A Holistic and Pro-Life Approach to IVF

President Donald Trump delivers remarks before signing an executive order on expanding access to IVF.

Many pro-life Americans have been alarmed by a recent presidential executive order on “Expanding Access to In Vitro Fertilization.” For those who believe that life begins at conception, the routine destruction or indefinite storage of embryos in IVF is a moral violation, akin to abortion. But this directive may also present the pro-life movement with a great opportunity.

Throughout his political career, President Trump has often asked the American people for policy suggestions, and he specifically calls for “policy suggestions” in this recent order. The pro-life movement can deliver those suggestions in such a way as to urge him both to move in a different direction and to address more effectively the underlying problems that have led to something of a schism within the conservative movement over IVF.

Those in the pro-life camp were not happy when Trump promised to expand IVF access during his campaign. Unfortunately (in this case), despite the incessant claims about his supposed mendacity, Trump remains one of the most honest politicians in American history. He follows through on his promises.

But, if honesty is one of his political virtues, so too is his willingness to be open to persuasion by intelligent, thoughtful individuals. Despite other claims about supposed tyranny, he is famous for listening to others and learning from them.

There are too many examples to name, but to stick to abortion, last fall’s controversy is instructive. In 2024, pro-lifers were upset not only about Trump’s IVF promises but also his talk about possibly voting for Amendment 4, which would have enshrined a right to abortion in Florida’s Constitution up to nine months.

Trump was worried that the state’s six-week abortion ban was perhaps too strict for what the majority of voters wanted and might have political repercussions that would lead to Republicans losing power and Democrats installing an extreme abortion regime. Indeed, that was the mainstream narrative in states like Kentucky, which, despite being a conservative stronghold, had voted in favor of a pro-abortion amendment.

Despite that impulse, however, Trump was open to persuasion. Many pro-life figures did talk to him, including Marjorie Dannenfelser and Lila Rose. Trump subsequently announced he would vote against the proposed amendment.  

While pro-life voters might ask why he had to be persuaded of such a bill, it’s important to remember that the president is more of a pro-lifer by gut and feeling than strict philosophical analysis. That is where a lot of the American people are. This is even more true when it comes to the question of IVF.

A 2024 Pew Research study showed only “about a third of Americans say the statement ‘human life begins at conception, so an embryo is a person with rights’ describes their views extremely or very well.” While the proposition that human beings early in their development do not have human rights is bracing, many Americans believe that embryos are not human beings – just one example of the challenges the pro-life movement must overcome to create a culture of life.

Even among that initial one-third group, “59% say IVF access is a good thing, while just 13% say it is a bad thing.”

In other words, three-fifths of Americans who have the most pro-life beliefs are in favor of IVF access. For those not affirming strongly or at all the position that embryos are humans with corresponding rights, you can guess that the numbers jumped considerably.

Pew’s overall numbers for support of IVF access were 70% in favor, 22% unsure, and only 8% opposed. 65% of Republicans were in favor.

Regardless of one’s feelings about Trump’s IVF order, it is important to remember how much his favorable attitude toward the procedure is in the mainstream of American opinion and even the Republican Party.

It is also important to remember that Trump’s order did not actually expand access to IVF immediately. Instead, it directed “the Assistant to the President for Domestic Policy” to “submit to the President a list of policy recommendations on protecting IVF access and aggressively reducing out-of-pocket and health plan costs for IVF treatment.” The due date for this assignment is ninety days from the issuing of the order on February 18.

That’s why left-wing outlets such as Mother Jones lamented that “Trump’s Order to Expand IVF Access Does Not Expand IVF Access.” Even more depressed was Susan Rinkunas at MSNBC, who wrote “Trump’s IVF executive order is worthless. What comes next could be worse.” Rinkunas mocked that Trump was only “asking for concepts of a plan to be delivered at a later date.”

This anger on the part of the left is why pro-life advocates should not be completely dejected. The IVF order is only asking for a plan. And it is giving plenty of time for serious persuasion of the American people and their honest but persuadable president.

