Get Ready. IVF Confusion is Coming.

By: Emily Geiger and Rebecca Carlson, originally published May 27, 2025, Equal Rights Institute

On February 18, 2025, President Trump signed the executive order “Expanding Access to In Vitro Fertilization,” setting off a firestorm of comments, criticisms, and confusion among pro-life and pro-choice people alike. “We want to make it easier for mothers and fathers to have babies, not harder, you know that…that includes supporting the availability of fertility treatments like IVF in every state in America,” Trump said on the campaign trail last spring. “I strongly support the availability of IVF for couples who are trying to have a precious, little, beautiful baby.”

It’s not hard to see why Americans overwhelmingly believe access to IVF is a good thing. I mean, Trump is right; IVF means that more couples can have more babies! What’s the problem with that?! So pro-choice people (and even some pro-life people) are incredibly confused why Trump’s Executive Order just 30 days into his presidency didn’t make us pop the champagne. 

By us, I mean Rebecca, Emily, and our awesome ERI Affiliate Groups who researched and brainstormed how to effectively respond to the bewildered looks we’ve been getting on college campuses. Rebecca and I co-wrote this article, but really the credit goes to our awesome Affiliate Group members. The pro-choice train of thought we all thought through together goes something like “Isn’t more babies exactly what pro-lifers want? But they don’t support IVF?! Oh, so it really IS just about controlling women’s bodies and sex lives after all…” Here’s what we found.

The Executive Order

Rule number one. If a pro-choice person (or anyone for that matter) asks you about a thing or makes claims about a thing, go read the actual thing for yourself. 

During his campaign, Trump promised public funding or mandated insurance coverage for IVF, so I’ll be honest; when I first heard about Trump’s executive order, I (and I think a lot of other people, at least based on the pandemonium in my social media feed) automatically assumed he was making that happen. But, as I discovered upon reading it, this executive order accomplishes neither. To be clear, the IVF executive order actually accomplishes nothing. 

Here’s the important part: 

“Within 90 days of the date of this order, the Assistant to the President for Domestic Policy shall 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.”

We’re currently 98 days out from the Executive Order’s publishing, so it’s quite likely IVF will be back in the news in the very near future when Trump’s team reviews those policy recommendations and presumably picks one or more to try implementing.

So…What’s the Problem?

Ok, so the executive order’s first steps are moving slower than we initially thought. But still, why shouldn’t pro-lifers (and everyone!) be excited about it? Regardless of your stance on abortion, if people who want to get pregnant but are struggling with infertility have a way to be able to get pregnant, that’s great! Here’s the thing: the end doesn’t justify the means. The end, or goal, of IVF is awesome—helping people who are struggling with infertility. The means, how it gets to the goal, is the problem: long story short, it involves killing prenatal humans. 

Most people know that the goal of IVF is helping people get pregnant. A lot of people don’t know how it accomplishes that. Eggs are retrieved from the woman’s body, semen is retrieved from the man’s body, and the eggs are fertilized in a lab. Just like when the fertilization process happens in a woman’s body, as soon as fertilization is complete, you now have a human being—a living organism of the species homo sapiens. The embryo grows for 3-5 days in a lab, and is then implanted in the woman’s uterus. 

Here’s the catch: because the process is very expensive and has a relatively low success rate, doctors typically create more embryos than they plan to implant in the woman’s uterus. The remaining embryos, after growing alongside their siblings for 3-5 days, can be frozen for possible later use, donated to other couples (embryo adoption), donated to be used for research, or discarded—that is, killed. 

In theory, there is a way to do IVF that doesn’t involve the likelihood of ending up with extra embryos that are then discarded: you can create a smaller number of embryos, and transfer all the embryos who survive into the woman’s uterus, likely over the course of multiple cycles. But because a single cycle of IVF is so expensive, and because the failure rate is so high, that is prohibitively expensive and rarely practiced. In fact, in the wake of the Alabama Supreme Court’s ruling that frozen embryos can be considered children, some Alabama IVF clinics stopped operations entirely, and two pro-IVF fertility doctors published an interview saying that “discarding embryos is inherent to the IVF process.”

