By: Shannon Leach, ARNP
“The only way you will ever get pregnant is through IVF (in vitro fertilization).” That is what I was told twelve years ago when my husband and I decided we wanted to grow our family, even though I had not had a period for years. I first sought a medical evaluation for my abnormal ovulatory cycle while in nursing school. I saw a reproductive specialist who suggested I start birth control pills to “normalize” my cycles. He said I “didn’t need to worry about the abnormal labs” until I decided to start a family.
But time went on and we were desperate to start a family, so I finally stopped the birth control pills … and I still wasn’t having menstrual periods. Of course, this should have been the first sign my medical team needed to take a deep dive into the root cause, but no one did. At the time, I was unaware the oral contraceptives (OCPs) I had so willingly accepted could impact my ability to conceive in the future—in part, by delaying an accurate diagnosis and treatment of the underlying disease.
“At the time, I was unaware the oral contraceptives (OCPs) I had so willingly accepted could impact my ability to conceive in the future—in part, by delaying an accurate diagnosis and treatment of the underlying disease.”
Due to my amenorrhea (lack of a menstrual period), I was immediately referred to an infertility clinic without further discussion. Ultimately, I was diagnosed with hypogonadotropic hypogonadism (HH).
Diagnosed with No Answers
So, what is HH? In hypogonadism, “the male testes or the female ovaries produce little or no sex hormones.” [1] In hypogonadotropic hypogonadism (HH), the problem originates in the pituitary gland or in the hypothalamus. [1] Without the hormones produced in those areas of the brain, there is no stimulus to produce the hormones needed for the female cycle to function as designed.
Beyond HH, other medical professionals assigned the diagnosis of hypothalamic amenorrhea. At least my husband and I had a diagnosis, as so many couples are simply told they have “unexplained infertility.”
Still, there was never a discussion as to finding the root cause of the problem or restoring my hormones holistically to avoid the expense and trauma of IVF to “treat” infertility. The anxiety and depression that occurred. The physical impact on my body from artificial reproductive technologies (ART). The lost work time. The loss of embryos. The feeling of being out of control.
“There was never a discussion as to finding the root cause of the problem or restoring my hormones holistically to avoid the expense and trauma of IVF to ‘treat’ infertility.”
Looking back, we wish we had known then what we know now: there is another way.
A Holistic Path to Answers
That said, I must be clear: I would never change my history. If I were to change my history, it would mean I would not have my five beautiful children.
Yet, I know so much more now. I know there is another way for women and couples who want to start a family. A better way. And because I have knowledge I lacked while going through it, I am committed to sharing this information with as many people as possible—anyone who needs to hear it as infertility impacts so many couples!
According to data [2] from the World Health Organization (WHO):
- About one in six couples experience infertility worldwide
- In the United States, 11% of women and 9% of men experience infertility
- The rate of infertility is higher (18%) among older women aged 35-44 compared to younger women (11%) aged 25-34
- The average age to seek treatment for infertility is 32 for women and 34 for men
Infertility is not a disease, but rather an indication of an underlying problem. The body and ovulatory cycle are alerting the patient and clinician to find out why this patient or couple is unable to conceive naturally. With this understanding, clinicians can evaluate and treat couples with infertility much sooner, and in a more holistic way—through restorative reproductive medicine!
The International Institute for Restorative Reproductive Medicine (IIRRM) describes restorative reproductive medicine (RRM) as “a branch of reproductive medicine that focuses on diagnosing and treating the root causes of reproductive issues by restoring and supporting the natural functions of the reproductive system. Unlike conventional approaches that may rely on artificial reproductive technologies (ART) and treatments that suppress natural function, RRM seeks to work with the body’s physiology, treating reproductive issues not by bypassing the body’s processes but by diagnosing, understanding, and addressing underlying health concerns, thus improving overall wellness of those looking to conceive healthy babies.” [3]
“Unlike conventional approaches … and treatments that suppress natural function, RRM seeks to work with the body’s physiology, treating reproductive issues not by bypassing the body’s processes but by diagnosing, understanding, and addressing underlying health concerns.” [3]
RRM incorporates:
- Body literacy through cycle charting with fertility awareness-based methods (FABMs)
- Targeted testing to diagnose and address the root cause of reproductive/hormonal symptoms that impact fertility
- Treating the patient’s condition with a personalized plan that may include medical and/or surgical interventions, nutrition, exercise, and other lifestyle changes
Clinicians trained in RRM use this approach to diagnose and treat common conditions such as polycystic ovary syndrome (PCOS), endometriosis, irregular cycles, infertility, recurrent miscarriage, premenstrual dysphoric disorder (PMDD), postpartum depression, low ovarian reserve, and more. A woman’s overall health and wellbeing often improve through RRM, preparing her for pregnancy, if desired, and beyond.
A Comprehensive Approach to Women’s Health
“The only way you will ever get pregnant is through IVF.” I now know these words reflected one possible approach, not the only path. Yet, twelve years ago, I was never given another option. To be fair, the doctor who told me IVF was the only way may have truly believed that. Why might that be? Unfortunately, the restorative approach to infertility is not typically taught in medical schools, PA schools, or nurse practitioner schools. [4]
I am so thankful that last year I was introduced to the world of RRM, FABMs, cycle tracking, body literacy, and FACTS — the Fertility Appreciation Collaborative to Teach the Science. Now I can help educate future healthcare professionals about evidence-based fertility awareness-based methods and restorative reproductive medicine so other healthcare professionals can teach, empower, and engage patients to care for their reproductive health.
If you and/or your partner have any of the above problems related to reproductive health, I urge you to seek help and care from a restorative approach . . . this decision could alter the entire course of your life.
Editor’s Note: FACTS developed a searchable national directory of physicians, other medical professionals, and educators trained in fertility awareness-based methods. As we continue to train medical professionals through our medical student elective, resident elective, CME courses, and conferences, this directory is a valuable resource for both the medical community and patients to make RRM accessible in every state and community!
References
[1] https://medlineplus.gov/ency/article/000390.htm
[2] C M Cox, M E Thoma, N Tchangalova, G Mburu, M J Bornstein, C L Johnson, J Kiarie, Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis, Human Reproduction Open, Volume 2022, Issue 4, 2022, hoac051, https://doi.org/10.1093/hropen/hoac051
[3] https://iirrm.org/what-is-rrm/
[4] https://www.factsaboutfertility.org/wp-content/uploads/2023/05/An-Evaluation-of-US-Medical.pdf
ABOUT THE AUTHOR
Shannon Leach
Shannon Leach, ARNP is a mother of five and lives with her husband and children in Everett, WA. She has been an advanced registered nurse practitioner since 2011 and works for Cascade Women’s Health in Everett, WA. She is a trained FACTS speaker and completed the FACTS NeoFertility cohort training in 2025. She is also training to become a FEMM teacher and FEMM-certified medical clinician. In nursing, women’s health is her greatest passion. She looks forward to inspiring and educating other healthcare students and practitioners so patients are treated from a restorative reproductive approach with the application of FABMs.
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