Most people who support expanding public funding for in vitro fertilization (IVF) do so for the best of reasons. The word "infertility" might make one think of a married couple who's been trying five years, ten years, or even longer to have a child, desperate to try whatever science can offer to welcome the blessing of new life to their family.

But even on their own terms, the push to expand support for IVF will fall short of its boosters' good intentions. Public funding for IVF will not rescue our nation's declining fertility rate, restore a family-friendly culture, or inoculate Republicans against the political complexities of our post-Dobbs v. Jackson Women's Health era.

The White House, and members of Congress who respect life and family, should proceed with extreme caution in addressing President Donald Trump's recent executive order calling for a plan to reduce costs and regulations in the fertility industry.

Many of the reasons offered for why we need to expand support for IVF are based in misconceptions. "We need to have babies by whatever means, whether it's IVF, surrogacy, whatever the case may be," said Elon Musk, the world's richest proponent of pro-natalism, during the 2024 campaign. "We just can't go extinct."

But it's far from clear IVF will help with the campaign against depopulation. Consider Hungary, which began offering free IVF services as a way of combating population decline in early 2020. The policy hasn't forestalled the decline in births in Hungary, with the total fertility rate dropping from 1.50 to 1.35 since the policy went into effect. It is, of course, true that we don't know what the decline would have been in the absence of such a policy, but the same pattern can be seen in other countries that have introduced public IVF subsidies, such as Japan, Denmark, and Australia. IVF subsidies do not lead to higher birth rates.

Part of the reason is that IVF subtly encourages would-be parents, or women interested in having kids, to delay attempting to get pregnant until later in life, when the likelihood of both natural and technologically assisted conception start to fall precipitously. IVF gives some couples a false sense of security, leading them to delay trying to get pregnant, even though IVF success falls rapidly after age 35.

The main exception in the worldwide data is Israel, which has higher-than-average birth rates and has been subsidizing IVF since the early 1980s. Yet Israel relies not on IVF to boost birth rates, but on a broadly pro-family culture, enhanced by generous spending on monthly child benefits for Israeli citizens. If Republicans in Congress wanted to preside over the next great American baby boom, they'd devote room in their budget negotiations for a generous baby bonus, ensuring all new parents receive highly salient, up-front support upon welcoming a new child.

Even if they don't lead to higher birth rates, backers might argue, surely IVF subsidies won't cost that much. Yet depending on the way a potential executive order would be implemented, expanding public subsidies for IVF could increase cost pressures in health care or raise federal expenditures. The average cost of an IVF cycle varies widely, but ballparks around $15,000, and many would-be parents need more than one cycle to successfully become pregnant.

One potential option for the Trump White House would be to require insurers to cover this cost, without co-payments, for all who want it. That route, however, will lead to a perceptible increase in health insurance premiums for workers and families across the board.

If the federal government were to assume the costs of IVF instead, the fiscal impact would be at least $80 billion over a ten-year budget window -- hardly chump change in an era of inflation pressures and rising budget deficits. If we had the money to spend at a federal level, we'd be better off investing in research that seeks to solve infertility's root causes. Many couples struggling with infertility achieve better outcomes through restorative reproductive medicine, such as NaProTechnology or hormonal therapies.

And expanding federal support of the fertility industry raises ethical problems supporters of the president's executive order haven't fully thought through. As my EPPC colleague Carter Snead and AEI's Yuval Levin have written, the U.S.' light-touch regulations around assisted reproduction raise questions about patient safety and bioethical concerns. The U.S. has fewer restrictions around IVF than most other countries do; its last major regulation was passed in 1992, and most nations require much higher standards of patient care from fertility clinics.

Additionally, the U.S. permits practices, such as eugenic embryo screening and sex selection, which raise serious concerns and are impermissible in many other countries. And the fertility industry shows no desire to slow down -- a major advocacy group told The Dispatch's John McCormack it would turn down federal IVF funding if it required them to treat embryos with more respect or curb practices that lead to eugenics.

Additionally, while the IRS currently limits the tax-deductibility of IVF expenses to married couples using their own genetic material, the fertility industry has a much broader understanding of who their client base is. Many apply the concept of "social infertility," defined as "the inability to reproduce via sexual intercourse due to social factors such as a person's lack of a partner or because of a person's sexual orientation." This concept deliberately opens the door to publicly subsidizing IVF for single parents or those using third-party surrogates. The recipients of publicly funded IVF may not be the sympathetic case of a long-suffering would-be mother and father, but those who seek to further delink sex, reproduction, childbearing, and the traditional institution of the family.

Lastly, while some polls suggest a political benefit to supporting IVF, very few polls have explored its morally gray implications. Would Americans support covering IVF expenses to the same degree if they knew doing so would raise their health insurance premiums by hundreds, if not thousands, of dollars a year? Despite attempts to attack President Trump over the politics of reproduction in 2024, very few polls suggest his discussion of IVF costs were a top issue for many voters, compared to immigration, the economy, and the escaped-from-campus cultural politics of many progressives.

If President Trump and his team truly want to deliver for parents, they'll fund research to address the root causes of infertility and support families with a robust Child Tax Credit. At the very least, they should proceed with eyes wide open about how the wants of the fertility industry do not coincide with the needs of parents desperate for a child, or the necessity of building an authentically pro-family America.

Patrick T. Brown (@PTBwrites) is a fellow at the Ethics and Public Policy Center, where he writes the weekly Substack newsletter "Family Matters."