Repronews #43: Trump promises universal coverage of IVF if elected

California legislature votes to mandate IVF coverage; Silicon Valley pronatalism; fertility: driven by culture or income?; cognitive aging; Liz Carr interviews Louise Brown

Source: RESOLVE

Welcome to the latest issue of Repronews! Highlights from this week’s edition:

• Repro/genetics

  • Trump backs universal coverage for IVF treatments, criticizes Florida abortion restriction proposal

  • California legislature adopts bill mandating coverage of IVF, awaiting governor’s signature

• Population Policies & Trends

  • Silicon Valley pronatalism emphasizes reprotech and genetic enhancement

  • Fertility rates are driven by culture, not income

• Genetic Studies

  • Study finds humanity’s most recent brain gains are most at risk from aging

• Further Learning

  • Podcast: Elisabeth Carr interviews Louise Brown on being the first IVF babies

Repro/genetics

Techno-natalist turn: “Trump says he would have government or insurance pay for IVF treatments if elected” (The Hill)

• Republican presidential candidate Donald Trump said his administration would protect access to in vitro fertilization (IVF) and have either the government or insurance companies pay for the treatment if elected in November.

• “We are going to be—under the Trump administration, we are going to be paying for that treatment,” he said in an exclusive interview with NBC News, adding that would apply to “all Americans who need it. So, we’re going to be paying for that treatment, or we’re going to be mandating that the insurance companies pay.”

• Trump justified covering IVF saying: “I was always for IVF … It’s fertilization. It’s helping women, and men, and families to be able to have a baby. Some have great difficulty and a lot of them have been very happy with the results. … We’re doing this because we just think it’s great. And we need great children, beautiful children in our country.”

• Vice President Harris’s presidential campaign slammed Trump’s pledge to pay for IVF, claiming it is “one of his most brazen lies yet. … Donald Trump’s own platform could effectively ban IVF and abortion nationwide.”

• Trump had drastically shortened the Republican Party platform, including removal of a call for a federal abortion ban. The new GOP platform now reads: “We will oppose Late Term Abortion, while supporting mothers and policies that advance Prenatal Care, access to Birth Control, and IVF (fertility treatments).”

• As president, Trump appointed originalist or textualist justices who went on to overturn Roe v. Wade’s right to abortion as unconstitutional, meaning each of the states is now largely free to regulate or restrict abortion as they see fit.

• While infertility remains a common problem among Americans, many insurance companies or employers still do not cover fertility treatments such as IVF. According to one study, 54% of the biggest U.S. employers—those with 20,000 workers or more—covered IVF in 2022.

• “We … appreciate President Trump’s acknowledgment of the significance of access to fertility treatments and the crucial role of government in ensuring this access,” said Sean Tipton, Chief Advocacy and Policy Officer for the American Society for Reproductive Medicine (ASMR). “Many things get said during campaigns. Candidates must provide detailed proposals for voters’ evaluation. We stand ready to work with any candidate or elected official with a sincere interest in ensuring all Americans have access to the medical care they need.”

• “We hope that former President Trump, Vice President Harris, and indeed everyone in and running for public office will commit to ensuring access to care for family-building therapies for all who need them,” Tipton added.

• Trump also said that Florida’s proposed six-week limit for abortions is “too short” and he would vote for a longer period.

• Israel is one of the few countries in the world reimbursing IVF. The cost of IVF per child can easily reach $12,000 to $14,000.

California legislature adopts bill mandating most private health plans to cover IVF (ASMR)

• The California General Assembly has adopted a bill requiring most private health insurance plans to cover IVF.

• “This bill requires both large and small healthcare plans to provide diagnosis and treatment of infertility and fertility services,” Assemblymember Buffy Wicks from Oakland said. “I know IVF is really important and we're hoping our health insurance plans cover it.”

• Sean Tipton, Chief Advocacy and Policy Officer for the American Society for Reproductive Medicine (ASMR), said: “We are very pleased that the California legislature has, after years of debate, passed SB 729, crucial legislation to provide appropriately inclusive coverage. We call on Governor [Gavin] Newsom to sign it immediately.”

Population Policies & Trends

“The pronatalism of Silicon Valley” (Heritage)

• Fewer babies means fewer adults who can contribute to the future economy, military readiness, Social Security, education, and family formation of their own.

• The fertility decline has caught the attention of socially conservative groups such as the Heritage Foundation, American Compass, the Ethics and Public Policy Center, and the Institute for Family Studies, as well as Silicon Valley elites like Elon Musk.

• There are different kinds of natalism. “Pro-family” natalism emphasizes the role of family formation, often defined by heterosexual marriage.

