When Donald Trump made his announcement, it got a lot of attention. Many of my patients were really hoping for insurance coverage for in vitro fertilization (IVF). It’s often the only way for individuals to start a family, but the costs can be prohibitively high for so many.
I can’t say I was shocked when the White House confirmed that there would be no plans to mandate IVF coverage. It’s pretty disappointing, really, especially since it feels like a step back from commitments made earlier this year to help reduce IVF costs.
But, honestly, I expected this outcome. It’s not the first time this administration has prioritized insurance profits over American families’ needs.
For quite a while, my colleagues and I have been concerned about the troubling trends pushing conservative ideologies. Groups like the Heritage Foundation have promoted concepts like “Restorative Reproductive Medicine,” which, unlike IVF, claims to tackle the underlying issues of infertility.
This anti-IVF stance is becoming more common, presented as assistance for those facing infertility. It raises questions about IVF’s legitimacy and poses a significant risk to accessible care for families.
To understand why this approach is so misleading, it’s important to know how infertility is typically treated.
When couples come to see me, experiencing difficulties in conceiving, I aim to provide tailored, evidence-based care.
This usually involves rigorous diagnostics—like hormonal assessments, imaging, and semen analysis—to identify any clear reasons for their struggles with pregnancy.
The goal is to uncover underlying issues such as polycystic ovarian syndrome (PCOS), endometriosis, thyroid problems, or male-factor infertility.
IVF should only be considered after determining the root causes of infertility, especially when other treatments haven’t worked.
Fertility treatments can be complex, and what’s effective for one person might not work for another. As a physician, I need a variety of tools at my disposal. In my role as a reproductive endocrinologist, IVF is a crucial option.
IVF is applicable for many different infertility diagnoses. In fact, nearly 2% of babies born in the U.S. are conceived through IVF. That number is likely to rise if we can make the procedure more financially accessible.
For some, IVF is their only chance of having biological children, particularly for women with blocked fallopian tubes or men with very low sperm counts.
Those who oppose IVF, often driven by political or religious beliefs, cherry-pick certain legitimate medical practices, branding them as “restorative.”
Proponents of restorative reproductive medicine suggest treating the causes of infertility, something infertility specialists already do for all of their patients. Many who push these ideas don’t come from a place of evidence-based medicine but from specific ideological beliefs.
They view the fetus as having legal rights and oppose IVF, which is known as fetal personality, even though it’s often the most effective treatment for many dealing with infertility.
Sure, the idea behind restorative reproductive medicine might seem appealing. After all, as doctors, it’s our job to address core health issues. But neglecting to use IVF when it’s appropriate could leave many unable to conceive. Dismissing IVF ignores the complexities of infertility and the pain those affected endure.
Restorative reproductive medicine should not be seen as a substitute for IVF. Ultimately, the movement seems more political than anything else—aimed at eradicating IVF altogether.
Even though the Trump administration may have walked back promises to make IVF more accessible, there’s also an indication that they intend to redirect funding toward restorative reproductive medicine. This shift could endanger IVF access for prospective parents nationwide, which is alarming.
Excluding IVF from fertility care can lead to severe consequences for patients, and it’s crucial to understand these potential impacts. When it comes to family building, IVF serves as a scientifically validated treatment option that must be both affordable and accessible.
Elizabeth Ginsburg, Maryland, is president of the American Association of Reproductive Medicine and Fellowship Director of Reproductive Endocrinology and Infertility at Harvard University.
