Findings

Congress finds the following: (1) All women and men are worthy of the highest standard of medical care, including the opportunity to assess, understand, and improve their reproductive health. Unfortunately, many couples do not receive adequate information about their reproductive health and do not have access to restorative reproductive medicine. (2) There is a growing interest among women to proactively assess their overall health and understand how factors such as age and medical history contribute to reproductive health and fertility. (3) Reproductive health conditions are the leading causes of infertility, which affects 15 to 16 percent of couples in the United States. Such conditions include the following: (A) Endometriosis, a disease where tissue resembling endometrial lining tissue grows outside of the uterus. The tissue often adheres to different organs, disfiguring them and, through scar tissue or adhesions, can make the organs stick to one another or to the pelvic walls. It has been found in the abdominal organs, the bowel, the diaphragm, the lungs, the brain, and the eye. It is a progressive disease and has been compared to growing like cancer. Endometriosis is often diagnosed in stages, with Stage I as the mildest form and Stage IV as the most severe and widespread form. The average diagnosis delay for endometriosis is 6 to 12 years. Endometriosis frequently goes undiagnosed, and women may suffer for years with painful periods, pelvic pain, or infertility. The cause of endometriosis is unknown. (B) Adenomyosis, a disease that occurs when endometrial tissue (tissue that would normally line the inside of the uterus) grows into the muscle layer of the uterus. Adenomyosis is different from, but can exist concurrently with, endometriosis. Adenomyosis may increase the risk of miscarriage and preterm labor and may contribute to infertility. The cause of adenomyosis is unknown. (C) Polycystic ovary syndrome, a reproductive hormonal disorder that causes cysts to grow on the ovaries, usually as a result of hormonal imbalances. Polycystic ovary syndrome affects approximately 15 percent of women overall but is more common among women with infertility. It is more prevalent among women with obesity and insulin resistance. Women with polycystic ovary syndrome who are trying to achieve pregnancy are commonly prescribed oral ovulation medication and hormonal injections that stimulate ovulation. Effective diagnosis and treatment exist, and should be made available for all women. Accurate and timely diagnosis and treatment can correct underlying hormonal imbalances, critical for both long-term health improvements as well as for fertility outcomes. (D) Uterine fibroids, which are muscular tumors that grow in the wall of the uterus. While not all women will experience symptoms associated with fibroids, if the tumors are large enough or embedded far enough in the uterine lining, they can lead to pain and heavy bleeding. Treatment for fibroids may include assessment of underlying hormonal imbalances, hysteroscopic myomectomy, abdominal myomectomy, uterine fibroid embolization, and uterine artery embolization. Uterine fibroids can increase risks of preterm labor, pregnancy complications leading to a cesarean section, and placental abruption, among other risks. The cause of uterine fibroids is unknown. (E) Blocked fallopian tubes, a condition where the fallopian tubes are blocked by tubal spasm, scarring from inflammatory conditions, debris, tubal polyps, tubal ligation, prior ectopic pregnancy, pelvic adhesions, endometriosis, prior pelvic infection (pelvic inflammatory disease or PID). Approximately 1 in 4 women with infertility have a tubal blockage. This condition makes achieving pregnancy difficult, if not impossible. Treatments for a blockage include fallopian tube recanalization, tubo-tubal anastomosis (tubal ligation reversal), or neosalpingostomy/fimbrioplasty. (4) Research shows 4 or more conditions or factors are the cause of most male and female infertility. (5) There is a gap in research and care for male and female reproductive health conditions, which affect many Americans struggling with unexplained infertility. (6) Restorative reproductive medicine aims to diagnose and treat underlying hormonal and other imbalances, restore health where possible, and improve women’s health functioning and long-term outcomes. (7) Restorative reproductive medicine can eliminate barriers to successful conception, pregnancy, and birth. It can also address some causes of recurrent miscarriages. (8) Restorative reproductive medicine often alleviates other difficult symptoms associated with reproductive health conditions, including hormonal acne, hormonal weight gain, hormonal mood and depression, painful periods, painful flare-ups, bloating, inflammation, heavy periods, irregular periods, nerve pain, bowel symptoms, pain during sexual intercourse, and back pain.