New analysis finds major care gaps before patients begin IVF
A new analysis of insurance claims raised questions about whether couples receive adequate opportunity to pursue alternative treatments before beginning in-vitro fertilization (IVF).
A new analysis of insurance claims from approximately five million commercially insured patients found that many people who ultimately underwent in-vitro fertilization (IVF) appeared to begin the procedure without documented completion of recommended testing or treatment for potentially correctable causes of infertility.
The research, released July 13 by the International Institute for Restorative Reproductive Medicine, compared real-world care with infertility recommendations published by the American Society for Reproductive Medicine and the American Urological Association. The authors found that IVF use rose rapidly after an infertility diagnosis while documented diagnostic and therapeutic care often lagged far behind.
CatholicVote Director of Government Affairs Tom McClusky told Zeale News that the findings support concerns the organization has raised repeatedly with lawmakers and federal officials.
“I always love it when science catches up to Catholic teaching,” McClusky said. “For years, in briefings, meetings and letters, this is what CatholicVote has been pointing out.”
Researchers Tracey Parnell, Monica Minjeur, Craig Turczynski, and Tony Pistilli examined MarketScan commercial insurance claims from January 2021 through December 2024. They identified patients with infertility-related diagnoses who later underwent IVF, then searched their claims for evidence of evaluations, medications, or surgical interventions recommended by professional fertility-care guidelines.
By three months after an infertility diagnosis, between 28% and 39% of patients in the relevant cohorts had already begun IVF. By nine months, IVF utilization commonly exceeded 70% to 85%, while documented adherence to many guideline-supported evaluations and treatments remained below 40%. Several recommended interventions appeared in fewer than 15% of claims.
The calculated gaps between recommended care and documented practice ranged from approximately 13% to 78% for most of the measures studied. In several categories, the difference exceeded 50 percentage points.
The researchers concluded that many patients “appeared to progress to IVF without documented evidence of diagnostic evaluation or therapeutic intervention” recommended under prevailing professional guidance. They said the results raise questions about whether couples receive a meaningful opportunity to identify and treat potentially reversible causes of infertility before reproductive barriers are bypassed through laboratory fertilization.
Those professional recommendations include evaluations that are not unique to Catholic or pro-life medicine. ASRM itself states that female infertility should be investigated in a “systematic, expeditious, and cost-effective manner,” while joint AUA-ASRM guidance recommends that male and female partners be assessed concurrently and that the initial male evaluation include reproductive history and one or more semen analyses.
The study’s authors argued that the gaps strengthen the case for restorative reproductive medicine, or RRM. Rather than creating embryos outside the body, RRM seeks to diagnose and correct conditions impairing normal reproductive function so that conception can occur naturally. Approaches may address endometriosis, polycystic ovary syndrome, hormonal dysfunction, thyroid disease, anatomical problems, male-factor infertility, and other underlying conditions.
The findings are preliminary. The manuscript is currently undergoing peer review and may change before final publication. Because it relies on insurance billing records, the absence of a claim also does not necessarily prove that no evaluation occurred; some care may have been paid for privately, coded differently, or received outside the available insurance network. The analysis nevertheless found a broad and consistent pattern across a large dataset.
ASRM has previously attacked RRM as an ideological repackaging of ordinary fertility care and warned that steering patients away from IVF could delay effective treatment. The new analysis is notable because it evaluates clinical practice using ASRM’s own diagnostic and treatment recommendations rather than a separate Catholic standard.
CatholicVote has pressed public officials to support fertility medicine that treats underlying disorders without creating and destroying embryonic children.
After the Trump administration announced measures to expand IVF access and reduce its cost, CatholicVote President Kelsey Reinhardt urged the White House to “fully commit” to addressing the root causes of infertility.
“Restorative Reproductive Medicine offers real, ethical care by diagnosing and healing the underlying conditions that prevent conception, rather than bypassing the body through an expensive, low-success, morally unacceptable procedure like IVF,” Reinhardt said at the time. “America should invest in medicine that heals, not in an industry that creates life only to discard it.”
CatholicVote also helped organize opposition to a Nevada bill mandating insurance coverage for IVF. Republican Gov. Joe Lombardo ultimately vetoed the measure after CatholicVote and other pro-life organizations warned that the proposal would subsidize an inadequately regulated industry in which clinics commonly create more embryos than couples intend to bring to birth.
As Zeale News has previously reported, the Catholic Church recognizes the profound suffering caused by infertility while teaching that IVF violates human dignity by separating procreation from the marital act and placing embryonic human beings under laboratory control. The procedure commonly results in embryos being discarded, indefinitely frozen, subjected to genetic screening, or destroyed.
>> Op-ed: IVF is a real temptation for Catholics facing infertility, but not the answer <<
The new research does not attempt to resolve those moral questions. It does, however, provide large-scale evidence for a practical concern long raised by CatholicVote and restorative-medicine advocates: Couples may be directed toward IVF before receiving comprehensive care aimed at understanding and healing the medical conditions that made conception difficult in the first place.
