Baby on the Brain

We got baby on the brain. Just yesterday, the US President, signed an executive order to Trump wants to lower the cost of IVF ( NPR , 2025) . In recent years, fertility health has become a focal point in healthcare discussions, driven by declining birth rates, societal shifts in family planning, and the growth of the fertility health industry. This article explores the rise of fertility health companies, the increasing demand for fertility benefits, the socio-economic factors influencing delayed parenthood, and the macroeconomic implications of these trends.

Declining Birth Rates and Delayed Parenthood

Globally, birth rates have been on a downward trajectory. In the United States, the fertility rate decreased by 3% in 2023 compared to 2022, continuing an annual decline observed since 2014 (National Center for Biotechnology Information, n.d.). Factors contributing to this trend include financial concerns, career aspirations, high housing costs, expensive childcare, and student debt (The Times, 2023). This has been highlighted by Science Magazine (2023) sharing the global replacement rate will drop by 2030 (Science Magazine, 2024) and the public chattering of Elon Musk are hard to avoid.

The Rise of Fertility Health Companies

The fertility health industry has experienced significant growth, with the U.S. market valued at approximately $7.9 billion in 2022 and projected to reach $16.8 billion by 2028 (ECG Management Consultants, n.d.). This expansion is fueled by advancements in assisted reproductive technologies (ART) and a societal shift toward delayed parenthood. Private equity firms have recognized the sector’s potential, leading to increased investments and consolidation within the industry (Financial Times, 2023). Notable players in the game:

1. IVF Center Solutions (Ava Fertility) - support a wearable "The Ava bracelet, reimbursed by thousands of companies, provides data-driven support that's proven to help couples get pregnant faster1, which can reduce the need to move on to costly or?invasive fertility options."
2. Freedom Fertility by Evernorth - Support self-pay pricing "Freedom Fertility Pharmacy exclusively supports patients undergoing fertility treatment and we are committed to the safety and support of our patients."
3. Carrot Fertility - Provides comprehensive fertility benefits programs for employers, facilitating access to fertility care and family-building support for employees worldwide.

Employer-Sponsored Fertility Benefits

Recognizing the importance of supporting employees’ family planning needs, many employers have begun offering fertility benefits. In 2024, 42% of U.S. employers provided fertility benefits, up from 30% in 2020 (Mercer, 2024). Notably, 47% of large employers now cover in vitro fertilization (IVF) treatments (Healthcare Dive, 2024). This trend reflects a growing acknowledgment of the role fertility benefits play in attracting and retaining talent, as well as promoting workplace. Major insurance providers such as Aetna, a CVS Health Company , Blue Cross Blue Shield Association , Cigna Healthcare , UnitedHealthcare , and TriCare offer IVF treatment. However, your employer has to purchase these features in order for you to be covered.?

Furthermore, Generation X and Millennials are now coming home to roost - literally and furtively.In the early 2000s, sitcoms humorously depicted topics like egg freezing and sperm donation. For instance, the pilot episode of The Big Bang Theory features Leonard and Sheldon visiting a sperm bank to earn extra money, highlighting the casual attitude toward sperm donation during that era. Similarly, in Friends, Monica considers sperm donors as a path to motherhood, reflecting societal discussions on reproductive choices. Today, many from these generations, who built successful careers at tech giants like 微软 , 苹果 , and 谷歌 , as well as in government sectors, are leveraging their resources to address fertility challenges they once viewed through a comedic lens.

Microeconomic Benefits to Families and Child Development

Delaying parenthood can have several microeconomic benefits for families. Older parents often have greater financial stability, allowing for more substantial investments in their children’s education and well-being. Studies suggest that children born to older parents may experience better developmental outcomes due to the enhanced resources and life experience their parents bring (Max Planck Institute for Demographic Research, n.d.). However, it’s essential to balance these benefits against potential medical risks associated with advanced parental age.

