{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:37:27Z","timestamp":1781624247412,"version":"3.54.5"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Restorative reproductive medicine represents a comprehensive approach to subfertility (infertility and miscarriage) with investigations, diagnoses, and treatments combined with fertility charting to restore optimal reproductive function. Restorative reproductive medicine assumes that multiple factors need to be identified and treated (cycle optimization) for up to 12 cycles to achieve a successful pregnancy. Conception can occur during normal intercourse without intrauterine insemination or <jats:italic>in vitro<\/jats:italic> fertilization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 35-year-old  Croatian female presented for fertility treatment in May 2019 with a previous diagnosis of polycystic ovaries, infertility of 16 years duration, and 8 unsuccessful embryo transfers with <jats:italic>in\u00a0vitro<\/jats:italic> fertilization and intracytoplasmic sperm injection. She was gravida 3 para 0, with 2 miscarriages after spontaneous conception at 5\u20136 weeks gestation in 2002 and 2004, followed by a miscarriage after <jats:italic>in vitro<\/jats:italic> fertilization at 12 weeks gestation in 2011. We initially found poor follicle function and suboptimal progesterone levels. Restorative reproductive medicine treatment resulted in conception after two cycles of treatment. This pregnancy ended in miscarriage at 7 weeks 4 days. Additional investigations found a balanced Robertsonian translocation (13, 14) and a uterine septum. We achieved repeat fertilization with restorative reproductive medicine after three cycles of treatment following resection of the uterine septum and ovulation induction with letrozole and human chorionic gonadotrophin. She had a full-term healthy pregnancy and live birth in 2021.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We propose that a full evaluation of underlying factors, and up to 12 cycles of cycle optimization, should be offered to subfertile patients before considering <jats:italic>in\u00a0vitro<\/jats:italic> fertilization treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-022-03465-w","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T23:02:52Z","timestamp":1655852572000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Successful pregnancy with restorative reproductive medicine after 16 years of infertility, three recurrent miscarriages, and eight unsuccessful embryo transfers with in vitro fertilization\/intracytoplasmic sperm injection: a case report"],"prefix":"10.1186","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2555-6294","authenticated-orcid":false,"given":"Phil C.","family":"Boyle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Stanford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Zecevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"issue":"5","key":"3465_CR1","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3389\/fmed.2018.00210","volume":"31","author":"PC Boyle","year":"2018","unstructured":"Boyle PC, de Groot T, Andralojc KM, Parnell TA. Healthy singleton pregnancies from restorative reproductive medicine (RRM) after failed IVF. Front Med (Lausanne). 2018;31(5):210. https:\/\/doi.org\/10.3389\/fmed.2018.00210.","journal-title":"Front Med (Lausanne)."},{"issue":"1","key":"3465_CR2","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1186\/s12884-021-03946-8","volume":"21","author":"JB Stanford","year":"2021","unstructured":"Stanford JB, Carpentier PA, Meier BL, Rollo M, Tingey B. Restorative reproductive medicine for infertility in two family medicine clinics in New England, an observational study. BMC Pregnancy Childbirth. 2021;21(1):495. https:\/\/doi.org\/10.1186\/s12884-021-03946-8.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"8","key":"3465_CR3","first-page":"822","volume":"108","author":"R Ecochard","year":"2001","unstructured":"Ecochard R, Boehringer H, Rabilloud M, Marret H. Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation. BJOG. 2001;108(8):822\u20139.","journal-title":"BJOG"},{"key":"3465_CR4","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12644","author":"S Najmabadi","year":"2020","unstructured":"Najmabadi S, Schliep KC, Simonsen SE, Porucznik CA, Egger MJ, Stanford JB. Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: a pooled analysis of three cohorts. Paediatr Perinat Epidemiol. 2020. https:\/\/doi.org\/10.1111\/ppe.12644.","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"5","key":"3465_CR5","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1007\/s00404-012-2433-0","volume":"286","author":"GS Siklosi","year":"2012","unstructured":"Siklosi GS, Banhidy FG, Acs N. Fundamental role of folliculo-luteal function in recurrent miscarriage. Arch Gynecol Obstet. 2012;286(5):1299\u2013305. https:\/\/doi.org\/10.1007\/s00404-012-2433-0.","journal-title":"Arch Gynecol Obstet"},{"key":"3465_CR6","doi-asserted-by":"publisher","first-page":"153","DOI":"10.3389\/fpubh.2018.00153","volume":"6","author":"LF Blackwell","year":"2018","unstructured":"Blackwell LF, Cooke DG, Brown S. The use of estrone-3-glucuronide and pregnanediol-3-glucuronide excretion rates to navigate the continuum of ovarian activity. Front Public Health. 