Why oppose IVF? As the Pew data show, even many people of pro-life convictions support the procedure, which puts sperm and egg together outside the womb and then implants the resulting embryo in a woman. After all, they reason, this is a procedure that allows people to have children who have not been able to do so in the natural way. Is this not the essence of being pro-life?

This is indeed the motivation revealed in the order, which tells us: “Today, many hopeful couples dream of starting a family, but as many as one in seven are unable to conceive a child.”

This sympathy with couples struggling is indeed a good thing, but it is important to remember that IVF is not only very expensive, but also a difficult and precarious procedure. As the order points out, it often takes multiple cycles of IVF treatment to achieve a live birth. The CDC calculates the success rate to be less than 50%.

But the way the procedure itself works is the primary problem. Not only does the creation of children in a laboratory make one think of them as products, but the usual practice inevitably leads to treating them as such. To increase success rates, IVF doctors usually create multiple embryos and examine them for their genetic strengths in order to choose the likely strongest. Often, multiple embryos are implanted in a woman, and the weakest are selectively aborted. The pro-life advocacy group Them Before Us summarizes some of the problems with the procedures thus:

• Only around 2.3% of lab-created babies will be born alive.
• The vast majority will be genetically screened, sex-selected, and graded out of existence.
• “Surplus” embryos are discarded as medical waste, “donated” (that is, destroyed) to research, or forgotten in freezers.

As Carter Snead and Yuval Levin observe in a policy paper designed to help government officials think about how to treat this procedure, there is also little regulation or long-term study on the health effects on mothers and children, a lot of rapid approval of experimental procedures, and a great deal of commodification of these embryos and other biological material.

A truly pro-life position does not end up with millions of embryonic humans in freezers and many, many more being treated simply as waste.

In addition to these moral problems, there is the consideration that more of this procedure is unlikely to help with the birth rate, even if the fact sheet accompanying the EO introduces this as a consideration in ease of access.

A National Review Online article by Kayla Bartsch showed that in Japan, where the number of IVF births has been increasing and IVF is now part of government health coverage, the birth rate has nevertheless hit fifty-year lows. Considering it from a psychological perspective, we might guess that more IVF naturally leads to a lower birth rate because it encourages more women to put off childbirth because they believe they can freeze their eggs and have children just as easily later. Late pregnancies, whether natural or assisted, nevertheless still have lower chances of resulting in live births.

Thus, the pro-life response must be to point out that the path of IVF is uncertain practically, morally fraught, and unlikely to bring about the revival of American families that the order discusses.

What ought to be done? An obvious first step is to encourage Americans to marry and have children at younger ages again, which would probably reduce greatly the difficulties in having children. But, even assuming we make progress on that very large task, there will still be couples who struggle to conceive and carry a child to term. What about them?

The answer may be right before the administration’s eyes. Robert F. Kennedy, Jr., has been talking about taking health away from Big Pharma and Making America Healthy Again. That is exactly what should be done with fertility in America. We need an overhaul of the healthcare system aimed at treating reproductive problems in the context of overall health.  

The Them Before Us response is right on the money: “Women deserve doctors who treat their bodies as whole, interconnected systems—not as broken machines that need to be circumvented with synthetic hormones and lab-created embryos.” They recommend directing more people and money to NaPro Technology and other systems aimed at understanding and healing women’s reproductive systems.

Getting these messages about the real problems with IVF (both practical and moral) and different and broader solutions to the underlying concerns is a task that should be at the top of the list for the next three months. Ultimately, pro-lifers, who as the data show have largely failed at educating even their own on these points, may have swayed not just a good portion of the American people, but also a president known to listen and act on moral principle and common sense.

David P. Deavel teaches at the University of St. Thomas in Houston. A past Lincoln Fellow at the Claremont Institute, he is a Senior Contributor at The Imaginative Conservative. Follow him on X (Twitter) @davidpdeavel.