Donald Trump made good on his promise to expand access to in vitro fertilization (IVF) on February 18, signing an executive order that “directs policy recommendations to protect IVF access and aggressively reduce out-of-pocket and health plan costs for such treatments.” The order is framed as a pro-family move, emphasizing “the importance of family formation” and stating that “public policy must make it easier for loving and longing mothers and fathers to have children. . . . As many as one in seven couples trying to have a baby are unable to conceive, and many face significant financial hurdles to accessing IVF.”
The executive order is long on pronatalist rhetoric and short on specific policy, noting the high costs of IVF (between $12,000 to $25,000 per cycle); that most healthcare insurance plans and employment benefit packages do not fully cover IVF; and that the American “fertility rate is at another historic low.” According to the Department of Health and Human Services, over 85,000 infants were born because of IVF in 2021.
That number, however, highlights precisely why IVF is an ethical nightmare. The CDC’s 2021 Assisted Reproductive Technology Fertility Clinic and National Summary Report estimated that 238,126 patients underwent 413,776 assisted reproductive technology (ART) cycles, around 99 percent of which would involve IVF. Considering that multiple embryos are usually transferred during each cycle, and that IVF involves the creation of a minimum of four to five embryos (usually far more), the actual birthrate of children conceived in this fashion reveals the horrifying human attrition rate of this process. Indeed, the number of frozen embryos left in storage freezers has become a nearly invisible national crisis. A minimum estimate indicates that at least one million embryos are frozen in the United States.
Trump’s executive order once again highlights the divide between the pro-life movement and the pronatalist crowd. Lila Rose of Live Action pointed out that a mere “7% of embryos created via IVF will result in a live birth” and that “93% of these lives are frozen indefinitely, miscarried, or aborted.” Trump ally and pronatalist advocate Elon Musk, the world’s richest man, has twelve children with three women (and purportedly his thirteenth child was born to a conservative influencer several months ago). At least eight of them were conceived via IVF. Most pro-lifers oppose IVF on the grounds that it commodifies unborn children and results in massive loss of life; the pronatalists want more babies at any cost.
Trump has firmly sided with pronatalist advocates in this debate. Trump’s 2024 platform, which removed key language endorsing the right to life of unborn children, included a new commitment to access for “Birth Control and IVF.” In October, he indirectly addressed the incompatibility of the pro-life and pronatalist positions on IVF when he referenced the Alabama Supreme Court’s ruling that frozen embryos created via IVF are children under state law. Citing a phone call from an Alabama senator concerned that the ruling could make IVF clinics illegal, Trump boasted that he took action immediately.
