New Research on the Cost of Infertility Says the Quiet Part Out Loud

Stanford research confirms what we’ve long known: cash rules everything around reproduction. The report, published by the

examines the public and private costs of infertility and explores how access and coverage lay the groundwork for birth rates to diverge along class lines.

The paper uses 14 years of data from Sweden to examine the long-term effects of infertility on couples and how insurance coverage impacts demand. The Nordic country is home to mandates that grant women under 40 three IVF cycles at little to no cost.

Data shows that women are 48 percent more likely to fill mental health prescriptions after five years of being infertile, and divorce rates rise by 6 percentage points for couples who never conceive. The authors say their findings challenge widely accepted beliefs that having kids makes couples unhappy—instead painting infertility as a silent stressor that can destabilize a couple's marriage and mental health over time.

Maria Polyakova, PhD, an associate professor of Health Policy at Stanford who authored the paper, says policies that dictate the affordability of IVF control who benefits from the technology. “This, in turn, means that insurance coverage of IVF ultimately affects the distribution of children across the income spectrum,” Polyakova told FSI News. It’s why cycle initiations in Sweden drop by half when women are no longer eligible for free treatment, with costs jumping to nearly two months of a couple's disposable income. Essentially turning fertility treatment into a tale of the haves and have-nots.

The cost of IVF treatment in the U.S. is staggering, ranging from $40,000 to $60,000—just shy of the median household income. The good news is that access to fertility benefits is improving, particularly among large companies that employ 500 or more people. Yet, more than half of states don’t require private insurance to cover any fertility treatment, with even fewer requiring providers to cover IVF.  But as birth rates in America continue to bottom out and we gain a better understanding of the emotional and social toll of infertility,  increasing access to treatment might be too costly to ignore.