Micah Hill: 30,000-Foot View of REI and RRM Congressional Briefings
Micah Hill, Practice Committee Chair, Society for Reproductive Endocrinology and Infertility at American Society for Reproductive Medicine (ASRM), shared a post on LinkedIn:
“This is my 30,000-foot view of yesterday’s REI and RRM Congressional briefings.
After 21 years in the Army and not being able to advocate, it’s fulfilling to be able to do so now. Ive helped draft 5 Congressional Inquiry replies about IVF and fertility preservation in the military during my career, but haven’t been able to advocate publicly. Im very excited to be able to do so now. Im passionate about evidence-based medical care and equitable access to care. Those two principles inform my views.
1. There is not a real RRM versus IVF debate. This is false narrative that the Heritage Foundation document and others have put forward. This document condemning IVF was published in March of 2024. From my view, this is a discussion about evidence-based and equitable access to medical care.
2. REIs do what others call RRM every day, where there is evidence for its efficacy. REIs call it Optimizing Natural Fertility and Pre-Pregnancy Counseling. We have entire practice documents that assess hundreds of published scientific studies and make informed decisions based on the evidence.
3. REIs have access to the full range of evidence-based fertility treatments, ranging broadly from optimizing natural fertility to IVF. I would liken this to oncology, where your doctor has access to optimizing your natural ability to fight cancer, but also has chemotherapy and surgery when you need it.
4. Most patients who see an REI do not end up doing IVF. Many of them get pregnant by optimizing natural fertility techniques and non-IVF technologies, like surgery, ovulation induction, IUI, ect. Unfortunately, many do not get to utilize IVF when medically necessary because they lack insurance coverage. RRM is actively being promoted at state and federal levels in an attempt to limit IVF access.
5. We do less IVF in the US per capita than almost every modern country. Even those with strict national guidelines about what qualifies for IVF. We are not meeting the medical need currently in the US.
6. Its become very clear that the arguments against IVF are not scientific. IVF is the most effective tool for many patients. Instead, the arguments come from those who ethically oppose IVF.
So when you hear REIs advocating for IVF, its not because IVF is all we do. Its not because we dont understand how to evaluate infertility. Its not because we dont understand treatment options. Its the exact opposite. Our main motivation is that we want all patients to have full access to evidence-based medicine, in all its forms.”
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