Yesterday we wrote about this very exciting new report from EPPC and Heritage's Natalie Dodson and Emma Waters on infertility. It's really a compendium of reports, and they are all fascinating.

The report consists of two main parts. The first introduces and describes "restorative reproductive medicine," an alternative to mainstream "reproductive health" for treating infertility.

"For many symptoms of reproductive health conditions or diseases, the medical professions’ instinctive response is pharmaceutical Band-Aids to mask and ignore the symptoms for as long as possible. Likewise, for infertility, the common response is in vitro fertilization (IVF), which circumvents the infertility by producing the child outside of the body without attempting to treat the underlying cause of the infertility. Both approaches fail to restore health and may instead contribute to worsening health for all patients involved," Dodson explains.

By contrast, "[restorative reproductive medicine, or RRM] is a comprehensive approach to addressing the symptoms and causes of reproductive dysfunction. Rather than treating reproductive or bodily dysfunction in a piecemeal manner, RRM examines the whole body and the multitude of conditions or comorbidities that may contribute to the symptoms patients experience. Once the underlying causes of the symptoms are identified, often through fertility awareness-based methods (FABMs), RRM protocols treat them through hormone-balancing, dietary and nutritional adjustments, environmental changes, and, in some cases, surgery."

Does this sound like woo to you? Maybe. But this is where the second half of the report comes in: it is an investigation and critique of the current fertility industry, which seems fixated on a cookie-cutter, profit-maximizing approach to fertility. Even if you don't have social-conservative qualms about embryo-creating-and-discarding practices, this might still make you think alternatives to the current default approach may not be a bad thing. A study in one of the papers statistically compares RRM and IVF and finds that RRM is equally, or more successful, than IVF at producing live births—and this is without taking into account the tremendous financial cost of IVF in any cost-benefit analysis.

Anyone who has struggled with infertility or has known people who have knows that it is a mysterious condition, intertwined with issues related to psychological issues or broader issues of hormonal or nutritional health, and that conventional treatments often fail, and unpredictably so. They may also have been shocked by even doctors' routine ignorance of the common side effects of popular treatments. This strongly suggests that a "holistic" approach may in fact be very medically judicious, not (or not only) for "crunchy" or bioethical reasons. "In most cases, infertility does not result from a single factor but multiple underlying health issues present in males and females," the authors write.

For example, the report contends, in many cases heavy or painful periods mask a diagnosis of endometriosis which is instead managed through birth control pills which only ameliorate the symptoms but do not affect the underlying condition. "It takes, on average, between eight to twelve years for a woman to receive a diagnosis of endometriosis" even though "70 percent of teenage girls who present with dysmenorrhea (painful menstrual cramps) are eventually diagnosed with endometriosis." The report includes several case studies of women with infertility or other reproductive-related problems who were successfuly treated thanks to RRM.

The report then invites us to look at the alternative: IVF. The authors note the interest of private equity firms in IVF clinics and that "by 2023, an estimated one-third of all IVF cycles in the United States were performed at clinics affiliated with private equity firms" and that private equity-owned clinics "are significantly more likely to promote high-margin procedures, such as preimplantation genetic testing (PGT) or egg freezing for otherwise fertile women."

They note that the industry is largely self-regulated. While the FDA and CMS ensure some quality control, the 1992 Fertility Clinic and Success Rate Certification Act "lacks a strong enforcement mechanism" and "most standards in the fertility industry related to procedure and ethics is 'self-regulated through membership with and recommendations from organizations such as the American Society for Reproductive Medicine'"

The article by Carter Snead and Yuval Levin is particularly illuminating in showing all the ways in which the IVF industry is unregulated and unscrutinized. Here are some of the problems they highlight: there is no comprehensive mechanism for data collection or monitoring of how reproductive technologies affect children, egg donors, or gestational mothers; IVF isn't subject to the same regulations that govern clinical research or new medical devices; there's an absence of longitudinal studies on health outcomes for mothers and children; no laws specifically protect mothers undergoing IVF or resulting children; there are no restrictions on practices that might increase health risks; and practices like embryo selection for non-medical purposes (including sex selection, intelligence screening, and physical traits) proceed without oversight. They further emphasize that there are no standard rules regarding the creation, preservation, handling, or disposition of unused embryos, with estimates suggesting over one million embryos may currently be in cryostorage in the US.

