As Americans have fewer babies than ever, more come via IVF
More than 100,000 babies were born via in vitro fertilization (IVF) in 2024, the American Society for Reproductive Medicine reported Tuesday. It was the first year that IVF births surpassed that threshold and the highest number recorded since America’s first IVF baby, Elizabeth Carr, was born in 1981.
IVF is a medical procedure in which an egg is fertilized by sperm outside the body and then implanted in the uterus to assist with pregnancy.
IVF births accounted for roughly 3% of the more than 3.6 million babies born nationwide in 2024, according to the Centers for Disease Control and Prevention. Despite the increase in total births, the U.S. fertility rate fell to a record low of roughly 1.6 births per woman — well below the replacement level of 2.1 needed to maintain a stable population. The U.S. has been consistently below that level since 2007.
In 2023, the fertility rate was 2.2 births per woman; in 1963, it was over five.
Although fertility rates do not tell the whole story of population trends — births still outnumber deaths and immigration plays a role— economists warn that sustained sub-replacement fertility can strain the economy, as fewer workers support a growing number of older Americans drawing on programs such as Social Security and Medicare. Environmental researchers, however, argue that slower population growth could ease pressure on natural resources.
The new report comes amid growing momentum to improve access and reduce the cost of IVF. President Donald Trump and other lawmakers have sought to boost fertility by expanding access to services such as IVF through a series of executive orders, proposed legislation and other policy changes.
Gaining momentum
More Americans are delaying parenthood until older age, in part, due to a higher cost of living and the exorbitant cost of child care but also because of improvements in reproductive medicine. This may, in part, explain the IVF’s rise as women over 35 are most likely to pursue fertility services.
The number of IVF babies has been steadily rising — in 2023, about 95,000 babies were born through IVF, up from around 91,000 the previous year — but cost remains a significant barrier. One cycle of IVF can cost upwards of $25,000, and most women need multiple rounds of treatment before a successful pregnancy.
Despite the cost, only 16 states currently require health insurance plans to cover IVF, though eligibility criteria vary. In Arkansas, for example, patients must have certain medical conditions that make conceiving difficult or a two-year history of unexplained infertility.
In the past year, policymakers and private companies have moved to expand access.
Trump campaigned on improving IVF. Weeks into his second term, Trump signed an Executive Order calling for policies that ensured access and improved affordability. In October, Trump signed an order allowing employers to offer fertility benefits, including IVF coverage, outside of traditional health insurance plans. That same month, the administration announced an agreement with pharmaceutical company EMD Serono to significantly reduce the price of GONAL-F, a commonly used IVF medication, through its TrumpRx program.
Last year, Sen. Tammy Duckworth, D-Ill., also introduced the Military Families Act, which would require TRICARE — the health insurance program for service members and their families — to cover IVF, as well as cryopreservation and fertility medications.
Earlier this month, Costco announced a partnership with telehealth marketplace Sesame and fertility clinic network IVI RMA to offer members virtual fertility appointments and discounted services, including IVF and intrauterine insemination.
Is IVF safe?
IVF is widely considered safe. Decades of research following millions of births globally have not found large differences in overall health outcomes between IVF babies and those conceived without medical assistance.
Historically, IVF has been associated with a slightly higher risk of certain complications including multiple births, preterm delivery and low birth weight — risks that are typically linked to transferring more than one embryo. In recent years, many clinics have shifted toward single-embryo transfer to reduce those risks.
Some studies have reported small increases in the risk of certain birth defects or rare conditions among IVF pregnancies, though the absolute risk remains low. Researchers note that it is difficult to disentangle whether these risks stem from the IVF process itself or from underlying infertility and parental health factors.
For patients, the more immediate risks are tied to the treatment process. Ovarian stimulation can, in rare cases, lead to ovarian hyperstimulation syndrome, where the ovaries swell and leak fluid into the abdomen, causing pain, bloating and rapid weight gain. Egg retrieval is an invasive procedure. Still, serious complications are uncommon, and major medical societies, including the American Society for Reproductive Medicine, consider IVF a safe and effective option for many individuals and couples seeking to build families.
Ella Rae Greene, Editor In Chief