There are several pieces of the typical IVF process that we argue are obvious human rights violations, assuming we start from the premise that the prenatal humans involved are people like you and me with an equal right to be protected from violence.

1. Since even embryos placed in the woman’s uterus are far from guaranteed to survive implantation and the rest of pregnancy, 65% of the time doctors will place multiple embryos in the woman’s uterus, in order to increase the chances that at least one embryo will successfully implant. But doctors don’t want multiple embryos to successfully implant, because multiple pregnancies (twins, triplets, etc) have higher risks for both mom and babies. So if multiple embryos do successfully implant, doctors will sometimes “selectively reduce”—that is, abort—all but one or two of the embryos.
2. Selective reduction is less common than it used to be because the technology that allows doctors to determine which embryos are likeliest to implant has improved, therefore the odds of a singleton embryo successfully implanting have increased. That’s a double-edged sword, though—it means fewer humans are being killed in utero by selective reduction, but more humans are being killed (or frozen and very likely killed later) before the implantation process even begins.

It’s worth noting that when doctors freeze or discard (kill) “extra” humans in a lab, or selectively reduce (kill) “extra” humans in a woman’s uterus, they’re not flipping a coin to pick which ones to keep. They always assess the “quality” of the embryos—the perceived likelihood that they will be able to successfully implant in the woman’s uterus—and choose embryos that are very likely to be able to implant over other embryos, including embryos that are still quite likely, but a little less likely, to be able to implant. That’s called eugenics. Worse, doctors will often (about 60% of the time) wait a few extra days to implant so that they have time to do initial genetic testing and weed out embryos who test positive for genetic diseases or chromosomal abnormalities. It’s even legal in the US to select which embryos to implant based on their sex.

Killing people—or freezing them cryogenically to maybe use them at some unspecified point in the future or maybe eventually kill them if you don’t find a use for them— at all is really bad, but choosing which people to kill based on who’s weaker or has less desired traits adds an extra layer of dystopian dehumanization. And on a practical dialogue level, the eugenics concern can be helpful to bring up with pro-choice people because it’s often common ground: even if someone is comfortable with the idea of killing very young prenatal humans, they’re typically very uncomfortable with the idea of eugenics.

Here are some additional concerns some pro-lifers may have about the IVF process:

• Natural law concerns about separating procreation from sex;
• The concern that paying for eggs to be fertilized in a lab inherently commodifies human beings;
• The idea that using IVF is “playing God” by creating humans at our will and paying for their creation as our property;
• Both moral and medical concerns about how eggs and sperm are retrieved. (Eggs are typically retrieved via ovarian hyperstimulation caused by artificial hormone medications, which can have serious side effects on a woman’s body. Sperm are retrieved via masturbation.)

Regardless of what your view is on those or other secondary concerns, it’s important to clearly differentiate them from the primary, obvious human-rights-violation concerns. Catholics in the pro-life movement often do an excellent job at this with differentiating how they see abortion from how they see contraception: They clearly communicate that while their theological teaching prohibits using condoms, for example, they don’t think using a condom is a human rights violation and don’t think it should be against the law for other people—they just want the right to act in accord with their own consciences. And they clearly communicate that they see abortion as a very different category, because it is a human rights violation, and human rights violations are the kinds of things we should have laws about.

We need the same clear distinction-making when it comes to concerns about IVF. There are some concerns that are really, really clear: every pro-lifer should be against the killing of prenatal humans, including in the IVF process. And the killing of prenatal humans, including in IVF, should be illegal. PAnd then some pro-lifers (of all theological and atheological stripes) have other secondary concerns too. Different pro-lifers disagree about which of the concerns in the secondary boat are significant, how significant they are, whether they’re legal or merely ethical matters, etc. And we should absolutely talk about those secondary concerns and our disagreements about them. But we also need to be extremely clear and emphatic that the primary, obvious, agreed-upon concern is that IVF as it is typically practiced involves killing humans.

