Rising Demand for Fertility Treatments Highlights Insurance Coverage Gaps

The use of assisted reproductive technologies (ART) in the U.S. has significantly increased over the past decade, with the number of infants conceived through these methods rising by 50 percent from 2012 to 2021, according to the U.S. Department of Health and Human Services.

This growth is reflected in broader societal awareness, as nearly half of U.S. adults now report personal experience with or knowledge of fertility treatments, a marked increase from just 33 percent in 2018, based on recent PEW Research Center data. Fertility treatments vary widely in cost and complexity, from basic consultations and sperm testing to more invasive procedures like in vitro fertilization (IVF), which can cost between $15,000 and $30,000 per cycle.

Only a small fraction of patients—about 2 percent—require such intensive treatments, yet many insurance plans do not cover these services or fertility preservation, which is crucial for patients undergoing treatments like chemotherapy. Currently, thirteen states mandate insurance coverage for infertility services, with another eight requiring some level of fertility care coverage.

Legislative efforts to expand these mandates, such as a recent bill in Iowa proposing coverage for multiple egg retrievals and embryo transfers, reflect ongoing debates about the extent of fertility coverage and religious exemptions, though this particular bill did not pass committee. This also highlights the personal dimension of fertility struggles, emphasizing the emotional and financial challenges faced by those undergoing treatments, underscoring the broader industry, regulatory, and policy implications for healthcare providers and payers as demand for fertility-related care continues to grow.