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August 7, 2025

Seeking a Better Answer to Infertility

The problems with federal insurance mandates for IVF are manifold.

By Chuck Donovan

In the classic Henry Wadsworth Longfellow story, Rip Van Winkle fell asleep under a tree in the Catskills and awakened 20 years later to a world transformed. Van Winkle missed the American Revolution, the death of his wife, and the marriage of his daughter. Thaddeus Daniel Pierce of Ohio will likely be even more famous in time, because he lost 30 years that he spent in an even deeper and more history-filled suspension.

Baby Thaddeus was frozen as an embryo for three decades, beginning in the second year of the first Clinton administration. His adoptive father now, Tim, was a toddler when Thaddeus was conceived, and Thaddeus’s sister is 30 years of age and has a daughter, Thaddeus’s niece, who is 10 years developmentally older than he.

Longfellow, it seems, simply lacked imagination.

Thaddeus is not the only “frozen-for-a-time” child of his age. He is merely the longest to have survived to birth after being held in the captivity of cryopreservation. He is, in fact, more than 30 years old. He is the same human being he was when his natural parents deployed in vitro fertilization (IVF) to conceive him and three siblings, one who is the 30-year-old sister mentioned above and two others whose fate is unclear. His natural parents turned to IVF, desperate for children of their own, but divorce came, bringing questions of divisions of the children that would bedevil a Solomon. His mother won custody and made the decision to donate the three unimplanted human beings via a Christian embryo adoption agency in Tennessee. Thaddeus is the result, a baby as remarkable in as many or even more ways than Louise Brown, the first “test-tube” baby conceived and born in England in 1978.

Thaddeus is a record setter for the duration of his isolation in temperatures in the range of -320 degrees Fahrenheit. In that condition, he was isolated, yes, but not alone. Estimates vary widely — from 400,000 to 1.5 million or more in the United States. One retrospective study published in the United States in 2020 surveyed the period from 2004-2013 and estimated that in 2003 there were some 400,000 embryos frozen in the United States and that by 2013 there were more than 303,000 embryos frozen in that single year.

For the entire decade, there were nearly two million embryos frozen for later “use,” which could include transfer to the mother’s uterus, adoption by other parents, research experiments, or thawing and discarding. A significant percentage of parents in the study reported feeling distress at and/or an inability to decide at the time of freezing how they would dispose of the embryos not selected for implantation or otherwise unutilized. Even if chosen for transfer, the reported rate of survival for selected embryos in 2013 was less than one in four.

The desire of parents for a child of their own biological heritage is as powerful a motive as there is in this world, as is the desire of social, political, and medical actors to make that unique experience accessible to couples for whom it has proven difficult or impossible. The nexus of ethical issues that arises when this desire is exercised without limits regarding who is being created — a unique human being of infinite value just like Thaddeus — has been explored by a range of writers and analysts who, it is safe to say, are as sympathetic to the profundity of procreation as anyone in our world today.

The complexity of the issue has been compounded recently by advocates, including figures associated with the current administration, who have sometimes spoken about IVF and related questions of procreation as matters of quantity and, to a lesser but still potent degree, quality among our offspring. Calls for tax credits, IVF, surrogacy, and other practices are often debated as if they were terrestrial missions to save humanity rather than straightforward questions about the intrinsic value of each human life, irrespective of its destiny in the academy or among the stars.

When it was reported this week that the Trump administration is likely backing away from its campaign proposal to mandate broad health insurance coverage for IVF, the reaction in much of the liberal media was to treat the decision as a betrayal of what some outlets called “conservative pronatalism.” Needless to say, that same needle is not being jabbed at the current administration’s much more portentous abandonment of the one million human beings who are naturally conceived in the United States each year and subsequently destroyed by abortion. The truth is that if the administration is indeed turning away from its rash and ethically fraught embrace of IVF, the quantitative aspect of the policy is the least significant part of what in fact is very good news for nascent human life and for the family.

The problems with federal insurance mandates for IVF are manifold. In addition to the ethical challenges wrought by preimplantation genetic screening, the mass freezing of human beings at their earliest stage, the challenges regarding the re disposition of abandoned children, and the extraordinary cost of IVF cycles, there is the underlying issue of the nature of insurance. Medical insurance will never be a zero-cost proposition; talk of “free” health care is absurd. Our nation spends billions of dollars on systems of review that have bureaucratized health care and expanded or circumscribed coverage terms based on the political judgments of elites.

But the purpose of insurance differs from that of a maintenance agreement where every item on a menu is weighed and costed out — the underlying purpose of insurance is not to determine each specific service an individual may obtain but to assist when costs get out of hand. The same is true of home and car insurance — people agree to share costs when they are unusual, not to indemnify gas-ups and oil changes — much less set up committees to debate each item. How much bureaucracy would disappear if insurers helped when expenses soared but did not micromanage treatment options?

A retreat from IVF need not be a retreat at all. The causes of declining fertility and birth rates are, for lack of a better term, multiplying. Dealing with the underlying causes of infertility, and related factors such as delayed marriage and childbirth, will require more comprehensive and nuanced efforts than IVF represents. Many of the measures are strongly consistent with President Trump’s initiative to reduce consumption of chemicals and pharmaceuticals with adverse effects on the human body.

A new report from the Heritage Foundation highlights the need for more dedicated effort and training of health care personnel to identify and treat underlying conditions that cause infertility for a growing percentage of women and men alike. The report includes an astonishing fact that illustrates how infertility is not just a woman’s problem, nor is it a stable phenomenon at the population level. The report notes, “Male-factor infertility and reproductive dysfunction [have] been on the rise since the 1970s, with a 1 percent decrease in sperm count, testosterone, and total fertility per year.” Clearly, everyone has a stake in seeking solutions to infertility issues for both sexes that do not contribute to a dehumanizing or eugenic mindset.

Mainstream media are paying more attention to these issues, including an extensive report on endometriosis this week on “The Today Show.” This malady, which affects as many as one in 10 women and is a leading cause of infertility, can be debilitatingly painful and take many years to diagnose and treat, a situation NBC says can be alleviated with better diagnostic practices and practitioners. Maggie Vespa’s report for “The Today Show” underscores the prevalence of this medical condition and points toward the kind of consensus solutions, without gross ethical downsides, that offer a way forward for many couples who want children of their own. Fixing infertility is about parental as well as child health.

Meanwhile, without doubt we should welcome Thaddeus Pierce more fully into the world he first entered in 1994. Perhaps we need not slumber another 20 years in order to wake up in a time where every child counts and none lies in frozen sleep.

Chuck Donovan served in the Reagan White House as a senior writer and as Deputy Director of Presidential Correspondence until early 1989. He was executive vice president of Family Research Council, a senior fellow at The Heritage Foundation, and founder/president of Charlotte Lozier Institute from 2011 to 2024. He has written and spoken extensively on issues in life and family policy.

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