Donald Trump’s administration has announced a new initiative to make IVF treatment more affordable by striking a deal with drugmaker EMD Serono to reduce the cost of common fertility medications and by issuing new federal guidance to expand employer benefits. While praised as a step forward by some, the plan faces scrutiny for falling short of his campaign promise of free IVF and for its potential impact on broader reproductive rights, drawing both support from hopeful patients and sharp criticism from political opponents and public health advocates.
In a significant move impacting reproductive health, President Donald Trump announced on October 16, 2025, a multi-pronged plan aimed at lowering the costs and expanding access to in vitro fertilization (IVF) treatments across the United States. Speaking from the Oval Office, Trump outlined a deal with major fertility drug manufacturer EMD Serono and introduced new federal guidance designed to encourage employers to offer fertility coverage. This initiative, framed as a response to declining national birth rates, comes after a February executive order pledging to make IVF more affordable and amidst ongoing national debates surrounding reproductive rights.
The ‘Fertilization President’s’ Vision for Family Building
During his campaign, Donald Trump famously pledged to make IVF treatment free, stating, “We want more babies, to put it nicely.” He has often championed a “pronatalist” position, describing himself as “the fertilization president” and expressing concern over the nation’s declining fertility rate, which currently stands at roughly 1.6 births per woman, below the replacement level of 2.1. This stance aligns with other prominent figures in his administration, such as JD Vance and Robert F. Kennedy Jr., who advocate for policies supporting higher birth rates, particularly among certain demographics.
However, the new plan represents a more measured approach than his initial campaign promise of entirely free treatment. It builds upon an executive order signed in February 2025 that called for recommendations to reduce costs and expand access to IVF. The initiatives unveiled are a direct response to the high financial burden of infertility treatments, with a single IVF cycle often costing between $15,000 and $30,000, and multiple cycles potentially pushing out-of-pocket expenses beyond $61,000.
Unpacking the New Initiatives: Drug Deals and Employer Benefits
At the core of Trump’s IVF plan are two main components:
- Fertility Drug Price Reduction: Through a “most-favored nation pricing agreement,” EMD Serono, a leading fertility drug manufacturer, has committed to lowering the cost of common medications by 42% to 79%. This includes significant discounts for Gonal-f, a widely used drug that stimulates egg production for IVF. These discounted drugs will be available to eligible patients earning up to 550% of the federal poverty level (approximately $86,000 per year) via TrumpRx, a government website launched for direct-to-consumer prescription drug sales, beginning in early 2026. These savings are projected to be between $1,200 and $1,900 per cycle for qualifying individuals.
- Expanded Employer Fertility Coverage: The administration is set to issue new guidance from the Departments of Labor, Treasury, and Health and Human Services. This guidance will allow companies to offer fertility benefits separately from major medical insurance plans, much like dental or vision plans. This aims to reduce administrative complexities for employers and provide workers with the option to purchase such benefits, addressing the growing demand for fertility coverage, which is among the most sought-after benefits for young adults in the workforce, according to a survey by Maven Clinic and Mercer.
Additionally, the Food and Drug Administration (FDA) will collaborate with EMD Serono to expedite the approval process for Pergoveris, another one of its fertility drugs currently available in Europe, to increase treatment options in the U.S.
The Real-World Impact and Critiques
The announcement has elicited a range of reactions. Patients like Corinn O’Brien, who underwent three rounds of IVF, welcomed the news, noting that drug costs alone could range from $1,000 to $5,000 per cycle. She emphasized that while covering the entire IVF cycle would be a “game changer,” helping with drug costs is “progress and is much appreciated.” Roger Shedlin, CEO of the fertility benefits company Win, also called these “steps in the right direction,” acknowledging the material positive impact on overall fertility cycle costs.
However, critics quickly highlighted the significant gap between Trump’s ambitious campaign promise and the current initiatives. Democratic senators, including Patty Murray and Tammy Duckworth, dismissed the executive order as a “PR stunt,” pointing out that Republican lawmakers have repeatedly blocked legislation that would mandate insurance coverage for IVF and make it more broadly affordable. The executive order itself does not establish new rights or guarantees, leaving its implementation dependent on existing laws and available funding. Concerns also linger regarding equitable access for LGBTQ+ individuals, who often face barriers and discrimination in accessing fertility care, particularly given the administration’s past rollbacks on protections for transgender people and diversity programs.
Broader Context: Pronatalism and Policy Paradoxes
The push for expanding IVF access is deeply intertwined with the administration’s broader “pronatalist” agenda, which advocates for increasing the nation’s birth rate. Yet, critics argue that this stance creates significant policy paradoxes. For example, the focus on IVF comes in the wake of the Supreme Court’s overturning of Roe v. Wade, made possible by Trump’s judicial appointments, which has fueled efforts in some GOP-led states to impose new restrictions on life beginning at conception, thereby threatening access to IVF itself, as seen in the Alabama Supreme Court ruling. Pennsylvania’s congressional delegation, for instance, includes cosponsors of the “Life at Conception Act,” which contains premises similar to Alabama’s ruling.
Furthermore, some observers point to other administration policies that appear to contradict a genuine commitment to child well-being. The “Merchants of Death” article highlights concerns such as the shuttering of the National Institute of Child Health and Human Development’s communications office and programs that track infant mortality and maternal health, like the Pregnancy Risk Assessment Monitoring System (PRAMS). It also cites Health and Human Services Secretary Robert F. Kennedy Jr.’s history of spreading doubt about childhood vaccinations and the nomination of individuals with anti-scientific views, such as Casey Means, as potential threats to child health. These actions suggest a disconnect between the stated goal of increasing birth rates and policies that could adversely affect the health and safety of children once born.
Experts also question the overall impact of expanded IVF access on the national birth rate. As noted in an article by Miriam Cates, IVF generally has low success rates for women over 35, a demographic increasingly delaying childbirth. Even in Israel, where fertility treatment is free and the total fertility rate is above replacement, only 5% of babies are born through IVF. There’s a concern that promoting IVF could create a false sense of security, leading women to delay conception even further, ultimately decreasing overall birth rates.
What This Means for the Future of Family Building
While the new initiatives offer a measure of relief for some of the millions of Americans struggling with infertility—estimated to be 1 in 8 women according to a KFF’s 2024 Women’s Health Survey—they also underscore the complex and often contentious landscape of reproductive healthcare in the U.S. The doubling of IVF use from 2012 to 2021, leading to a 50% rise in ART-conceived births, demonstrates a clear and growing demand for such treatments, as explored in The American Journal of Managed Care. The administration’s plan provides some financial alleviation and regulatory streamlining, particularly concerning employer-offered benefits.
However, the lack of a mandate for insurance coverage, coupled with broader policy decisions impacting reproductive rights and public health infrastructure, leaves many questions unanswered. The long-term success of increasing birth rates through these measures remains speculative, and the debate over comprehensive, equitable, and affordable fertility care for all Americans will undoubtedly continue to be a central issue in national discourse.
