Government-Funded IVF Would Not Fix America’s Massive Underpopulation Problem

A review of studies on the impact of subsidies such as taxpayer funds for in-vitro fertilization (IVF) on the fertility rate suggests there is no resulting surge in fertility, according to a report at the Institute for Family Studies (IFS).

Although the goal of helping people who struggle with infertility is a positive one, Lyman Stone, a senior fellow and director of IFS’ Pronatalism Initiative, also wrote in a report Thursday that taxpayer subsidies for IVF or government insurance mandates are likely not the way to go.

Stone’s review of studies on the impact of IVF subsidies on fertility came amid the Democrats’ attempt to vilify Republicans and, in particular, former President Donald Trump with the claim their lack of support for IVF is causing harm to people who want to have children.

Democratic nominee Kamala Harris used this talking point during the presidential debate Tuesday night. “Understand what has been happening under Donald Trump’s abortion ban: couples who pray and dream of having a family are denied IVF treatments,” she said, condemning those with ethical concerns about IVF.

Trump interjected: “Excuse me, I have to respond – another lie. I have been a leader on IVF … which is for fertility.”

Stone cited Trump’s interview with NBC News in August, during which the GOP nominee said that, if elected in November, he would ensure in-vitro fertilization (IVF) is free for “all Americans that get it.”

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“We are going to be, under the Trump administration, we are going to be paying for that treatment,” Trump said at the time. “We’re going to be mandating that the insurance company pay.”

“So, either the government will pay for it or the insurance company,” NBC News’ Dasha Burns summarized.

“Under a mandate,” Trump acknowledged, “Yes. As you know I was always for IVF, right from the beginning, as soon as we heard about it.”

“It’s fertilization and it’s helping women, and men, and families,” Trump added. “But it’s helping women [be] able to have a baby. Some have great difficulty and a lot of them have been very happy with the results.”

“And we’re doing this because we just think it’s great,” Trump continued. “We need great children, beautiful children in our country.”

“Unfortunately, IVF subsidies are not the way to achieve this goal,” Stone explained:

That’s because they don’t work, and they don’t work for the exact reason they are popular: such policies overwhelmingly help older women have a first birth. This is a laudable outcome, but older women facing fertility challenges are implausible candidates to help propel society-wide fertility higher. In 2022, just 0.5% of births to women ages 25-29 involved IVF, compared to 55% of births to women ages 50 or older. And whereas just 4% of non-IVF births were to women aged 40 or older, 23% of IVF births occurred among women in their forties or older. Additionally, most IVF users do not have high odds of going on to have more children: whereas 2.3% of first births in 2022 involved IVF, just 1.8% of second births and 0.9% of third births did. Society-wide fertility is unlikely to be increased by interventions aimed at 40-something women having a first child.

But Stone also pointed to another segment of the population, largely seen as Democratic constituents, who are likely to use IVF: gay and lesbian partners.

In a recent “large, not-yet-published survey,” the researcher nevertheless noted that IFS found 36% of gay and lesbian individuals reported wanting “zero children,” in contrast to only 14% of heterosexuals.

“[M]uch lower shares also reported desiring 3 or more children,” he added. “In other words, the individuals who would probably have the most use for IVF also tend to have lower fertility desires. So, again, IVF subsidies don’t seem like a plausible avenue for boosting society-wide fertility.”

Stone further illustrated what would happen if IVF became more easily available.

“While more people, especially older individuals, would gain new options to boost their fertility,” he explained, ”younger people would also gain those options, and as a result might possibly change their fertility behavior in expectation of using IVF in the future.”

Stone suggested more employers might offer free egg freezing as a benefit to workers in their late 30s. “IVF not only helps older people have kids, but it also makes it easier for younger people to delay kids,” he observed.

When it comes to taxpayer funding of IVF, Stone looked at studies using data from states in which insurance coverage is mandated for the treatment to determine if fertility has increased as a result:

Across four studies with six different family-related outcomes measured, one study didn’t report an overall effect, but found approximately offsetting changes in fertility rates of women under and over age 35. Another study found effects on delayed marriage. Two studies found no overall effect on first birth rates: one of them found an increased rate for women over 35 and no effect on women under 35; the other found a reduced rate on women under 35 and no effect over 35. Remember, though: first births are not all births, and studying only first births is a way of stacking the deck in favor of IVF, since IVF disproportionately impacts first births.

The one study cited by Stone that examined a “wide range of endpoints,” found IVF led to “no effect on overall first birth rates or on increased age at first birth, and no effect on completed fertility.”

“Overall, we see that when U.S. states provide subsidies for IVF, overall fertility rates are unaffected, in general, because while fertility rises for older women, it falls for younger women,” Stone concluded, adding:

If the goal is to boost births, subsidies for IVF are a peculiar kind of policy. They disproportionately go to people unlikely to have additional births beyond the first birth, and only subsidize very specific subsets of individuals and families with specific values (i.e. people without ethical objections to IVF), and they may incentivize fertility delay among younger couples.

LifeNews Note: Susan Berry writes for CatholicVote, where this column originally appeared.