Fertility Status as a Marker for Overall Health (R21 Clinical Trial Optional) | PA 18 049

Opportunity Information: Apply for PA 18 049

The National Institutes of Health (NIH) funding opportunity "Fertility Status as a Marker for Overall Health (R21 Clinical Trial Optional)" (Funding Opportunity Number PA-18-049) is designed to support early-stage, exploratory research that treats fertility status not just as a reproductive outcome, but as a potential indicator of broader, whole-body health. The central idea behind the program is that while it is already well established that many chronic diseases and conditions (such as cancer, diabetes, and obesity) can reduce fertility, there is a major gap in understanding the reverse relationship: whether a person's fertility status can help predict, signal, or reflect overall health risks and long-term health outcomes. In other words, the program is aimed at testing the concept that fertility may function as a "window" into general health, potentially revealing underlying physiologic, metabolic, genetic, or systemic issues that extend well beyond the reproductive system.

A key feature of this FOA is its emphasis on the growing body of evidence suggesting infertility is often not an isolated problem limited to the reproductive axis. Instead, infertility may be intertwined with other diseases and disorders through shared biological pathways or genetic architecture. The announcement points to epidemiologic findings that link fertility status in both females and males with a range of somatic diseases and conditions, implying that fertility-related measures might serve as early markers for later health problems or identify individuals who warrant closer monitoring for non-reproductive disease risks. Because the mechanism can run through shared physiology, the intended research scope includes investigating connections where fertility status is used as the starting point or predictor, rather than the outcome being harmed by some other illness.

The scope boundaries are explicit: applications that primarily study how a disease or disorder affects fertility are considered outside the program's intent. The research focus must be on evaluating fertility status as a marker for overall health, meaning fertility (or fertility-related indicators) should be framed as a signal, correlate, or predictor of broader health status, comorbidities, or future disease risk. The "Clinical Trial Optional" designation indicates that applicants may propose studies that include a clinical trial component if appropriate, but it is not required, which allows for a broad range of exploratory designs that may include observational studies, secondary analyses, biomarker development, pilot interventions, or feasibility work that can justify larger future studies.

This opportunity uses the NIH R21 mechanism, which typically supports high-risk, high-reward developmental projects intended to generate preliminary data or proof-of-concept findings. The listed award ceiling is $200,000, reflecting the program's role in funding smaller-scale projects that can quickly test promising hypotheses. The opportunity is categorized as discretionary funding through a grant instrument, with activity areas tied to health and social services (CFDA numbers 93.113 and 93.865). The original closing date shown in the source data is 2020-05-07, and the FOA was created on 2017-11-15, which helps place it in context for timeline and version checking if someone is searching for current NIH equivalents or reissued announcements.

Eligibility is broad and includes many types of U.S. public and private organizations and governments, such as state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations that are not federally recognized; public housing authorities; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses); and small businesses. The FOA also highlights additional eligible applicant categories, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, U.S. territories or possessions, regional organizations, and even non-U.S. entities (foreign organizations). This inclusive eligibility language signals NIH's interest in drawing ideas and data resources from a wide array of institutions and communities, which is especially relevant for fertility and health questions where population diversity, access to care, and different exposure profiles can strongly shape findings.

Overall, the grant opportunity is essentially a call for innovative, early-stage projects that connect reproductive metrics to broader health trajectories, with the longer-term goal of determining whether fertility status could help clinicians and researchers identify health risks earlier, understand shared disease mechanisms, and potentially refine prevention or screening strategies. The emphasis is not on infertility treatment by itself, but on using fertility-related information as a meaningful health indicator that may reflect underlying systemic conditions.

• The National Institutes of Health in the environment, health, income security and social services sector is offering a public funding opportunity titled "Fertility Status as a Marker for Overall Health (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.113, 93.865.
• This funding opportunity was created on 2017-11-15.
• Applicants must submit their applications by 2020-05-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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