Restoring fertility: the forgotten road in the public debate

The issue of fertility restoration has recently taken center stage in public discourse, particularly in light of the ongoing fertility crisis affecting countless couples. While much of the conversation has revolved around assisted reproductive technologies such as in vitro fertilization, egg cryopreservation, and surrogacy, there exists a third, often overlooked path: restoring fertility through scientifically sound and personalized treatments. This approach focuses on addressing the root causes of infertility rather than immediately resorting to artificial methods. It emphasizes respecting natural physiological processes and enhancing overall health, both for individuals and their potential offspring.

Many causes of infertility can indeed be treated, corrected, and overcome with tailored medical interventions that respect the body's natural cycles and promote holistic well-being. However, current clinical practices frequently bypass comprehensive diagnostics, opting instead for in vitro fertilization as the primary solution. This tendency undermines the breadth of available treatments, limiting access to medical and surgical options that could address underlying issues more effectively. The restorative reproductive approach seeks to treat the causes of infertility directly, offering a more respectful alternative to conventional methods while also supporting the overall health of both partners and future children.

In Chile, there are professionals committed to this vision who have successfully integrated these approaches into clinical practice using advanced technology and precise diagnostics. Today, it is possible to offer therapies and surgeries targeting specific causes of infertility in men and women, including hormonal imbalances, structural abnormalities, and complications arising from infections or other diseases. Even when a woman is diagnosed with cancer and must undergo chemotherapy, the horizon does not necessarily close. Although it is commonly suggested that the only option is to freeze eggs, another deeply hopeful possibility exists: ovarian tissue cryopreservation.

The central focus of restorative medicine is to restore the health of the individual, whether male or female. When this is achieved, it enables the possibility of conceiving one or more children without requiring the couple to undergo new treatments in each cycle, thereby reducing the psychological, physical, and economic burdens associated with repeated attempts. It is now time to give fertility restoration its rightful place in public discussion. While Chile has made progress in coding examinations and treatments within the field of reproductive medicine, significant gaps remain regarding effective access for individuals.

Currently, funding mechanisms under Fonasa concentrate on baskets associated with assisted reproduction techniques, which is replicated by Isapres. Without comprehensive coverage or realistic reference fees for ovulation induction with scheduled intercourse or reconstructive tubal surgery in the Free Choice Modality, practical asymmetries emerge, pushing patients toward assisted reproduction techniques. If we genuinely wish to confront the fertility crisis, a concrete and achievable first step would be for Fonasa to incorporate comprehensive coverage for the diagnostic study of infertility and improve funding for medical and surgical treatments aimed at restoring fertility. Such a measure would allow many couples to access timely evaluations and therapies currently little known and difficult to access.

This would provide couples with a broader range of therapeutic alternatives, enabling them to make decisions based on clinical criteria and their own convictions, rather than being constrained by a financial structure that favors certain options over others. In a country concerned about its demographic future, expanding access to these treatments represents a crucial step forward.