The Center for Reproductive Rights has published a helpful primer on IVF, an important resource as this vital form of health care becomes politicized. The primer is titled "IVF: A Critical Method for Building Families." It notes that IVF accounts for 2.6% of all U.S. births. It explains that IVF is used by many communities, including heterosexual couples facing infertility, individuals and couples who do not have a gamete necessary to become pregnant, and individuals or couples with genetic conditions to be screened. It highlights key barriers to accessing IVF:
Limited insurance coverage: IVF insurance coverage is limited, and even where it exists, it can be discriminatory. Currently, only 21 states and Washington, D.C. mandate some degree of private insurance coverage for fertility care. Not all of these mandates include coverage for IVF, and even some that do impose discriminatory eligibility requirements that exclude non-married individuals, same-sex couples, and individuals or couples who need to use donor gametes. These mandates do not apply to self-insured employers, may only apply to certain types of private insurance plans (e.g., individual or small group), and often exempt religious employers. Notably, there are no states that provide comprehensive IVF coverage to those on Medicaid, which disproportionately impacts people living on low incomes, people with disabilities, and Black, Indigenous, and other people of color.
Stigma and bias: Infertility is often also highly stigmatized and a person struggling to become pregnant may not feel comfortable talking about it with others, including their health care providers. Additionally, people may face bias from providers who hold stereotypes or negative preconceptions about who can or should be able to parent. These barriers lead to disproportionately low rates of IVF access for Black, Indigenous, and other people of color, people living on low incomes, people with disabilities, people with a high body mass index, and the LGBTQ+ community.
State laws limiting access: Following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Center, there have been increased efforts across state legislatures to limit IVF access. These bills include those that would grant legal rights to embryos as well as Targeted Restriction of IVF Providers (TRIP) bills. TRIP bills, like TRAP laws in the anti-abortion context, single out IVF providers with unnecessary and burdensome licensing schemes and reporting requirements. If enacted, these kinds of bills could lead fertility health care providers and clinics to close, leaving people without access to quality IVF care.