Can Trump’s IVF Policies Please His Pronatalist Base?

In the leadup to the 2024 election, Donald Trump repeatedly promised to make IVF more accessible. He made the commitment central to his campaign, even referring to himself as the “father of IVF.” In his first month in office, Trump issued an executive order promising to expand IVF access. The order set a 90-day deadline for policy recommendations for “lowering costs and reducing barriers to IVF,” although it didn’t make any substantive reproductive healthcare policy changes.

The response to the order was an early indication that when it comes to reproductive healthcare, Trump might face problems in pleasing his pronatalist base. IVF advocates critiqued the order as a “glorified press release” that did not substantively improve IVF access, while conservative Christians saw the order as a betrayal of Trump’s commitment to the anti-abortion cause.

Despite these rifts, Trump continued to claim reproductive healthcare as a priority for his administration, predicting in March that he would be known as the “fertilization president.” Meanwhile, amid broader HHS layoffs, the administration cut the CDC team that tracks IVF outcomes.

The executive order’s 90-day deadline passed in May with no policy updates from the White House. Newsreports indicated that Trump’s advisors had been meeting repeatedly with both conservative policymakers opposed to IVF and fertility clinic chain executives eager to promote its use. Left out of the conversation despite its attempts to participate was the American Society for Reproductive Medicine (ASRM), the fertility industry’s trade and professional organization.

The Trump administration’s waffling over IVF may point to deeper political struggles among his advisors and supporters.

Competing pronatalist projects

Predicting where the Trump administration might end up on IVF policy has proved challenging, not least because Trump’s own base is divided over the issue. While support for pronatalism facilitated a pro-Trump coalition that included Silicon Valley tech bros, conservative Christians, and Far Right nationalists, IVF exposes fault lines that are difficult to smooth over.

Some of Trump’s close allies and advisors from Silicon Valley embrace repro-genetic technologies that go far beyond IVF. Elon Musk, for instance, has had multiple children via IVF and surrogacy and has reportedly also used the startup Orchid’s polygenic embryo screening for IQ.  Likewise, Simone Collins, one half of a prominent pronatalist couple known for advocating for genetic engineering, was recently revealed to be behind the report that suggested “motherhood medals” and other means of promoting childbearing (for certain Americans).

While conservative Christian supporters of Trump also embrace the pronatalist project, many oppose the use of IVF. The Heritage Foundation’s recently released draft position paper, “We Must Save the American Family,” declares that the United States needs a “Manhattan project” that will “restore the nuclear family” by encouraging more births. Unlike Silicon Valley pronatalists, however, the paper rejects what they call “extraordinary technical solutions,” including IVF, genetic selection of embryos, and surrogacy.

Heritage Foundation policy analyst Emma Waters appears to be leading policy strategy for this faction of the Trump base by assembling a coalition of Christian conservatives and MAHA movement adherents. They are lobbying the administration to redirect policy priorities away from IVF and towards alternatives that these groups find less objectionable. According to The New York Times, Waters appears to be responsible for the coalition’s decision to promote “restorative reproductive medicine” as an alternative to IVF that should receive government support.

What is restorative reproductive medicine?

According to The Guardian, “restorative reproductive medicine” (RRM) refers to “a constellation of therapies that are meant to revive the “natural” fertility of people trying to conceive” without IVF techniques –– from hormone therapies and lifestyle changes to surgeries to remove endometriosis. Although the term has been around for decades, its close association with conservatives and their opposition to IVF is more recent. It gained prominence earlier in 2025 when Arkansas passed legislation “prioritizing restorative reproductive medicine” by mandating that Arkansas insurance companies cover it. Although Arkansas’ law did not directly impede IVF access, it ignited debate about whether legislation focused on expanding access to RRM would imperil IVF.

Critics of RRM, including many reproductive endocrinologists and providers who do offer IVF, worry about spotlighting RRM as an alternative to IVF. They suggest that most RRM techniques are already offered as a part of mainstream infertility treatments and point to the limited scientific evidence suggesting that RRM methods alone are effective in treating infertility. Emphasizing widespread public support for IVF, they see a policy turn away from IVF toward RRM as ideologically, rather than scientifically, motivated.

Some influential organizations promoting RRM do vocally oppose abortion and see the use of IVF as morally wrong. This includes the St. Paul VI Institute in Omaha, Nebraska, which a Catholic physician founded to develop reproductive healthcare offerings for Catholics who objected to oral contraception, abortion, and the destruction of embryos in the IVF process. The Institute’s infertility treatment approach, NaProTechnology, can be understood as a form of RRM in that it aims to understand and treat underlying causes of infertility through menstrual cycle tracking and with interventions including surgery for endometriosis.

Other conservatives embracing RRM are less motivated by religious opposition, including those aligned with RFK Jr.’s “MAHA” movement. These groups find RRM appealing because it embraces a “holistic” approach and calls mainstream reproductive healthcare approaches into question. (A new report by RFK Jr. may signal support for RRM as it outlines the Department of Health and Human Service’s goal to research and address root causes of infertility through a new “infertility training center.”)

There are also well-established RRM practitioners and organizations who do not see RRM as aligned with anti-abortion politics at all –– for instance, the communications and development director for the International Institute for Restorative Reproductive Medicine, Dr. Monica Minjeur, told The Guardian that RRM is “not an anti-IVF movement” and that she identifies as a Democrat. Minjeur views RRM as “another option” for people who are told “IVF is your only option.”

Pronatalists divided: RRM or IVF?

Whether religiously motivated or not, conservatives’ embrace of RRM could threaten Trump’s campaign promise to expand access to IVF.   

In Washington, the RRM vs. IVF debate continues to take center stage. At competing briefings on Capitol Hill last week patients and practitioners promoted RRM to congressional aides, while ASRM’s IVF advocates highlighted RRM’s partisan ties in an effort to encourage skepticism among staffers. Anti-abortion conservatives’ laudatory posts about the RRM briefing may further cement the association between the approach and Republican politics, despite the varied political positions of its practitioners.

A focus on RRM vs. IVF short-circuits necessary discussions about how IVF providers and fertility clinics should be regulated. Media investigations into fertility clinic practices continue to demonstrate the risks of under-regulation and the perils of venture capital and private equity investment in reproductive healthcare.New regulatory frameworks can focus on addressing the economic and social forces that play into these issues, without suggesting that IVF itself is the problem.

It remains to be seen which approach the Trump administration’s policies will adopt. The continued delays may signal a dawning realization that it will be impossible to please all of Trump’s pronatalist supporters at once.