On February 18, 2025, President Trump issued an executive order instructing the assistant to the president for domestic policy to compile policy recommendations within 90 days aimed at protecting in vitro fertilization (IVF) access and reducing related costs. The deadline for these recommendations has now passed.
Katie Watson, a medical ethicist and reproductive health expert from Northwestern University, has contributed an opinion piece titled “Rethinking the ethical and legal relationship between IVF and abortion,” published in JAMA on May 22. Watson highlights a perceived inconsistency in current U.S. policies under President Trump's administration regarding IVF and abortion.
“U.S. voters have elected a president who promised he would make the government or private insurance cover IVF, yet takes credit for reversing Roe v. Wade,” Watson writes.
She argues that while some view IVF and abortion as distinct due to differing intentions—creating versus avoiding having a baby—both are comparable as family-building interventions. “Support for IVF access ought to lead to support for abortion access,” she states.
Watson, who is also the author of "Scarlet A: The Ethics, Law and Politics of Ordinary Abortion," suggests policymakers should adopt a broader perspective that considers lifetime reproductive goals rather than focusing on single moments in patients' lives. She emphasizes this by saying, “Modern medicine has made embryo destruction part of many people’s parenting journey.”
In her analysis, Watson addresses why IVF and abortion have faced different regulatory treatments. For instance, after Roe v Wade was overturned, Indiana clarified its laws to exclude IVF from criminalized abortion provisions.
The financial implications are also discussed; infertility care generates about $8 billion annually in gross revenues with a median cost of $19,200 per cycle. Furthermore, she notes that 55% of abortion patients are already mothers and often cite benefits for existing or future children as reasons for their decisions.
Watson points out complexities such as pronatalism influencing support for IVF and societal perceptions linking it predominantly with middle- or upper-class white populations.
Data from her viewpoint shows significant demographic differences between users of IVF and those seeking abortions: most fertility patients have higher incomes compared to many abortion patients who earn less than twice the federal poverty line; racial demographics also vary significantly between these groups.
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