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It's been a major talking point in the final months of Donald Trump's 2024 presidential campaign: If re-elected, the Republican leader has promised to make in vitro fertilization (IVF) free for those who want to get pregnant.
“Under the Trump administration, we're going to pay for this treatment,” Trump told NBC News last year, adding that his plans would cover “all Americans who get it, all Americans who need it.”
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“We're going to pay for that treatment. Or we're going to make the insurance company pay.”
While that campaign promise remains unfulfilled, the Trump administration took a step Thursday to make the procedure more affordable.
Speaking from the Oval Office, Trump announced a partnership with the company EMD Serono, a subsidiary of pharmaceutical giant Merck, to offer lower-priced fertility drugs on its upcoming TrumpRx prescription marketplace.
“EMD Serono, the world's largest manufacturer of fertility drugs, has agreed to provide massive discounts on all fertility drugs they sell in the United States, including the most popular drug of all, the IVF drug Gonal-F,” Trump told reporters.
Expanding the TrumpRx Project
The announcement marks the third major pharmaceutical company to agree to provide discounted products on TrumpRx, a direct-to-consumer website set to launch in 2026.
Trump threatened pharmaceutical companies in September with 100 percent tariffs on their products unless they began building manufacturing facilities in the United States.
But that tariff was delayed after pharmaceutical manufacturer Pfizer announced a deal with TrumpRx on September 30, the day before the planned tax increase. AstraZeneca, another powerful player in the industry, followed suit last week.
At Thursday's news conference, Trump again credited his threats of tariffs for driving companies to the brink.
“They're going to bring a significant amount of drug manufacturing back to the United States,” Trump told EMD Serono. “This is for many reasons, but primarily because of the result of the election, November 5, and perhaps most importantly because of the tariffs.”
In addition to the upcoming rebates from EMD Serono, Trump indicated he would encourage insurance companies to expand coverage for IVF treatments.
In the US, laws vary by state regarding whether health insurance must cover fertility treatments such as IVF. Trump touted the guidelines as a breakthrough in making reproductive health care more accessible and affordable.
“Effective immediately, for the first time in history, we will make it legal for companies to offer supplemental insurance plans specifically for fertility,” Trump said.
“Americans will be able to opt in, get specialty coverage, just like they get vision and dental insurance.”
These plans usually come at an additional cost on top of regular health insurance rates. This raises questions about how effective the new insurance guidelines will be.
More than 26 million Americans — roughly 8 percent of the population — are uninsured, according to the U.S. Census data. Even more so the lack of access to additional policies for dental and vision care.
The American Dental Association, a professional industry group, estimates that more than 22 percent of U.S. adults will not have dental insurance by 2021.
Trump appeared to acknowledge the gaps in coverage during his remarks, but he maintained that the government's new guidelines will offer some adults a path to parenthood.
“They will get fertility insurance for the first time,” he continued. “So I don't know. I don't know how well these things are covered.”
Controversy during the campaign
The Republican leader also credited a 2024 court decision with prompting him to focus on IVF treatment.
IVF involves removing eggs from a patient's ovaries and fertilizing them in a laboratory environment. These eggs are then placed into the patient's uterus or frozen for future use.
The use of such treatments is increasing in the US: in 2023, the American Society for Reproductive Medicine found that 95,860 babies were born as a result of an IVF procedure.
But in February of the following year, a ruling by the Alabama Supreme Court raised concerns about whether IVF would remain widely available.
In a new ruling, the court — located in a heavily conservative state — ruled that embryos created through in vitro fertilization can be considered children under state law, making the destruction of such embryos a potential criminal offense.
The decision sent shockwaves through the IVF industry, with clinics in Alabama temporarily suspending services. Embryo discard is standard practice in IVF: usually more eggs are collected than will ultimately be used, and not all fertilized eggs are suitable for starting a pregnancy.
Within weeks, the Alabama state legislature stepped in to protect IVF providers from prosecution. But the decision raised lingering concerns that IVF could be targeted by abortion rights advocates.
On Thursday, Trump revisited that controversy, which occurred in the midst of his re-election bid. He called the court's decision a “bad decision” and credited it with helping him learn about IVF.
“I wasn't that familiar with it,” Trump said. “Now I think I've kind of become a father.”
Sen. Katie Britt, who represents the state of Alabama, echoed that assessment, praising Trump for taking steps to protect IVF.
Thursday wasn't the first time Trump has made gestures toward lowering the cost of the fertility procedure. In February, he also issued a presidential executive order urging his administration to begin “protecting access to IVF and aggressively reducing out-of-pocket and health plan costs.”
“Mr. President, this is the most professional thing that any president in the history of the United States of America has done,” Britt told Trump on Thursday. “You are the reason the Republican Party is now the party of parents.”
Turning to US birth rates
Trump, who previously called himself the “fertilization president” at a Women's History Month event, also described the new measures as progress toward increasing the U.S. birthrate.
In April, the Centers for Disease Control and Prevention (CDC) reported that fertility remains at historic lows, rising slightly to 1.6 births per woman in 2024.
Those numbers have fueled a push within the Republican Party to spark another baby boom, with right-wing figures like tech billionaire Elon Musk going so far as to a call low birth rates “the greatest danger civilization has ever faced.”
At Thursday's meeting, senior figures in the Trump administration voiced those concerns, including Health and Human Services Secretary Robert F. Kennedy Jr.
“We're below replacement right now,” he said, referring to the number of births needed to overtake deaths in the US. “This is a threat to the national security of our country.
Mehmet Oz, who served under Kennedy as administrator of Medicaid services, took a more positive approach, citing the new IVF guidelines as the beginning of reversing this downward trend.
“There's going to be a lot of Trump babies,” Oz quipped. “I think that's probably a good thing. But it turns out that the main creative force in society is making babies.”
But it remains to be seen whether insurance companies and employers will follow Trump's lead to offer additional fertility benefits to adults who want to get pregnant.
Most Americans receive health insurance as part of their workplace benefits. Senator Britt said the guidelines would put employers “in the driver's seat”, allowing them to shape the benefits they offer their workers.
“Employers will be able to decide how to cover root causes of infertility, things like obesity and metabolic health and other things that impact infertility,” she said. “We want employers to be the ones who can make those decisions, not the government.”
But for Democrats, the guidelines fall far short of what Trump promised on the campaign trail.
“Donald Trump lied when he promised to make IVF available to every family for FREE,” Senator Elizabeth Warren of Massachusetts published then on social media. “It's insulting – a broken promise.”
