President Trump issued an executive order on Tuesday aimed at making in vitro fertilization (IVF) more affordable. The procedure assists individuals struggling with infertility to build families.
The order acknowledges the significant cost of IVF, ranging from $12,000 to $25,000 per cycle, and emphasizes the need for increased access and more affordable treatment options. It states that supporting and improving access to affordable fertility treatments helps families pursue parenthood with greater hope and confidence.
The order directs the assistant to the president for domestic policy to submit recommendations within 90 days on safeguarding IVF access and substantially lowering out-of-pocket and health plan expenses for IVF treatment.
IVF emerged as a key discussion point during the 2024 presidential campaign following Alabama’s decision to shield IVF providers from legal liability, shortly after the state Supreme Court classified frozen embryos as children under state law.
Trump publicly declared his strong support for IVF access. A June poll by The Associated Press-NORC Center for Public Affairs Research revealed that roughly 60% of U.S. adults favor protecting access to IVF, with 26% expressing neutrality and approximately 10% opposing it.
In 2018, assisted reproductive technologies, including IVF, accounted for 2% of all births in the United States, according to data from the U.S. Centers for Disease Control and Prevention.
Here’s what to know about this increasingly prevalent fertility treatment.
What is IVF?
IVF provides a solution for women experiencing difficulty conceiving, typically employed after less costly fertility treatments have proven unsuccessful.
The process involves retrieving a woman’s eggs, combining them with a man’s sperm in a laboratory dish to create a fertilized embryo, and then transferring the embryo into her uterus to initiate pregnancy.
IVF is conducted in cycles and may require multiple attempts. The procedure can utilize a couple’s own eggs and sperm or those from donors.
Does insurance cover the procedure?
Insurance coverage for IVF and other fertility treatments varies widely depending on the insurer.
Larger employers are increasingly offering this coverage to attract and retain employees. Many businesses are expanding coverage beyond those with infertility diagnoses, making it accessible to LGBTQ+ couples and single women.
Government-funded programs like Medicaid generally have limited fertility treatment coverage. Smaller employers are less likely to offer this coverage.
Critics argue that the lack of widespread coverage creates inequity, restricting access primarily to those who can afford the substantial out-of-pocket costs.
What is the history of IVF?
The world’s first IVF baby was born in England in 1978. The first IVF birth in the U.S. occurred in 1981 in Norfolk, Virginia, with the arrival of Elizabeth Carr.
Her mother, Judith Carr, experienced three abnormal pregnancies requiring the removal of her fallopian tubes. She and her husband sought treatment from Howard and Georgeanna Jones, physicians who established a fertility clinic at Eastern Virginia Medical School.
The Norfolk clinic encountered opposition even before opening. A 1979 state certification hearing attracted over 600 attendees. While some women testified in support of IVF, citing their desire to have children, anti-abortion groups raised concerns about medical interference with conception and embryo disposal.
Despite legislative attempts to halt the clinic, it opened in 1980, followed by others in California, Tennessee, and Texas. By 1988, at least 169 in vitro centers operated across 41 states.
While IVF use expanded, opposition within the American anti-abortion movement persisted, according to Margaret Marsh, a history professor at Rutgers University. Marsh notes that although some within the movement had accepted IVF as a treatment for infertility, opposition has intensified since the overturning of Roe v. Wade in 2022.
“Not everyone in the anti-abortion movement opposes these reproductive technologies, but many do,” she stated.
How are embryos made?
The treatment often involves using hormones to stimulate ovulation, producing multiple eggs that are retrieved using a needle from the ovaries.
Fertilization occurs by either adding sperm to the eggs in a lab or injecting a single sperm into each egg.
The fertilized egg is cultured for about five to six days to develop into a blastocyst—the early-stage embryo—which is then either transferred or stored for later use, explains Dr. Jason Griffith, a reproductive endocrinologist in Houston.
Griffith explains that a three-day-old embryo comprises six to 10 cells, while a six-day-old embryo has 100 to 300 cells. This is in contrast to a human body containing over 1 trillion cells.
How are embryos frozen and stored?
Frozen embryos can be used for future pregnancies, and the majority survive the thawing process.
Freezing involves replacing the water in embryo cells with a protective fluid and flash-freezing using liquid nitrogen, according to Johns Hopkins Medicine.
Frozen embryos are stored in liquid nitrogen tanks at hospital labs or reproductive medicine centers. Griffith notes that they can also be stored in facilities contracted by healthcare providers, especially for long-term storage. Frozen embryos can remain safely preserved for a decade or more.
Griffith emphasizes that these facilities meticulously monitor conditions and employ physical security measures, including backup generators for power outages.
—Ungar reported from Louisville, Kentucky. Associated Press writers Tom Murphy in Indianapolis and Ben Finley in Norfolk, Virginia contributed reporting.
