Miraya Gran and her husband took out a second mortgage and had a family fundraiser to be able to conceive their first child through in vitro fertilization in 2021. She still does not have insurance coverage for IVF, and despite having two embryos waiting to be implanted, she cannot afford the cost on her own to give her daughter a sibling. (Courtesy of Miraya Gran)

Miraya Gran is the kind of person who Republican President Donald Trump and his administration say they are going to help with new policies on in vitro fertilization.

It took a second mortgage on her Minnesota house and a family fundraiser to afford the IVF treatment she needed to have her first child in 2021. Gran’s husband has male-factor infertility, and she has a genetic blood disorder, making it extremely difficult for them to conceive on their own. But unless the cost of IVF goes down a lot, Gran can’t afford to give her daughter a sibling.

“I’ve got two embryos waiting for me, and I’m not accessing them due to lack of insurance coverage,” she said.

But Gran doesn’t have much hope left that IVF costs will drop enough after Trump’s announcement at the White House on Thursday, Oct. 16. The president said his administration negotiated steep discounts on a key fertility drug, as well as a new regulation allowing employers to offer IVF coverage as a standalone policy like dental or vision. EMD Serono, a major pharmaceutical brand, will offer the medication at an 84% discount via direct sales on a government webpage called TrumpRX, according to a company representative who spoke at the White House event.

Gran said that isn’t good enough. The drug prices are only a portion of what makes treatment expensive. One IVF cycle ranges between $12,000 and $25,000 on average but can cost more depending on medical needs. Many people require more than one round of IVF to get pregnant. 

Plus, the new policy only clears the way for employers to offer coverage options — it’s not required by the government.

“They have the ability to put the onus on insurance companies,” Gran said. “There really isn’t a solution for our community until we have insurance coverage.”  

Trump campaigned on a promise to make IVF treatment free for all, either through federal funding or insurance, but has so far not fulfilled that promise.

Dr. Eve Feinberg is an OB-GYN professor at Northwestern University, and a reproductive endocrinologist and fertility specialist who treats IVF patients every day. She said lowering the cost of the drugs is a positive step, but that’s only about one-third of the cost of a typical IVF cycle — less in some cases.

“For some patients, the medications can go as high as half the cost,” Feinberg said. “If you have a good reserve of eggs, you require less medication. If you have a lower reserve, you’ll need more. So for some, it’s $3,000 … and for some, it’s $10,000.”

‘Restorative reproductive medicine’ not a replacement for IVF, doctor says 

Trump’s promise to make IVF free is a difficult one to fulfill not only because of the overall cost but because of divisions among conservative groups about the ethics of the treatment. IVF requires the collection of as many eggs as possible that are then fertilized. Some are later destroyed because they would not make it after implantation in the uterus due to abnormalities or other medical factors.

The Alabama Supreme Court ruled in 2024 that embryos have the same legal rights as children, which threw the medical community into chaos and caused some Alabama IVF clinics to close. Later that year, the Southern Baptist Convention adopted an anti-IVF resolution stating the church’s opposition to the practice.

The ruling happened just as Latorya Beasley was waiting on a transfer date for the embryo she hoped would be her second child. Her clinic temporarily canceled appointments but eventually reopened, and she was able to have a second child. Beasley had IVF insurance through her employer, which only about 25% of companies with more than 200 employees offer nationwide, according to KFF. But there were still out-of-pocket costs.

“There was a point where we ran out of medicine for like one day, and we paid $1,000 out of pocket for that,” Beasley said. “And that was with insurance coverage.”

Feinberg said she was also worried about the aspects of the announcement that talked about “restorative reproductive medicine,” which is a newer field of medicine not recognized by the same medical boards guiding reproductive endocrinology. The practice has been promoted by the Heritage Foundation — a conservative advocacy organization that authored Project 2025 — as the “new frontier” of reproductive medicine.

“There were certain things said in the briefing that made me think the idea of fertility coverage, especially for companies whose beliefs and ideas are religiously focused and religiously based, that may mean offering restorative reproductive medicine and not offering IVF,” she said.

The restorative practice focuses on cycle tracking to conceive, as well as weight loss and nutrition. Feinberg said she had a patient who had been using those methods for four years with no success, and she was 43 by the time a reproductive specialist told her that her husband had such a low sperm count, there was no way they could conceive without medical intervention.

“He had a genetic mutation that the restorative reproductive medicine person was not trained to ever diagnose,” she said. “They could have and should have done IVF.”

Gran and Beasley said if the Trump administration put forward plans that made a real difference for families in need of IVF, they would be the first to celebrate it. But until then, the lack of action is frustrating.

“It just feels like I’m being sold a complete line from a traveling salesman, because until there’s actual substantiated change, I have no faith in what they say,” Gran said.

Dr. Lauren VanDeHey speaks at a press conference on Tuesday in favor of legislation to require insurers to cover infertility treatment. (Photo by Erik Gunn/Wisconsin Examiner)

Treatments for infertility can cost tens of thousands of dollars, leaving some couples to borrow huge sums to cover the expense and others to decide against having children at all.

Lawmakers are circulating a draft bill to change that by requiring health insurers in Wisconsin to cover infertility procedures. If the measure is enacted, Wisconsin would join 22 states and the District of Columbia in providing some form of coverage for fertility treatments, according to advocates.

“Infertility is a medical issue,” said state Rep. Jodi Emerson (D-Eau Claire) at a Capitol press conference Tuesday. “And like any other health condition, it deserves the medical treatment to be affordable and accessible. Yet right now, too many individuals and couples are forced to choose between financial stability and the chance to start a family. That’s a choice no one should ever have to make.”

Emerson is the lead Assembly author of the proposal, along with Sen. Kelda Roys (D-Madison), the lead Senate author.

Roys described infertility as a deep source of disappointment for many couples who want to have children. “One of the things that it shouldn’t do, though, is bankrupt you,” she said. “Everyone should be able to access treatment for health conditions and diseases like infertility without regard for the type of insurance you have.”

Dr. Bala Bhagavath, an infertility specialist based in Madison, told reporters that he previously practiced in New York and Rhode Island, where state laws mandate coverage for infertility treatments. Relocating to Wisconsin “has been a rude awakening,” he said.

“Although some patients get coverage for diagnosis of their condition, most pay out of pocket for both diagnosis as well as treatment,” Bhagavath said. “It’s quite common for patients to take out loans and second mortgages so that they can build a family. I’ve had patients taking a second job or moving south of the border to Illinois as they would get insurance coverage for infertility treatment.”

Dr. Lauren VanDeHey, a medical resident in obstetrics and gynecology, said that as a cancer survivor she underwent a procedure to preserve embryos to avoid the risk of damage from chemotherapy and radiation. She was able to get free medication and the cost of some of her in vitro fertilization services discounted, but is still faced with a $17,000 bill she and her husband  will have to pay off over the next several years, she said.

“I am fortunate I will be able to pay these debts off when I complete my medical training,” she said. “For others, taking on this expense is simply not an option. Support for this bill needs to be a bipartisan effort because cancer and infertility can affect anyone.”