Fertility doctors: Patients aren’t getting the full story on IVF 

Is fertility medicine hiding the ball? A growing chorus of researchers say the public has been sold an incomplete story on assisted reproductive technology (ART) – one that oversells success rates and glosses over health risks to kids born from it.

Now, doctors and bioethicists are pushing back, arguing patients deserve the full picture before turning to IVF and other procedures.

For decades, conventional medicine has used assisted reproductive technology (ART) – everything from in-vitro fertilization to donated eggs or sperm – to “solve” infertility.

In fact, current estimates say 2.6% of all children born in America are conceived using ART, with a worldwide average of 2-4%.

The U.S. Department of Health and Human Services categorizes as many as 15% of couples as infertile – 11% of women and 9% of men.

For such people, ART may seem like the only way to have children.

But researchers are now questioning if people are being properly informed about the risks of ART, and whether the medical establishment is using ART to sweep underlying health issues under the rug.

“Public perceptions of assisted reproduction have been shaped by an incomplete and, in many cases, misleading narrative regarding both efficacy and safety,” wrote Dr. Francisco Güell of the University of Navarra.

While ART is viewed as a solution to age-related fertility issues, Güell notes this isn’t necessarily true.

For example, IVF becomes exponentially more difficult in women older than 35, much like natural conception.

IVF success rates for women aged 35 to 37 are 35%; women aged 38 to 40, 22%; and women over 40, a meager 7%.

Furthermore, one UK study found even after six cycles of IVF, only two-thirds of women would deliver a living baby.

Güell observes the potential of health risks for children as well.

Previous studies have found babies conceived via ART are more likely to suffer preterm birth, low birth weight and birth defects.

And the National Library of Medicine says artificially conceived children may also be at greater risk for a whole slew of health issues – cardiovascular and metabolic problems, higher blood pressure, neurological conditions, epigenetic disorders and cancer.

“The earliest stages of embryonic development are extraordinarily sensitive,” Dr. Güell explains, “and the manipulation of gametes and embryos in laboratory conditions may interfere with the mechanisms that regulate gene expression.”

All types of ART “take place during a critical window in which the embryo is establishing essential programs of genetic and epigenetic regulation,” he continues. “Even minor environmental perturbations at this stage could shape future susceptibility to disease.”

And in the cases where donated egg or sperm is used, bioethicists are concerned about denying children the knowledge of their biological parents.

“The psychological distress reported by donor-conceived individuals has led to the creation of advocacy organizations in several European countries calling for an end to donor anonymity, greater recognition of their psychological struggles, and acknowledgment of the right to know one’s biological origins,” Güell recalls.

But perhaps the most controversial aspect of ART is how quickly it is used to paper over deeper health issues.

The International Institute for Restorative Reproductive Medicine analyzed insurance data from 5 million people between 2021 and 2024 and found a significant trend of people failing to treat the root of their infertility.

According to its analysis, about one-third of patients began IVF within three months of receiving a fertility diagnosis. Rates rose to 70-85% by nine months.

Meanwhile, evaluation and treatment for the underlying causes of infertility was below 40%.

Researchers questioned whether “patients receive meaningful opportunities for diagnosis-directed treatment of potentially reversible causes of infertility” since many “appeared to progress to IVF without documented evidence of diagnostic evaluation or therapeutic intervention.”

As a result, some conservative groups are now advocating for restorative reproductive medicine (RRM).

The U.S. Conference of Catholic Bishops recently asked the Trump administration to focus on supporting the more holistic RRM approach rather than IVF.

“RRM approaches generally recognize that infertility is a symptom of an underlying condition, not a disease in and of itself; and they therefore seek to restore normal reproductive function by identifying and treating its root causes,” the Conference wrote.

In contrast, “in vitro fertilization does not aim to treat the underlying causes of infertility but seeks to bypass them – in a sense, overriding the symptom.”

And the Trump administration has already shifted the rhetoric of IVF in HHS documents by referring to frozen embryos as “children who already exist.”

Regardless of whether one supports ART, Güell concludes the public needs to be better informed.

“Serious public discussion about assisted reproduction will remain incomplete without a serious and transparent discussion of health risks, the real limitations of these techniques, the quality of informed consent, and the familial, social, and public health implications of ART,” he writes.