Former President Donald Trump announced Thursday a new plan to make IVF widely available and subsidized by the federal government.
“Under the Trump administration, your government will pay for, or your insurance company will be mandated to pay for, all costs associated with IVF treatment,” Trump said at a Michigan campaign event, referring to the fertility treatment that involves creating an embryo in a lab setting and then implanting it under medically controlled conditions.
“Because we want more babies, to put it very nicely. … But the IVF treatments are expensive. It’s very hard for many people to do it and to get it, but I’ve been in favor of IVF, right from the beginning,” the former president added.
On its face, this is an appealing idea. Who wouldn’t want to help couples struggling with infertility? And Trump is right: We do need more babies in this era of declining birth rates.
But IVF comes with both moral and practical challenges.
First, IVF does not guarantee a child. Women who are 35 and under have a 51% chance of having a successful single child pregnancy from IVF using their own eggs, according to the Society for Assisted Reproductive Technology. For women who are 38 to 40, that chance drops to 25%. For women 41-42, the odds are even lower: There’s only a 12% chance they will have a child.
Furthermore, don’t think IVF is easy for women, who must undergo a grueling treatment of hormones to allow for egg retrieval and then optimal implantation of the fertilized egg or embryo. As the data shows, many women will face that extremely difficult medical treatment—and have no happy ending.
Just take the case of Kaitlyn Abdou.
“Three years, five egg retrievals, 10 embryo transfers, 19 embryos, $165,000 and over 80 pounds of weight gained—and I have nothing to show for it,” Abdou wrote for NBC News’ “Today” in April.
“[A]s I look back on who I used to be three years ago, the confident, happy, hopeful young woman who dreamed of raising a family of her own, I can’t help but think that despite its magnificence, IVF ruined my life,” Abdou added.
“I am a broken shell of the person I used to be. I have nightmares; I have inescapable bouts of depression. I can’t look at an ultrasound image without choking back tears.”
That’s not the story we like to hear about IVF—but it is an experience that many women sadly face.
Some evidence also suggests that women who conceive by IVF may have more health pregnancy challenges than women who conceive naturally. For instance, women who conceived via IVF had a higher likelihood of developing gestational diabetes, according to a 2023 study from Finnish researchers. A 2019 study found that women using assisted reproductive technology to conceive had a higher chance of developing preeclampsia.
Furthermore, IVF is extraordinarily expensive.
“[C]osts for a single cycle of IVF have recently been estimated to range from $15,000 to $20,000 and can exceed $30,000,” stated a March fact sheet from the U.S. Department of Health and Human Services. “Given the average number of cycles that are needed to become pregnant from IVF is 2.5, this means that the average cost of IVF to conceive successfully can easily exceed $40,000.”
If insurance companies are mandated to cover IVF, those costs will be passed along to their customers via higher premiums. If the government starts subsidizing IVF, taxpayers would foot the bill.
There are also the moral challenges. While a May Gallup poll found that 82% of Americans think IVF is morally acceptable, 43% of Americans say it’s morally wrong to destroy the extra embryos created during IVF.
The typical IVF treatment involves producing a lot of extra embryos. Emma Waters, a senior research associate at The Heritage Foundation, estimated in a March report that on average, IVF involves the creation of 10 embryos.
“[T]his means that the 413,776 rounds of IVF reported in 2021 resulted in the creation of approximately 4.1 million embryos,” Waters wrote. “When dividing the total number of live-born infants by 4.1 million, this would mean that only 2.3 percent of all embryos created in the United States result in the live birth of a baby.”
The United States doesn’t have to allow such high numbers of embryos to be created. For instance, Germany allows the creation of only three embryos per cycle.
For those who believe that life begins at conception, these unused frozen embryos pose quite the conundrum. If we are opposed to ending the life of an unborn child in the womb, how can we be OK with ending these children’s lives?
Some have advocated donating the embryos to other couples. In 2022, twins created in 1992 and frozen for decades were born. But this solution poses its own moral quandaries. On a practical level, there are also concerns: Do enough people exist who want a child and are OK with embryo adoption to carry these millions of discarded embryos to term?
Nor are these the only moral issues present in IVF.
Right now, three quarters of fertility clinics allow testing of embryos for genetic issues, and nearly as many allow let parents test for sex, hair, eye, and even skin color. Do we really want parents discarding embryos with Down Syndrome or other so-called “undesirable” conditions? Do we want parents rejecting boys in favor of girls? Do we want to encourage racist preferences through skin color selection?
Yes, more babies would be wonderful. As a 36-year-old woman who hopes to have children myself, I completely sympathize with couples who are facing infertility and want to try everything they can to have children, particularly in this era where adoption can be so difficult.
But we cannot be blind to the downsides of IVF, nor can we ignore the defenseless embryonic children who never consented to be frozen for decades or discarded, their lives prematurely ended.
Right now, the focus should be on addressing the moral challenges around IVF, not increasing the number of IVF treatments.
If policymakers want to increase the number of babies and help couples facing infertility, there are other options. One such solution would be funding medical research on infertility and eliminating regulatory barriers affecting this area.
The onerous burdens of student loans, high housing costs, and everyday expenses like gas and groceries make life unaffordable for many young Americans. Those fortunate enough to meet their spouse at a young age too often delay having children right away because of economic factors. Lawmakers could implement family-friendly policies, including a child support tax credit.
Such a debate would be welcome among our leading presidential candidates, putting the focus of this election on children and families. But when we advocate for more babies, let’s make sure we’re advocating for all babies, including the millions of embryos created in the course of IVF treatments.