It’s also important to remember whenever you raise any of these concerns that we’re talking about real people—the embryos who are frozen and killed, yes, but also the parents who have used IVF to conceive, and their born children. It’s still important to clearly communicate our concerns about IVF, even though the topic might be emotionally painful for people who have personal experiences with it. But it’s also important to engage compassionately and clearly communicate our common ground: that infertility can be extremely emotionally painful, that it makes sense that people could feel desperate to conceive, that parents who have used IVF that involved killing embryos are not murderers, and that children and adults who were conceived through IVF are valuable people with meaningful lives.

“So if a couple can’t get pregnant, tough for them?” 

IVF, as it is typically practiced, is a human rights violation. It should be illegal. But that’s a really hard pill to swallow for most Americans. Based on our team’s thousands of conversations with pro-choice people, we firmly believe that the majority of pro-choice people come to their position from a place of compassion and genuinely desiring to help others. They don’t want women to be stuck in poverty. They don’t want children to be born into difficult circumstances. The average pro-choice person recognizes that pregnancy and parenthood are challenging, and they want to make sure that women are going in with their eyes open, freely choosing this lot in life, and with all the resources and support they need to succeed. I’m not saying that describes every single pro-choice person out there, but it’s the vast majority. Contrary to the stereotype I hear from a lot of conservatives, it’s rare that we meet someone who genuinely believes having children is always bad or that abortion should be encouraged.  

So if most pro-choice people are coming to their position from that place of compassion—if they are truly “pro-reproductive-freedom,” as Mini Timmaraju, the President of NARAL Pro-Choice America described herself when she and I had an abortion dialogue live on MSNBC—then they should be just as sad when a woman who wants to get pregnant can’t because IVF isn’t available as when a woman who wants an abortion can’t get one because abortion isn’t available. 

Oh wait, this gets even better: I just googled NARAL Pro-Choice America and discovered that it has formally changed its name to Reproductive Freedom for All. Thank you for making my point for me. That is their new name precisely because that is the message they’re finding resonates with average Americans. 

That’s why explaining the concerns we have about IVF is a tough task. Making IVF illegal (or majorly adjusting how it’s done in a way that makes it not kill humans but also makes it more expensive and less successful) takes away the “fundamental freedom to decide if, when, and how to have a family” that Mini Timmaraju claimed we all possess. Not to mention that about 10% of US couples have experienced fertility problems. The pro-choice person you’re talking with probably knows someone who has been through infertility or miscarriage, and if it comes across like our legitimate and serious concerns with IVF mean we lack compassion for that couple, then your argument is dead on arrival. It’s not logically false, but they’re really going to struggle to hear you when you seem to have a bad case of fetus tunnel vision. 

Luckily, there are medical treatments and strategies to help couples conceive that don’t kill unborn humans. This is why IVF can actually be easier to talk about than abortion. In a lot of painful and difficult situations where abortion feels like the best way out, I don’t have an easy solution, and I have to communicate compassion without one—I have to demonstrate to the pro-choice person that I genuinely want to do anything I can to help this woman in a legitimately difficult situation, but that I don’t think it’s okay to kill people to try to solve it. 

But in the case of infertility, we actually have a potential solution, and one that’s typically cheaper, easier, and more effective than IVF. Being able to talk about this alternative to IVF is extremely helpful for your dialogues, and it’s also just a good thing for people to know about anyway! 

Dos and Don’ts of Bringing Up NaProTechnology 

NaProTechnology is incredible. It’s basically a blanket term for understanding that infertility is a symptom, and if we can find its underlying cause, then we may be able to treat it, resolve it, and cause the symptom (the infertility) to go away. For example, hormone treatments can correct a woman’s low progesterone that’s preventing her from getting or staying pregnant. Identifying and correcting vitamin deficiencies can do the same. Surgeries can unblock fallopian tubes, correct uterine abnormalities, repair pelvic adhesions, and treat endometriosis. There is a long list of medical and surgical means available to correct the conditions causing infertility, and at a vastly lower cost than IVF. A single cycle of IVF can cost between $12,000 to $25,000 and is not covered by health insurance, while NaProTechnology, because it treats underlying women’s health issues, is typically covered (and costs vastly less in the first place). 

