President Donald Trump has taken steps to enhance accessibility to in vitro fertilization (IVF) and aims to lower its prohibitive costs, which can reach up to $25,000 per cycle.

He plans to unveil a proposal for a nationwide IVF expansion within the next 90 days, although the timeline for any potential changes in out-of-pocket expenses remains unclear.

Currently, IVF treatments are covered by insurance in at least 40 states, with numerous employers providing fertility benefits to their employees.

The incidence of infertility is increasing in the U.S., affecting approximately 1 in 8 women.

Despite the push for improved access, the specifics regarding funding for these treatments have not yet been clarified. Many insurance companies in the U.S. do not cover infertility treatments.

While some employers extend cost-sharing fertility benefits to help mitigate the financial strain of assisted reproductive technologies like IVF, many individuals find themselves paying out of pocket. The cost for a single IVF cycle typically ranges from $12,000 to $17,000, potentially hitting $25,000 when medications are included.

It’s important to note that undergoing an IVF cycle does not guarantee a live birth, and multiple cycles may be necessary.

“To support American families, my Administration is committed to ensuring reliable access to IVF treatment by removing unnecessary statutory or regulatory barriers, making IVF significantly more affordable,” Trump stated.

Access to IVF varies across different states. At present, 22 states and Washington, D.C., have infertility coverage laws, which differ considerably. For example, Massachusetts and Illinois have enacted laws mandating insurance coverage for IVF treatments.

In response to the rising demand for IVF services, a growing number of employers are offering fertility benefits to assist with cost-sharing. Such fertility insurance can help cover the costs of infertility testing, diagnostics, and treatments.

“It’s entirely feasible to mandate IVF coverage from insurance providers, as this has already been implemented on a state level,” remarked Roger Shedlin, MD, CEO of WIN, a provider of fertility and family wellness benefits.

“This executive order acknowledges the critical importance of access to fertility care. We’ve witnessed successful state-level expansions of IVF coverage through mandated insurance benefits, and now there’s a chance to replicate that success on a national level,” he told Healthline.

Nonetheless, changes in state and federal policies don’t happen instantly.

Trump’s executive order has set a 90-day deadline for the Assistant to the President for Domestic Policy to present “a list of policy recommendations aimed at protecting IVF access and significantly reducing out-of-pocket costs for IVF treatment.”

This indicates that the executive order will not result in immediate changes to IVF costs or accessibility. Beyond the 90-day window, it remains uncertain when any policy alterations surrounding IVF might start to take effect.

“Typically, such changes require time to be fully realized and are contingent on the system adjusting to meet demand,” shared Christy Lane, Co-Founder of Flora Fertility, a provider of fertility insurance.

“The ability to afford treatment will still largely dictate access. It’s vital for individuals to take charge of their health outcomes through private coverage when feasible, so they are not at the mercy of shifting political circumstances that could affect their healthcare access,” she noted.

Lane further explained that proposals like Trump’s IVF plan could expand coverage for those with health insurance, helping them avoid steep out-of-pocket expenses. However, she cautioned that the surge in demand could put fertility clinics under pressure, resulting in longer wait times.

“It will be crucial to utilize all available treatment options that precede IVF (such as medications and IUI), which can yield positive results with early intervention. Unfortunately, these options are not addressed in the executive order,” she concluded.

Trump’s initiative to enhance IVF access is at odds with certain conservative factions and political leaders who have raised concerns about the concept of personhood concerning frozen embryos created through IVF.

In February 2024, the Alabama Supreme Court ruled that frozen embryos are considered children, and their destruction—which often occurs after a successful live birth from IVF—could be classified as murder under state law. Subsequently, Alabama Governor Kay Ivey, a Republican, signed legislation providing legal protections for healthcare providers and patients involved in IVF.

While Trump has maintained his support for IVF accessibility, the executive order does not clarify whether frozen embryos conceived through IVF will be included in the proposed expansion.

Furthermore, the executive order remains silent on whether transgender couples will have enhanced access to IVF, which could conflict with the new federal “gender ideology” policy that recognizes only male and female genders.

In Congress, Republican support for broader IVF accessibility is still lacking. In June 2024, the party rejected a Democratic bill that aimed to guarantee nationwide access to IVF services.

“Fertility treatments are medical services and should be treated as such,” Shedlin asserted.

“Offering limited financial assistance isn’t sufficient—we need structured insurance coverage that ensures timely access to the appropriate treatments.”

The increasing rates of infertility can be attributed to various factors, leading many couples to consider assisted reproductive technology (ART) as a means to conceive.

Intrauterine insemination (IUI) is a frequently used intervention, though its success rates diminish for women over 40. This method involves injecting sperm directly into the uterus via a catheter, boosting the chances of fertilization during a woman’s peak fertility period. IUI is generally less invasive and more affordable than IVF.

IVF treatment begins with self-administered injections containing estrogen-blocking and follicle-stimulating hormones to encourage the ovaries to produce multiple eggs. Once it’s time to induce ovulation, the eggs are retrieved, fertilized in a lab, and either transferred to the uterus or frozen for future use.

Fertility specialists often recommend opting for IVF over IUI due to its higher success rates, particularly for older couples or those classified as “advanced maternal age” (over 35).

However, IVF is not without its challenges. A study from 2021 found that successful implantation occurred in just 19% of individuals undergoing fresh embryo transfers.