"There’s been a fundamental change in how women organize their lives.”
Many American women spend their 20s and 30s focused on education, careers, and personal goals, finding that when they are ready to be mothers, they do not have a partner to make a family with. Women are increasingly turning to IVF and sperm donation instead of waiting for a spouse.
IVF has become a routine part of American reproductive health care since the nation’s first IVF baby was born in 1981. Today, IVF accounts for about 2 percent of all US births, or nearly 100,000 babies a year, a 50 percent increase over the past decade.
The procedure involves retrieving a woman’s eggs, fertilizing them with sperm in a laboratory, and implanting an embryo into the uterus. While commonly used to treat infertility, IVF has also become a key factor in the rise of older, unmarried mothers at a time when the overall US birth rate is falling.
Government data show the number of unmarried women in their 40s giving birth has increased by 250% over the past 30 years. While some of those women have spouses, many do not. “
There’s been a fundamental change in how women organize their lives,” said Rosanna Hertz, a sociologist at Wellesley College and author of 'Single By Chance, Mothers by Choice.' She told NPR that more women are pursuing higher education, establishing careers and prioritizing financial independence before considering parenthood.
When some women look for long-term partners in their mid-30s, Hertz added, they often find fewer options. “There’s no one to settle down with,” she said. “So the question becomes whether to wait or move forward alone.”
Research shows most women who want children would prefer to raise them with a partner, Hertz said, and many see IVF as a backup plan. But as fertility declines with age, that alternative can become the only viable option.
The odds of conceiving through IVF drop below 50 percent per cycle after age 35 and fall sharply with each year that follows. Many women undergo multiple cycles without a guarantee of pregnancy. Later-age pregnancies also carry higher risks of miscarriage and other complications, adding physical and emotional strain.
Cost remains one of the biggest barriers. A single IVF cycle typically costs between $15,000 and more than $30,000, putting the procedure out of reach for many Americans. Some women drain savings or take on debt to pay for treatment, while others rely on insurance coverage, a benefit that remains relatively rare.
Only about one in four companies with more than 200 employees covers part of IVF costs, according to industry data. President Donald Trump has recently called for measures to reduce the cost of fertility drugs and urged employers to expand infertility coverage.
Access to IVF also varies sharply by education and income. Women with advanced degrees are significantly more likely to use assisted reproductive technology than those with less education, according to the US Department of Health and Human Services.
In 2023, 1.8 percent of US births were conceived using IVF or similar technologies. Among women with doctorate or professional degrees, who tend to be older, the figure was 6.4 percent. Higher incomes among those women make it easier to afford treatment and support a child independently. IVF has also expanded access to parenthood for LGBTQ+ couples and individuals facing medical infertility.
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