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In the face of rising national infertility and economic uncertainty, the institution of family is more important than ever. With 1 in 6 globally experiencing infertility, the current administration’s presidential order to make in vitro fertilization more affordable was a welcome development. It may be light on action, but it shows our government recognizes that building families strengthens the foundation of society, safeguards tomorrow, and ensures long-term stability.
That’s because a nation’s future depends on its total fertility rate. Today, America is at 1.66. When the total fertility rate falls below 2.1, the consequences are immediate: shrinking workforces, slower economic growth, and overwhelming strain on social systems. This is not just a challenge; it’s a quiet crisis demanding urgent and visionary action.
By addressing the declining fertility rate now, policymakers can secure future prosperity and social resilience. This is leadership in action, and it deserves recognition.
Yet the recent elimination of the Centers for Disease Control and Prevention’s oversight group tasked with tracking IVF success and failure rates at America’s fertility clinics represents a considerable obstacle for policymakers endeavoring to broaden access to IVF care.
Prioritizing reproductive health care isn’t simply about addressing private struggles — it’s about ensuring public well-being. Accessible IVF services and policies that support family building are no longer optional; they are essential for sustaining America’s population and economic vibrancy.
It may be surprising to see a fertility physician and clinic founder advocate for increased governmental oversight and more comprehensive regulations. But in the absence of such interventions, critical safeguards to protect an emotionally vulnerable population from financial and medical exploitation are effectively nonexistent.
The women, men, nonbinary, and intersex individuals who come to me are often dealing with the heartbreak of infertility or the challenge of growing their families against the odds. Some are cancer survivors. Others are at risk of developing cancer and other conditions that affect fertility. Some have been told they are infertile, or close to it. And most — if not all — are emotionally vulnerable. They deserve transparent information about success and failure rates so they can make informed decisions about which clinics and doctors to trust.
Without the CDC’s Assisted Reproductive Technology Surveillance team, that transparency is all but lost and subject to marketing.
Of particular concern is the potential for certain clinics to disengage from the Society for Assisted Reproductive Technology, thereby circumventing established standards of accountability. This withdrawal could enable the spread of inaccurate or deliberately misleading data, which could help clinics prioritize profitability over ethics.
The domain of third-party reproduction remains alarmingly underregulated and warrants more resources. This was the case before the Department of Health and Human Service’s most recent round of layoffs, and it’s even more true now.
As the president reviews policy recommendations intended to make IVF more accessible for Americans, he has a critical opportunity to reinstate the CDC’s ART Surveillance team. Without them, we have very little information about fertility clinic success and failure rates.
The average cost of an IVF cycle ranges from $15,000 to $40,000. Imagine having to spend that much money without data showing a clinic’s success rates. That’s the reality we’re approaching after layoffs leading to the dissolution of this critical government agency whose job is to keep clinics accountable and find ways to improve IVF through the power of data and applied demography.
More data and oversight help patients and physicians make informed family-building decisions. Clinic outcome data is not the only metric of relevance. For example, experts have long called for additional forms of tracking, such as a centralized registry for donors (egg, sperm, and embryo) and gestational surrogates.
Such a registry is imperative to provide donor-conceived people with access to essential medical and genealogical histories.
Importantly, such a registry would also deliver the longitudinal data necessary for egg and sperm donors to make educated decisions about their contributions, while offering gestational carriers (also known as surrogates) a robust understanding of the inherent risks, benefits, and alternatives associated with their pivotal role in the reproductive process.
This is just one example of additional regulation and oversight that would have benefited the fertility industry at large, providing transparency for patients and accountability for clinics. Rather than moving the industry forward, recent HHS and CDC layoffs make this level of transparency even more out of reach, while exposing patients to possible exploitation. What the president and his team must understand is that less oversight will lead to worsened outcomes and the need for additional cycles, ultimately forcing Americans to spend more on IVF — not less.
The existing lack of regulation in the fertility industry highlights the urgent need for a consolidated, data-driven framework that upholds transparency, accountability, and ethical integrity across all clinics and third-party reproduction services. Developing such a regulatory infrastructure is not only a moral imperative but also a crucial step toward ensuring the well-being and autonomy of all stakeholders within the reproductive health care continuum.
The loss of the CDC’s ART Surveillance team signals a worrisome trend toward less safety and transparency and has immediate practical and personal implications for anyone on a fertility journey.
As the nation awaits word from the White House on how IVF will become more affordable, it’s a good time to remind ourselves what Americans deserve.
Americans who want to become parents deserve more: more safety, more transparency; more positive outcomes. And more families.
Brian Levine, M.D., is founding partner and practice director at CCRM Fertility of New York.
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