And the success rates are impressive. Artificial fertility treatments like IVF have a success rate of 31-33%. Using NaProTechnology after failed artificial fertility treatments has a success rate of 53%. And the success rate when NaProTechnology is the initial treatment of infertility is up to 80%! 

It’s cheaper, and it’s more than twice as successful. So why isn’t everyone talking about this?! 

I’ll be completely honest; I think it’s because NaProTechnology is often brought up in a very Catholic way that turns off non-Catholic people. Emily here, Catholic and Natural Family Planning enthusiast. Yes, NaProTechnology was created by a Catholic and aligns with Catholic teachings, and that makes me super excited and proud. It works in tandem with the Creighton Model of Natural Family Planning, both of which were developed by Dr. Thomas Hilgers, founder and director of the Pope Paul VI Institute for the Study of Human Reproduction. But that, tragically, is where we lose a lot of people. I don’t want to call out specific websites or people, but when I hear Catholics talk about NaProTechnology, 90% of the time it’s Catholic-ness is brought up within the first 5 seconds. 

“NaProTechnology respects God’s design for married love.” 

“NaProTechnology aligns with the teachings of the Catholic Church.”

How about “NaProTechnology holistically supports women’s health?” 

Or even “NaProTechnology is cheaper and more effective for helping women achieve pregnancy!” 

Cheaper, more effective fertility care for women—care that is non-violent, focused on supporting the entire woman, and treats the underlying cause of her infertility—should be something we can all get behind. And it’s not like Catholics are the only game in town here; the idea of getting to the root cause of health issues rather than just treating the symptoms has been around medical care for centuries, and some non-Catholic doctors already do things like identify and treat endometriosis that’s causing infertility. 

Catholic or not, wouldn’t it just be better for women’s health if we consistently tried to find out why she’s struggling to get or stay pregnant, and treat that underlying condition? NaProTechnology has up to an 80% success rate when it’s the initial treatment; artificial fertility treatments like IVF have a success rate of 31-33%. At the very least, shouldn’t women know that and be able to make an informed decision?

And shouldn’t we want to identify and heal whatever is going wrong in her body instead of ignoring it? Isn’t that supposed to be what women’s healthcare is all about?

Yes, NaProTechnology was created by a Catholic and aligns with Catholic teaching. I think that’s awesome, and I want more people to understand that the Catholic Church views women with great inherent dignity and is on the cutting edge of women’s healthcare treatments. But NaProTechnology is also just plain amazing for women’s health, and I think our conversations should start there.

Three Steps To a Productive Conversation about IVF

So when IVF headlines inevitably pop back to the top of your Instagram feed, you can have a productive conversation by focusing on three key areas. 

1. Show compassion: Just like discussing abortion, discussing IVF effectively requires unpacking an emotionally wrought topic—one that is tied up with people’s personal stories, tragedies, and vulnerabilities. Our first aim should be to demonstrate genuine compassion for people struggling to conceive and love for those already conceived via IVF. 
2. Keep the main thing the main thing: IVF, at least as it is currently practiced, involves killing prenatal humans. And the killing of prenatal humans, including in IVF, should be illegal. Pro-life people may have a variety of other serious concerns about IVF, and we should absolutely talk about those, but we must be extremely clear that the primary, obvious, agreed-upon concern is that killing prenatal humans is wrong and should be illegal. 
3. Offer a (cheaper, easier, more effective!) alternative: When someone is experiencing infertility, medical providers should provide holistic care; they should be digging in to find the underlying cause of the infertility in order to provide treatment, instead of attempting to circumvent the problem by plopping a tiny unborn human in her body and just hoping it survives—or worse, creating multiple tiny humans and killing the “extras” (or freezing them to plausibly be killed later). NaProTechnology, a method of holistic women’s healthcare, is not only an ethical way to treat infertility, but it has more than double the success rate of artificial fertility treatments at a fraction of the cost.

Let’s work together to provide effective, holistic medical care that doesn’t kill anyone in the process.

Emily Geiger is Director of Education & Outreach at Equal Rights Institute.

Rebecca Carlson is the Director of Scholarship at Equal Rights Institute.