Evidence map›Paper›PMID 40546415›Full record

ReviewTherapeutic advances in reproductive health

Revitalizing reproductive health: innovations and future frontiers in restorative medicine.

Francesco Maria Bulletti, Evaldo Giacomucci, Maurizio Guido, Antonio Palagiano, Maria Elisabetta Coccia, Carlo Bulletti

Abstract readReview
In one paragraph

Review in Therapeutic advances in reproductive health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Francesco Maria BullettiCHUV Lausanne, Département D'hôpital Maternité/Gynécologie et Obstétrique, Lausanne, Switzerland.
Evaldo GiacomucciDepartment of Obstetrics and Gynecology, Ospedale Maggiore, Bologna, Italy.
Maurizio GuidoMeSVA Department, University of L'Aquila, L'Aquila, Italy.
Antonio PalagianoCSA, Naples, Italy.
Maria Elisabetta CocciaDipartimento di Scienze Biomediche, Sperimentali e Cliniche "Mario Serio," AOU Careggi, Florence, Italy.
Carlo BullettiDepartment of Obstetrics, Gynecology, and Reproductive Science, Yale University, 333 Cedar Street, Suite 302 FMB, New Haven, CT 06520, USA Help Me Doctor (Worldwide Platform for Medical Opinions), 47841 Cattolica, Italy.ORCID https://orcid.org/0000-0001-8190-9387

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Infertility affects around 17.5% of reproductive-aged individuals worldwide, posing significant personal and public health challenges. Although Medically Assisted Reproduction and Assisted Reproductive Technology (ART; e.g., in vitro fertilization) have advanced outcomes, many couples fail to conceive due to unaddressed pelvic, uterine, or systemic factors. Objectives: We aim to (1) define the current usage of Restorative Reproduction Medicine (RRM) in clinical practice, (2) compare RRM outcomes with conventional ART, and (3) propose an integrated model of RRM plus ART for optimal fertility care. Design: A systematic review following PRISMA guidelines was conducted (INPLASY registration no. INPLASY2024110069). Data sources and methods: We searched PubMed, Scopus, and Web of Science (January 1995-October 2024), combining terms such as "restorative reproductive medicine," "intrauterine adhesions," "myomas," "polyps," "hydrosalpinx," "endometritis," "BMI," "thyroid dysfunction," "microbiome," and "assisted reproductive technology." Inclusion criteria: studies on uterine/systemic factors affecting infertility, focusing on surgical/pharmacological RRM interventions and ART limitations. Exclusion criteria: male-only infertility, case reports, narrative reviews, non-English publications. Quality assessment employed the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool. We also briefly noted potential publication bias due to language and study-type restrictions. Results: From >25,000 initial titles, 3 sequential screenings yielded 145 key articles addressing uterine (septum, myomas, polyps, adhesions) and systemic (body mass index (BMI) extremes, thyroid dysfunction, microbiome imbalance) factors. Surgical corrections (e.g., hysteroscopic removal of polyps/myomas, salpingectomy for hydrosalpinx) significantly improved natural conception and ART success (⩾20%-40% increase in clinical pregnancy). Chronic endometritis treatment, endometrial microbiome modulation, and BMI/thyroid optimization further improved pregnancy rates by 15%-20%. Comparisons of RRM versus ART alone indicated that RRM often lowers overall cost and may reduce miscarriage, while ART offers immediate embryo transfer. Combining RRM to correct pathologies prior to ART can boost implantation and live birth rates (⩾40%-70% improvement in some studies). Conclusion: Restorative Reproductive Medicine comprehensively addresses pelvic and systemic abnormalities, thereby enhancing fertility outcomes and complementing ART. A proposed integrated model-RRM diagnostics/interventions followed by ART if needed-maximizes success, reduces time/cost, and emphasizes holistic reproductive health. Further multicenter trials are warranted to standardize protocols and fully realize RRM's potential in modern fertility care.

Indexed as

assisted reproductive technologyBMIendometritishydrosalpinxmicrobiomepelvic factor infertilityRestorative Reproductive Medicinethyroid dysfunctionuterine abnormalities

Identifiers

PMID40546415
PMCPMC12182620

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.