The FACTS Innovative Network of Excellence (FINE) Program - The FACTS Innovative Network of Excellence (FINE) is a proposed NAVIGATE Reproductive Center of Excellence dedicated to improving the diagnosis, treatment, and care coordination of infertility, recurrent miscarriage, endometriosis, polyendocrine metabolic ovarian syndrome (PMOS), reproductive endocrine disorders, and related reproductive health conditions. FINE builds on the proven clinical success of the Washington, DC based medical practice, MD for Life, the national educational reach of FACTS, and a growing network of clinical and specialty partners to expand access to evidence-based, root-cause reproductive healthcare for women and families across the United States. FINE brings together FACTS’ national educational infrastructure, MD for Life’s clinically validated root-cause care model, partner clinic in Orlando, Florida—Palm Integrative Fertility’s replication capacity, and specialized partners such as RRM Diagnostics, Chart Your Cycle and RestoreEndo to create a unified, multi-site Center of Excellence. At the core of FINE is a standardized clinical framework that ensures consistent, high-quality care across all participating sites. Clinical teams, including family physicians, OB/GYNs, midwives, fertility educators, nutritionists, pharmacists, pelvic-floor physical therapists, ultrasound technologists, male-factor diagnostic specialists, and advanced endometriosis and restorative surgeons, deliver care through shared, evidence-based pathways. These pathways incorporate pre-visit cycle charting, cycle-timed laboratory and ultrasound protocols, EMR-embedded decision-support tools, and structured referral triggers. Too often, women with reproductive health conditions experience years of symptoms, fragmented referrals, and delayed or missed diagnoses. FINE addresses these challenges by helping patients begin the diagnostic process before their first appointment through fertility literacy education and cycle charting. When paired with standardized diagnostic pathways, multidisciplinary care teams, and coordinated referral networks, this approach supports earlier identification of underlying conditions and more timely treatment. The project will improve access to care through telehealth, patient navigation services, and replication of the MD for Life model at pilot sites in Washington, DC, Orlando, Florida, and Pittsburgh, Pennsylvania. FINE aims to reduce diagnostic delays, ensure women receive an initial evaluation within 90 days of first contact and men within 180 days, and decrease travel burdens through expanded virtual and satellite-site services. Patient navigators will help individuals and couples move efficiently through care by coordinating appointments, referrals, fertility education, and supportive services. FACTS will also strengthen the reproductive healthcare workforce through clinician training, continuing medical education, implementation support, mentorship, and technical assistance. Participating clinicians will receive practical tools, standardized protocols, and ongoing coaching to support adoption of cooperative hormonal and restorative reproductive medicine and fertility awareness-based approaches in diverse practice settings. A rigorous mixed-methods evaluation led by Midwest Evaluation and Research will assess implementation, access, clinical outcomes, patient-reported outcomes, and workforce development. Findings will be used to drive continuous quality improvement and will be translated into clinical toolkits, training resources, webinars, presentations, and peer-reviewed publications that can support replication nationwide. Over the 24-month project period, FINE will create a scalable model for coordinated, root-cause reproductive healthcare that improves access, strengthens the workforce, reduces delays in diagnosis and treatment, and advances health outcomes for women and families.
