and understand their bodies and appreciate the importance of natural reproductive health to overall health and well-being, often through the use of body literacy programs that incorporate science based charting methods and teacher lead reproductive health education. RRM comprises many different methods. Some better known methods include medical interventions based on the Billings Ovulation Method, Naprotechnology (based on the Creighton Method), NeoFertility, Marquette and FEMM. There are several others, including a number of symptothermal or sympto-hormonal based approaches, but they all share a common goal of using biomarker information from a cycle chart and working to optimize normal function. There are also surgical methods that exclusively adhere to this restorative approach, such as surgical Naprotechnology.
" Does RRM use artificial insemination? "
No. RRM exclusively supports and optimizes natural reproductive function, so that pregnancy can result from natural sexual intercourse. Artificial insemination is an example of a technique that seeks to bypass the underlying problem.
"What is the difference between using RRM for infertility and using Assisted Reproductive Technology (ART), including In-Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)?"
There is a fundamental difference in approach. RRM identifies what is not working and fixes it, so that conception and pregnancy can occur naturally in vivo [in the body]. ART and related approaches bypass the problem and make a baby in vitro [outside the body]. Many of the issues (cost, side effects, ethical concerns) raised by ART are not a problem with RRM. Restorative reproductive medicine would also provide treatment post pregnancy or if no pregnancy occurred aimed at normalizing reproductive function and minimizing long term health issues that often occur in medical conditions that have the side-effect of causing fertility problems. The goal in RRM is improved health, which leads to ability to conceive naturally.
"Can RRM methods help with male factor infertility? "
Yes. Men with very low sperm counts or anti-sperm antibodies can be treated. Often, improvements in semen quality can be made by healthy lifestyle changes. A number of medical and surgical treatments can also improve semen quality and sperm function. Even if the sperm function is not ideal, evaluating and maximizing the woman’s fertility cycle, together with ideal timing of intercourse will often result in pregnancy.
"Does RRM treat couples? "
When treating for infertility or miscarriage the RRM physician treats the committed couple, the male and the female, as a single unit. This process requires significant collaboration and communication between the two and their treatment team. It is often successful in addressing underlying reproductive health issues. The team approach supports relationships that often become strained when dealing with the stress associated with infertility or miscarriage.
" What problems can RRM help with? "
The entire range of reproductive health can be addressed through a restorative reproductive lens. This includes infertility (male and female), miscarriage, polycystic ovarian syndrome, premature birth, ovarian cysts, premenstrual syndrome, postpartum depression, irregular cycles, pre and post-menopausal symptoms, irregular vaginal bleeding, family planning, endometriosis, and more!
How to find a doctor trained in restorative reproductive medicine?
IIRRM's team can help match you with a qualified RRM clinician, practitioner, or clinic based on your location, preferences, and care needs. Virtual and in-person consultations may be available depending on your region. Please visit: https://iirrm.org/rrm-referral-request/.
In a 24-hour Global Summit for RRM, expert physicians from IIRRM, IRRMA and AIRRM, introduce what restorative reproductive medicine (RRM) is and how this new approach to reproductive healthcare can be used to treat infertility and prevent miscarriage, as well as to treat conditions such as PMS, PMDD and PCOS. RRM restores hope, restores health and heals patients.