Trump Signs Executive Order to Expand IVF Access, Lower Costs

President Donald Trump signed an executive order to improve access to in vitro fertilization (IVF) and reduce costs, which can run as much as $25,000 for a cycle.

Trump anticipates a proposal for nationwide IVF expansion within 90 days, but it’s unclear how long it could take for changes to out-of-pocket costs to occur.

Fertility treatments like IVF are already covered by insurance in at least 40 states, with many companies offering fertility benefits to workers.

Infertility rates are rising in the United States, with as many as 1 in 8 females affected.

The president has not yet specified how the treatments would be paid for. Infertility is not covered by many insurance companies in the U.S.

While some employers provide cost-sharing fertility benefits to help reduce the financial burden of assisted reproductive technologies like IVF, many Americans pay out-of-pocket. A single IVF cycle can range from $12,000 to $17,000, and as much as $25,000 if medications are needed.

However, an IVF cycle does not guarantee a live birth and often requires multiple treatment rounds.

“Therefore, to support American families, it is the policy of my Administration to ensure reliable access to IVF treatment, including by easing unnecessary statutory or regulatory burdens to make IVF treatment drastically more affordable.”

IVF access varies from state to state. Currently, 22 states and Washington, DC have infertility coverage laws that vary widely. Massachusetts and Illinois have legislation mandating insurance coverage for IVF treatment.

To meet the growing need for IVF treatments, an increasing number of employers offer fertility benefits to workers to help with cost sharing. Fertility insurance can help offset infertility testing, diagnostics, and treatment costs.

“Mandating coverage of IVF by insurance companies is certainly feasible as it is already being done on a state-by-state basis,” said Roger Shedlin, MD, CEO of WIN, a fertility and family wellness benefits provider.

“This executive order is an important acknowledgment that access to fertility care matters. We’ve already seen state-level success in expanding IVF coverage through mandated insurance benefits—now there’s an opportunity to build on that momentum at a national scale,” he told Healthline.

However, state and federal-level policy change doesn’t happen overnight.

Trump’s executive order set a 90-day deadline for the Assistant to the President for Domestic Policy to submit “a list of policy recommendations on protecting IVF access and aggressively reducing out-of-pocket and health plan costs for IVF treatment.”

This means the executive order will not immediately impact IVF costs or access. Beyond the 90-day timeline, it is unclear when changes to policies around IVF may start to shift.

“Generally, changes like this take time and are subject to the system catching up with demand,” said Christy Lane, Co-Founder of Flora Fertility, a fertility insurance provider.

“[The] ability to pay will still often prioritize who gets access. It is important for people to own their health outcomes through private coverage where possible, so they are not subject to shifting political outcomes that can impact their healthcare access,” she told Healthline.

Lane explained that proposals like Trump’s IVF plan would broaden coverage for people with health insurance to help them avoid high out-of-pocket costs. While this is undoubtedly a positive effect, she noted the increase in demand could stretch fertility clinics beyond capacity and lead to longer wait times.

“It will be imperative to utilize all the treatment options that come before IVF (such as medications and IUI), which can have successful outcomes with early intervention. These are currently not addressed in the executive order,” she said.

Trump’s position on improving IVF access clashes with some conservative groups and political leaders that have challenged the concept of personhood with regard to frozen embryos conceived via IVF.

In February 2024, an Alabama Supreme Court ruled that frozen embryos are children, and destroying them, which is common practice after a successful live birth from IVF, is considered murder under state law. Alabama Gov. Kay Ivey, a Republican, later signed a bill offering legal protection for medical professionals providing IVF as well as patients.

While Trump has continued to support IVF access, the executive order does not address whether frozen embryos conceived via IVF would be eligible under the proposed expansion.

The executive order does not address whether transgender couples are eligible for improved access to the procedure, which would clash with the new federal “gender ideology” policy recognizing only two sexes: male and female.

In Congress, Republicans are not yet on board with expanding IVF access. In June 2024, the party blocked a Democratic bill that would have guaranteed nationwide access to the procedure.

“Fertility treatments are medical treatments and should be covered like them,” Shedlin said.

“Simply offering limited financial assistance isn’t enough — we need structured insurance coverage that ensures people can access the right treatments at the right time.”

Rising infertility rates may be attributed to a number of factors, including:

Couples facing fertility challenges often turn to assisted reproductive technology (ART) to help them conceive.

Intrauterine insemination (IUI) is a common intervention with varying success rates that decrease among females over 40. With IUI, the sperm is injected into the uterus through a catheter to increase the odds of fertilization during a female’s most fertile window. It requires far less medication and is more cost-effective than IVF.

With IVF, the treatment begins with self-administered injections containing estrogen-blocking medications and follicle-stimulating hormones to help the ovaries produce more eggs. When it’s time to trigger ovulation, the eggs are retrieved and fertilized in a laboratory dish (in vitro) before being transferred to a uterus or frozen.

Fertility doctors often recommend bypassing IUI and trying IVF since the success rates are higher, particularly if the couple is older or of “advanced maternal age” (over 35).

Still, IVF success rates are not high. A 2021 study shows that implantation was successful in 19% of people who underwent fresh embryo transfers.