2018;6:153. https:\/\/doi.org\/10.3389\/fpubh.2018.00153.","journal-title":"Front Public Health"},{"issue":"3","key":"3465_CR7","first-page":"273","volume":"39","author":"JH Check","year":"2012","unstructured":"Check JH. Understanding the physiology of folliculogenesis serves as the foundation for perfecting diagnosis and treatment of ovulatory defects. Clin Exp Obstet Gynecol. 2012;39(3):273\u20139 (In eng).","journal-title":"Clin Exp Obstet Gynecol"},{"issue":"3 Pt 1","key":"3465_CR8","first-page":"332","volume":"72","author":"CJ Chuong","year":"1988","unstructured":"Chuong CJ, Coulam CB, Bergstralh EJ, O\u2019Fallon WM, Steinmetz GI. Clinical trial of naltrexone in premenstrual syndrome. Obstet Gynecol. 1988;72(3 Pt 1):332\u20136 (PMID: 3043289).","journal-title":"Obstet Gynecol"},{"issue":"6","key":"3465_CR9","first-page":"495","volume":"43","author":"TW Hilgers","year":"1998","unstructured":"Hilgers TW, Stanford JB. Creighton Model NaProEducation Technology for avoiding pregnancy. Use effectiveness. J Reprod Med. 1998;43(6):495\u2013502 (PMID: 9653695).","journal-title":"J Reprod Med"},{"issue":"1","key":"3465_CR10","first-page":"12","volume":"53","author":"TW Hilgers","year":"1979","unstructured":"Hilgers TW, Prebil AM. The ovulation method\u2013vulvar observations as an index of fertility\/infertility. Obstet Gynecol. 1979;53(1):12\u201322.","journal-title":"Obstet Gynecol"},{"issue":"3","key":"3465_CR11","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1002\/ijgo.13375","volume":"152","author":"S Bansal","year":"2021","unstructured":"Bansal S, Goyal M, Sharma C, Shekhar S. Letrozole versus clomiphene citrate for ovulation induction in anovulatory women with polycystic ovarian syndrome: a randomized controlled trial. Int J Gynaecol Obstet. 2021;152(3):345\u201350. https:\/\/doi.org\/10.1002\/ijgo.13375 (Epub 2020 Oct 14 PMID: 32920843).","journal-title":"Int J Gynaecol Obstet"},{"issue":"4","key":"3465_CR12","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/s0015-0282(97)81359-3","volume":"67","author":"JD Isaacs Jr","year":"1997","unstructured":"Isaacs JD Jr, Lincoln SR, Cowan BD. Extended clomiphene citrate (CC) and prednisone for the treatment of chronic anovulation resistant to CC alone. Fertil Steril. 1997;67(4):641\u20133. https:\/\/doi.org\/10.1016\/s0015-0282(97)81359-3 (PMID: 9093187).","journal-title":"Fertil Steril"},{"issue":"8","key":"3465_CR13","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.1093\/humrep\/17.8.2035","volume":"17","author":"SA Amer","year":"2002","unstructured":"Amer SA, Gopalan V, Li TC, Ledger WL, Cooke ID. Long term follow-up of patients with polycystic ovarian syndrome after laparoscopic ovarian drilling: clinical outcome. Hum Reprod. 2002;17(8):2035\u201342.","journal-title":"Hum Reprod"},{"issue":"6","key":"3465_CR14","first-page":"653","volume":"68","author":"KM Zohni","year":"2016","unstructured":"Zohni KM, Gat I, Librach C. Recurrent implantation failure: a comprehensive review. Minerva Ginecol. 2016;68(6):653\u201367 (Epub 2016 Mar 16 PMID: 26982235).","journal-title":"Minerva Ginecol"},{"issue":"10","key":"3465_CR15","doi-asserted-by":"publisher","first-page":"2672","DOI":"10.1093\/humrep\/dei157","volume":"20","author":"JW van der Steeg","year":"2005","unstructured":"van der Steeg JW, Steures P, Hompes PG, Eijkemans MJ, van der Veen F, Mol BW. Investigation of the infertile couple: a basic fertility work-up performed within 12 months of trying to conceive generates costs and complications for no particular benefit. Hum Reprod. 2005;20(10):2672\u20134. https:\/\/doi.org\/10.1093\/humrep\/dei157 (Epub 2005 Jun 24 PMID: 15979991).","journal-title":"Hum Reprod"},{"key":"3465_CR16","doi-asserted-by":"crossref","unstructured":"Hughes E, Brown J, Collins JJ, Vanderkerchove P. Clomiphene citrate for unexplained subfertility in women. Cochrane Database Syst Rev. 2010; (1): CD000057.","DOI":"10.1002\/14651858.CD000057.pub2"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03465-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-022-03465-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-022-03465-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T23:03:26Z","timestamp":1655852606000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-022-03465-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,22]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["3465"],"URL":"https:\/\/doi.org\/10.1186\/s13256-022-03465-w","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,22]]},"assertion":[{"value":"4 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This is a retrospective case review of anonymous data. The patient cannot be identified in the manuscript, so ethical approval from IRB is not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr Phil Boyle is president of the International Institute for Restorative Medicine (IIRRM) and has an interest in promoting restorative fertility treatment. Dr Boyle is the founder of the NeoFertility method and co-founder of the ChartNeo fertility app.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"246"}}