EBSA-2026-0232-0001, Ukrainian Association of Perinatologists

Professor Volodymyr Artyomenko, MD, PhD, DSc (Med), Vice-President Ukrainian Association of Perinatologists, Honored Physician of Ukraine, EU CBHE Expert Ukraine Ministry of Health Expert in "Obstetrics and Gynecology", "Child and Adolescent Gynecology" (2021-2023) Odessa National Medical University Odessa City Maternity Hospital # 5 Medical experience for more than 30 years From national vice-president, coauthor of the national guidelines and protocols for the OB/GYNs’ and MOH expert view: For the today’s Ukrainian situation with the demographic collapse and lack of funding the RRM approach is more than umbrella - it’s like a sip of the water in the desert giving real opportubity for the million of couples to prepare thouroughly to and achieve pregnancy. RRM is a longitudinal model, chronic-disease based approach that prioritizes healthy singleton pregnancy, full-term birth, and optimized maternal and neonatal outcomes, while also addressing underlying health conditions that may contribute to infertility. Long term this reduces the public health burden: Boyle P. Understanding Restorative Reproductive Medicine. J Restorative Reprod Med. 2025;1:1-2. doi:10.63264/f0b0xh81 Please take into account that all world professional societes are moving forward to more early assessment of problematic couples that it was before: ASRM 2025/2026, Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) 2025, Society of Obstetricians and Gynaecologists of Canada (SOGC) and the Canadian Fertility and Andrology Society (CFAS), Early Pregnancy Loss in the 1st Trimester: Guideline of the DGGG, OEGGG and SGGG 2025 Costs & effectiveness are now the priority for my country: RRM cost drivers are described as largely team-based and longitudinal, while ART/IVF cost drivers include laboratory infrastructure, medications, procedures, and embryology laboratory services: Woodcock S; reviewed by Golden KE. How much does IVF cost? GoodRx [Internet]. Updated August 20, 2025 [cited 2026 May]. Available from: https://www.goodrx.com/conditions/fertility/ivf-costs. Due to the lack of qualified medical presonell through the war the problem of education and training is also very important. RRM training may be undertaken by physicians and advanced practice providers from multiple specialties, allowing broader workforce participation while maintaining specialty-specific clinical expertise. International Institute for Restorative Reproductive Medicine (IIRRM). "RRM postgraduate education pathways: certificate, diploma, fellowship, and board certification program framework". Available from: https://iirrm.org/defining-the-future-of-rrm-advanced-postgraduate-training/. Moreover the subfertile couples today are unfortunately treated as infertile whithout prior proper assessment. https://www.rjdnmd.org/index.php/RJDNMD/article/view/2227 Artyomenko et. al. Woman’s microbiome and obstetric and perinatal risks: what do they have in com-mon? Reprod Health Woman. 2023;(6):37-45. doi:10.30841/2708-8731.6.2023.289995. (In Ukrainian). Although I am based in Ukraine, these issues are directly relevant to the U.S. Both countries face the need to improve access to effective fertility care while using limited health-care resources responsibly. In the U.S . insurance benefit design influences which evaluations and treatments patients can realistically obtain. When coverage is concentrated on IVF or other assisted reproductive technologies without comparable coverage for comprehensive diagnostic evaluation and treatment of underlying reproductive disorders, couples may be directed toward costly and invasive procedures before potentially treatable causes of infertility have been adequately assessed. U.S. fertility benefits should therefore include early, comprehensive evaluation of both partners and coverage for restorative reproductive medicine, fertility-awareness-based assessment, preconception care, and medical or surgical treatment of identified conditions. This is particularly relevant for patients with ovulatory disorders, PMOS, endometriosis, metabolic or endocrine dysfunction, inflammatory or infectious conditions, anatomic abnormalities, RPL, and male factor infertility. The longitudinal and multidisciplinary nature of RRM is also relevant to U.S. concerns about affordability, workforce capacity, maternal health, and the prevention of avoidable complications. By involving physicians and appropriately trained advanced practice professionals from multiple specialties, RRM can expand access to fertility evaluation while maintaining appropriate clinical expertise. Earlier identification and treatment of underlying disease may also benefit patients’ broader health and support the goals of healthy singleton pregnancy, full-term birth, and improved maternal and neonatal outcomes.