Efforts by President Donald Trump to make in vitro fertilization (IVF) more affordable could potentially lead to tens of thousands more births in the U.S. However, a recent international study indicates that even a substantial increase in IVF births may not reverse the country’s overall fertility decline.
Potential IVF Birth Increase
Research shows halving out-of-pocket IVF costs more than doubles births achieved through assisted reproductive technology (ART), potentially resulting in 140,000 to 160,000 additional births annually in the U.S. This substantial increase in IVF births would only slightly offset the larger trend of declining fertility rates.
In February 2025, Trump signed an executive order to develop recommendations to expand IVF access and reduce associated costs, aiming to address America’s declining birth rate. The order targeted high IVF prices, often ranging from $12,000 to $25,000 per cycle, as a significant barrier for prospective parents.
Administration Measures and Study Findings
The Trump administration launched initiatives to lower fertility treatment costs, including reducing prices of fertility drugs and exploring new coverage options. Lower IVF costs are linked to concerns about the U.S. falling fertility rate, below replacement level for several years.
An international study presented at the European Society of Human Reproduction and Embryology meeting found a 2.67-fold birth increase through ART when treatment costs are halved. In the U.S., this could mean 140,000 to 160,000 additional births annually.
The study compared the affordability of fertility treatment across 25 countries. Places where costs represented a small share of household income, like Israel, Japan, and Spain, had higher ART birth rates. In contrast, in countries where costs exceeded annual household income, IVF births were minimal.
Cost Barriers and Executive Order
Cost remains a significant barrier for many seeking fertility treatment. A Kaiser Family Foundation study found 12 percent of women who needed fertility care couldn’t access it due to costs. While one IVF cycle may cost between $12,000 and $25,000, totals can reach $70,000 for those requiring multiple cycles.
Trump’s administration took steps to cut fertility drug prices and expand fertility healthcare coverage. This includes creating new benefit options for employers to offer their employees. Despite these efforts, constraints such as clinical capacity and the availability of embryologists need consideration.
Impact on U.S. Birth Rate Trends
U.S. fertility rates have consistently fallen below replacement levels. According to the CDC, in 2024, the birth rate was 1.6 births per woman, whereas replacement level is approximately 2.1. This decline concerns policymakers and economists due to its implications for economic growth and workforce participation.
IVF is one of the few pronatalist policies with a direct link to birth rates, yet it can only address a portion of the fertility decline influenced by broad demographic and economic changes.
Alison Gemmill, Associate Professor of Epidemiology at UCLA, noted that more IVF births aren’t addressing the root causes of the long-term decline in U.S. births. Affordability impacts a smaller group of infertile people, implying it might not fully mitigate broader birth decline trends.
Trump’s Fertility Initiatives
Trump’s IVF affordability initiatives are part of larger efforts to help families dealing with infertility. Despite potential increases in IVF births, resolving America’s broader fertility slowdown demands more comprehensive solutions, addressing issues like housing costs, child care expenses, and economic conditions.
The study shows that although Trump’s policies could work, they might only tackle part of the larger demographic challenge.