In vitro fertilization (IVF) has become a focal point of political unrest, especially, because the procedure raises a series of complex and nuanced ethical questions that cannot be easily categorized in binary terms, as some politicians may suggest. IVF, one of the most effective fertility treatments, is one in which doctors collect mature eggs from a woman's ovaries, fertilizing them with sperm to create embryos, and then freeze many of those embryos for future use (1). The embryos are stored by replacing the water in their cells with a protective fluid and freezing them using liquid nitrogen (4), a procedure that is highly controversial over its morality. Since the overturning of Roe v. Wade, opposition to IVF has gained traction, with some anti-abortion groups questioning the ethics of embryo creation and destruction. This division highlights the broader moral dilemma facing lawmakers: balancing the potential benefits of IVF in helping individuals start families against the ethical concerns surrounding embryo creation and destruction.
In February 2024, the Alabama Supreme Court ruled that "embryos are children under law," a decision that threatened the accessibility of IVF (2). In response, many Republicans began to take a stance supporting the procedure, a surprising shift from their previous positions on reproductive rights. These Republicans defended IVF as a “pro-life issue,” but struggled with reconciling this stance with their opposition to abortion. The central dilemma lies in the idea that, as proponents of “life beginning at conception” argue, IVF involves the creation of embryos that may ultimately be discarded—raising ethical concerns about the destruction of potential life (2). Florida Senator Marco Rubio captured this tension, acknowledging that “the ethical dilemma is that, in order to create life, you have to destroy life because you’ll create embryos that are not going to be used” (3). Some, like Emma Waters, a Senior Research Associate in the DeVos Center for Life, Religion, and Family at The Heritage Foundation suggest the U.S. adopt policies limiting the number of embryos created to reduce this ethical conflict. She explains that Republican lawmakers need not be boxed into a strict "binary" choice of fully supporting or opposing IVF (3). While Alabama's legislature has passed a bill protecting IVF providers from legal liability, the legal and ethical questions from the state court's ruling remain unresolved.
IVF treatments typically cost between $12,000 and $25,000 per round, and insurance coverage for the procedure is often inconsistent (5). Many businesses only extend coverage to individuals with infertility, while others, including coverage under Medicaid, often limit fertility treatment access or exclude certain groups, such as LGBTQ+ couples and single women (4). This inconsistency in coverage creates a divide, limiting IVF access to those who can afford the treatment out-of-pocket. During his campaign, Donald Trump promised that IVF would be made free for families, either through insurance coverage or government funding. President Trump, aiming to address the growing concern around the high cost of IVF, signed an executive order on February 18th, 2025, in which he tasked the assistant to the President for domestic policy with providing a list of recommendations to protect IVF access (4). However, Senators like Patty Murray (D-Wash.) have criticized his recent executive order, calling it a "PR stunt" due to the lack of concrete policy action (5). They point to the history of Republican resistance to legislation that would make IVF more affordable and accessible. Senate Democrats, including Senator Tammy Duckworth, argue that if Trump is serious about making IVF free for all, he should urge Senate Republicans to back the "Right to IVF Act," which would require insurance plans to cover the procedure (6). The bill has been blocked by Senate Republicans for over a year due to concerns that its language could be used to justify abortions.
Ultimately, Trump's executive order only requests recommendations to make IVF more affordable but does not guarantee direct action. This cautious approach reflects the complex position Republican lawmakers find themselves in, balancing support for IVF with their anti-abortion stance. As the debate continues, it remains to be seen whether Trump will take more definitive action on IVF accessibility. Until then, the political conversation surrounding IVF will remain deeply divided, with ongoing ethical debates over the potential benefits of wider access to fertility treatments versus concerns over the moral implications of destroying human embryos in the process.
Reviewed by Leya Edwards-Headen
References
[1] “In Vitro Fertilization (IVF).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Sept. 2023, www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716.
[2] Schapitl, Lexie. “How IVF Is Complicating Republicans’ Abortion Messaging.” NPR, NPR, 16 Mar. 2024, www.npr.org/2024/03/16/1238966404/how-ivf-is-complicating-republicans-abortion-messaging.
[3] “IVF as an Election and Policy Issue .” KFF, 9 Oct. 2024, www.kff.org/quick-take/ivf-as-an-election-and-policy-issue/.
[4] Ungar, Laura. “Trump Has Signed an Executive Order on IVF. Here’s What You Should Know about the Procedure.” AP News, AP News, 18 Feb. 2025, apnews.com/article/ivf-vitro-fertilization-trump-executive-order-65972cc1b10151bf1a0d9390fe5754d9.
[5] Simmons-Duffin, Selena, and Diane Webber. “Trump Wants to Lower the Cost of IVF. New Executive Order Seeks Ideas to Do That.” NPR, NPR, 19 Feb. 2025, www.npr.org/sections/shots-health-news/2025/02/18/nx-s1-5301201/trump-executive-order-ivf-in-vitro-fertilization.
[6] O’Connell-Domenech, Alejandra. “Trump’s IVF Order: Democrats Allege ‘PR Stunt’ as Anti-Abortion Groups Bristle .” The Hill, The Hill, 19 Feb. 2025, thehill.com/policy/healthcare/5154154-trump-ivf-order-criticized/.
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