The final article, by Melissa Moschella, introduces a fascinating practice we had never heard of, to address the issue of frozen embryos: embryo adoption. She notes that there is already a licensed agency doing embryo adoptions, called Nightline Christian Adoptions. Embryo adoption is exactly what it sounds like: couples choose to adopt an embryo and have it implanted.

All in all, this report—as we said, a compendium of articles as well as a report—was a fascinating deep dive on an important and underexplored subject. And we just enjoy reading quality work, which sadly does not come out of think tanks as often as you'd think (insert joke here).

Of course, like dark matter in some physicists' theories, the context is everywhere present between the lines without being mentioned: that is to say, the enormous political popularity of IVF with the broad American people, including Republicans and self-described social conservatives, and among the secular parts of the Republican coalition. Pro-lifers must object to IVF because it destroys embryos, but pro-lifers as a political force in the US know that they are one part of a coalition and that they must work within the constraints of that coalition.

Implicitly, therefore, the report sketches out a strategy for conservatives on how to "tackle" IVF: sponsor more studies on the long-term health effects of IVF, call for more stringent regulations on IVF in the name of health and safety and anti-private-equity-profiteering, and promote restorative reproductive medicine as an alternative to IVF for couples who suffer from infertility. From a political and policy standpoint, it's certainly a smart approach. And, if RRM is as good as it sounds, it may even lead to more babies being born and more happy families, without the dystopian nightmare of frozen embryos.

Policy News You Need To Know

#Ed — President Trump is expected to sign an EO today "abolishing the Department of Education." Since that can't be done by executive order, we're curious to see what the EO actually says and does.

#HigherEd — A new Manhattan Institute issue brief by Renu Mukherjee looks at so-called "percent plans." New York's governor recently promised one, but the state most famously associated with the policy is Texas. This states that any student ranked in the top 10% of their high school class is granted direct admission to that state's state university system. It sounds well-intentioned and fair, but it's not. Top 10% at a really bad high school might not be that good, while someone who is in the 89th percentile at a really good school might be much better. What's more, it can be used as a way to continue affirmative action policies in disguise.

#HigherEd #FreeSpeech — Great article by MI's Charles Fain Lehman at The Dispatch summarizing the issue of Columbia and free speech.

#TheEconomy — As of this writing, stocks are up. It looks like, potentially, the huge market selloff that had everybody scared a week ago is tapering off.

#KOSA #OnlineSafety — Protecting kids online is extremely important. However, as we know too well, even policies with the best intentions can backfire. R Street's Spence Purnell highlights a new study which suggests online safety laws might actually drive users to more-dangerous sites.

SEE ALSO: Modest Proposal: How To Make The Internet Perfect For Kids

#PublicHealth — We always read Scott Gottlieb's contributions with great interest. Currently a Senior Fellow at AEI, he was an FDA commissioner during the first Trump Administration. Here, he writes about how to protect America's eggs from bird flu so that we don't have a repeat of last year.

#Immigration — Statements from pro-immigration advocates should always be taken with a grain of salt—this is not an ideological point, they are just a group with a long record of twisting facts—but this is still worrisome: according to sworn declarations highlighted by American Immigration Council Senior Fellow Aaron Reichlin-Melnick, one of the Venezuelans sent to prison in El Salvador is "a professional soccer player tortured by the Maduro regime who entered this country legally to seek asylum and has no criminal record in either country." It's certainly true that the scale of the immigration crisis left by the Biden Administration justifies the use by the Trump Administration of sweeping executive powers to allow America to gain control over its borders and its immigration policy. However, one of the advantages of due process is that it might prevent things like this (if it's confirmed).

#GreenNewScam — You may have heard of the legal battle where the Trump Administration is trying to claw back $20 billion in environmental program money that was spent in the waning days of the Biden Administration. $7 billion was dedicated to a program called "Solar for All." As James Varney at RealClearInvestigations reports, that program is a boondoggle.