Delaying parenthood is associated with an increased risk of reproductive challenges and congenital anomalies in offspring. Advanced maternal age is linked to a higher incidence of chromosomal abnormalities, such as trisomy 21, leading to conditions like Down syndrome. Similarly, advanced paternal age correlates with an increased risk of de novo mutations, contributing to disorders such as achondroplasia and Apert syndrome. These findings underscore the importance of considering parental age in reproductive planning and genetic counseling

Macroeconomic Implications

The decline in fertility rates carries significant macroeconomic consequences. Initially, a lower birth rate can lead to a higher proportion of working-age adults relative to dependents, potentially resulting in a ‘demographic dividend’ characterized by accelerated economic growth. Sustained low fertility rates may eventually lead to an aging population, labor shortages, and increased pressure on social welfare systems. Governments may face fiscal challenges, including reduced tax revenues and increased expenditures on healthcare and pensions (Aspen Economic Strategy Group, n.d.).

While declining birth rates and populations are often viewed with concern, several positive macroeconomic effects can emerge from these demographic shifts. A smaller population can lead to a higher capital-to-labor ratio, enhancing labor productivity as resources are distributed among fewer workers (Lee & Mason, 2014). Additionally, reduced population growth can alleviate pressure on natural resources, contributing to environmental sustainability and potentially lowering costs associated with environmental degradation (The Times, 2025). Moreover, with fewer dependents, families and governments may allocate more resources per individual, improving access to education, healthcare, and social services, thereby enhancing the quality of life (Pew Trusts, 2022). These shifts can also influence savings rates, as a higher proportion of the working-age population relative to dependents may lead to increased aggregate savings, providing more capital for economic development (Bloom, Canning, & Sevilla, 2003). It’s important to note that while these potential benefits exist, they depend on effective policy responses and societal adaptations to the changing demographic landscape.

Policy Changes Supporting IVF and Fertility Health

In response to these challenges, several policy changes have been implemented at both federal and state levels in the United States, as well as internationally, to support IVF and fertility health:

• Federal Initiatives in the United States: In February 2025, President Donald Trump signed an executive order aimed at expanding access to IVF and reducing its costs. The order directs the Domestic Policy Council to provide recommendations within 90 days to ensure reliable IVF access and significantly lower treatment expenses, which currently range from $12,000 to $25,000 per cycle. This initiative seeks to alleviate the financial burden on families seeking fertility treatments.
• Legislative Efforts: In June 2024, the “Right to IVF Act” was introduced in the U.S. Senate, aiming to establish a statutory right to access fertility treatments, including IVF. The bill seeks to protect and expand nationwide access to fertility services, ensuring that individuals and couples have the necessary support to pursue family planning.
• Federal Employee Health Benefits (FEHB): For Plan Year 2025, the FEHB program expanded its coverage to include IVF services. Twenty-five FEHB plans now offer IVF coverage without cycle or dollar limits, and all carriers are required to cover three cycles of IVF-related drugs. This policy change reflects a commitment to supporting federal employees in their family planning endeavors.
• International Perspectives: Globally, there is a growing recognition of infertility as a significant public health issue. A study published in the Journal of Global Health emphasizes the need for global action to address infertility, highlighting that access to fertility treatments should be considered a fundamental human right. The study calls for the implementation of national plans covering fertility to ensure equitable access to treatments worldwide.

These policy changes and legislative efforts signify a broader acknowledgment of the importance of fertility health and the need to support individuals and families in their reproductive journeys.

Conclusion

The intersection of declining birth rates, delayed parenthood, and the growth of the fertility health industry presents a complex landscape with profound personal and societal implications. As individuals navigate family planning decisions, the support of fertility health services and benefits becomes increasingly vital. Simultaneously, policymakers and businesses must consider the long-term economic impacts of these demographic shifts to develop strategies that support both families and broader economic stability.

References

Aspen Economic Strategy Group. (n.d.). The causes and consequences of declining US fertility. Retrieved from https://www.aspeninstitute.org/publications/the-causes-and-consequences-of-declining-us-fertility/

Bloom, D. E., Canning, D., & Sevilla, J. (2003). The demographic dividend: A new perspective on the economic consequences of population change. RAND Corporation. https://www.rand.org/pubs/monograph_reports/MR1274.html

ECG Management Consultants. (n.d.). Fertility forecast: Rising investment and industry trends. Retrieved from https://www.ecgmc.com/thought-leadership/blog/fertility-forecast-rising-investment-and-industry-trends

Financial Times. (2023, March 15). Private equity has made fertility roll-ups its latest baby. Retrieved from https://www.ft.com/content/0a1b2c3d-4e5f-4a6b-8c7d-9e0f1a2b3c4d

Healthcare Dive. (2024, August 27). Fertility benefits are on the rise: report. Retrieved from https://www.healthcaredive.com/news/fertility-benefit-on-the-rise/726030/

International Foundation of Employee Benefit Plans. (2024, May 15). Organizations adding more fertility and adoption support. Retrieved from https://blog.ifebp.org/organizations-adding-more-fertility-and-adoption-support/

Kaiser Family Foundation. (2024, October 18). 2024 Employer health benefits survey. Retrieved from https://www.kff.org/report-section/ehbs-2024-summary-of-findings/

Lean, S. C., Derricott, H., Jones, R. L., & Heazell, A. E. P. (2017). Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLOS ONE, 12(10), e0186287. https://doi.org/10.1371/journal.pone.0186287

Lee, R., & Mason, A. (2014). Is low fertility really a problem? Population aging, dependency, and consumption. Science, 346(6206), 229-234. https://doi.org/10.1126/science.1250542

Max Planck Institute for Demographic Research. (n.d.). The gendered impacts of delayed parenthood on educational and labor market outcomes. Retrieved from https://www.demogr.mpg.de/en/publications_databases_6118/publications_1904/mpidr_working_papers/the_gendered_impacts_of_delayed_parenthood_on_educational_and_labor_market_outcomes_7001

Mercer. (2024, November 20). Employers enhanced health benefits in 2024, adding coverage for weight loss medications and IVF despite growing health costs. Retrieved from https://www.businesswire.com/news/home/20241120305316/en/Employers-Enhanced-Health-Benefits-in-2024-Adding-Coverage-for-Weight-Loss-Medications-and-IVF-Despite-Growing-Health-Costs-Mercer-Survey-Finds

National Center for Biotechnology Information. (n.d.). Declining global fertility rates and the implications for family and health policy. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987469/

Olshan, A. F., Schnitzer, P. G., & Baird, P. A. (1994). Paternal age and the risk of congenital heart defects. Teratology, 50(1), 80–84. https://doi.org/10.1002/tera.1420500111

Pew Trusts. (2022, December). The long-term decline in fertility and what it means for state budgets. https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2022/12/the-long-term-decline-in-fertility-and-what-it-means-for-state-budgets

Santora, T. (2024, April 18). Population tipping point could arrive by 2030. Science. https://www.science.org/content/article/population-tipping-point-could-arrive-2030

Superville, D. (2025, February 18). Trump signs order to study how to expand IVF and calls for ‘radical transparency’ from government. Associated Press. https://apnews.com/article/143316eda581ac466cd923cdf4568d87

The Times. (2023, March 10). Oh, baby, baby? Why women are choosing to say no. Retrieved from https://www.thetimes.co.uk/article/why-women-are-choosing-to-delay-parenthood-2023

Tournaye, H., & Cohlen, B. (2010). Reproductive ageing. Cambridge University Press. https://doi.org/10.1017/CBO9780511777302

Wiener-Megnazi, Z., Auslender, R., & Dirnfeld, M. (2012). Advanced paternal age and reproductive outcome. Asian Journal of Andrology, 14(1), 69–76. https://doi.org/10.1038/aja.2011.69

Yang, Q., Wen, S. W., Leader, A., Chen, X. K., Lipson, J., & Walker, M. C. (2007). Paternal age and birth defects: How strong is the association? Human Reproduction, 22(3), 696–701. https://doi.org/10.1093/humrep/del453