• Narrow pronatalism tends to encourage childbearing detached from its natural role within the family.

• Silicon Valley pronatalists have a distinct goal that supersedes both categories.

  Many of these Silicon Valley elites are in the emerging class of “right-wing progressives” who view technology as the natural solution to and means of childbearing itself.

• Their selective pronatalism aims to ensure that their future children are the healthiest, smartest, and best potential children they can be.

• The author warns: “unless Silicon Valley pronatalists impose principled self-restraint onto their reproductive technological developments, such efforts may only further birth inequality and demographic collapse in the United States.”

• $800 million was invested in fertility technology start-ups in 2022 alone.

• The author criticizes the desire to create “genetically superior babies who are selected, often out of a misguided compassion on the part of their parents, based on their health, potential creativity, or other characteristics.”

• Investors in fertility technology include Elon Musk, Peter Thiel, Sam Altman, Brian Armstrong, Jack Abraham, Nicole Shanahan, and Vitalik Buterin. Such techno-optimists are looking for a way to reverse reproductive aging, overcome infertility, and optimize child selection.

• Some investments are focused on developing fertility awareness-based methods or restorative reproductive medicine.

• The phone application 28—a Peter Thiel-backed application from the right-leaning Evie Magazine— teaches women how to live within their natural cycle with fertility tracking, fitness, and nutritional insights.

• Nicole Shanahan, Robert F. Kennedy Jr.’s running mate and former spouse of Google co-founder Sergey Brin, pledged to give $100 million for reproductive research, especially focused on helping women become pregnant later in life.

• Beyond this, much of Silicon Valley’s fertility research tends to fall into three categories: embryonic optimization, technologies that replace the need for human gametes or wombs, and the use of AI in the analysis and selection of human life.

• In 2021, Noor Siddiqui—a former Peter Thiel fellow—launched Orchid, a fertility service that allows couples to screen for more than 1,200 monogenic diseases. While basic preimplantation genetic testing is widely available in the United States—with 75% of clinics offering these services—Orchid allows couples to sequence more than 99% of an embryo’s genomes. Instead of merely testing for single-gene disorders such as Down syndrome, polygenic testing allows Orchid to screen for conditions that involve multiple genes.

• With an initial investment of $12 million, interest in Orchid and similar start-ups like Genomic Prediction and MyOme has only continued to grow.

• Orchid’s investors alone include Fidji Simo, the CEO of Instacart; Anna Wojcicki, the co-founder and CEO of 23andMe; Brian Armstrong, the co-founder and CEO of Coinbase; and George Church, a professor of genetics at Harvard Medical School and the Massachusetts Institute of Technology.

• Musk and Shivon Zilus, director of Neuralink, used Orchid’s genetic screening service to have their third child.

• The author dismisses emerging reprotechnologies’ potential to reduce the risks of childbirth as “misleading,” condemns the prevention of birthing embryos with congenital diseases as a deprivation of personhood, and sees genetic enhancement as just another luxury good, not a way to enable the health and flourishing of future generations.

• The author condemns Silicon Valley natalism and calls for “a cultural revolution that promotes a sustainable and life-giving pronatalism that asks men and women, in the words of Dr. Catherine Pakaluk, “why not have one more child?”

“More money, more babies: What’s the relationship between income and fertility?” (IFS)

• Evidence suggests that across almost all pre-industrial human societies, higher-status and higher-income families had more children.

• The author argues that historic fertility declines were overwhelmingly caused by novel cultural norms, which were often correlated, but distinct from, income.

• In France, fertility fell 100 years before industrialization, while in England, the first country to industrialize, fertility did not decline for a century after industrialization.

• Today, fertility in Africa is lower than it was for European or Asian countries when they had similar income levels, because modern Africa, though poor, is nonetheless highly exposed to globalized cultural norms. At the individual level, when African women get richer, they actually tend to have more children.

• In the United Stats, correlations between fertility and income differ widely by race. Among whites and to a lesser extent Asians, tends to rise with income (except for the high-fertility very poor).

• By contrast, wealthy black and Hispanic women have rather low birth rates, whileforeign-born women exhibit little connection between income and fertility.

• Among the Amish and Ultra-Orthodox Jews in the U.S., fertility is negatively correlated with income: poorer income brackets have 6 to 8 children, while the richer ones have 3 to 5. Overall, the higher fertility of these two groups compared to other Americans is overwhelmingly driven by cultural factors however.

• Among the Arab countries, which range from poor to oil-rich, there is no national correlation between wealth and lower fertility.

  

  • Within poorer Islamic/Middle Eastern countries (Egypt, Syria, Turkey, Tunisia, Morocco, Algeria, Sudan, Yemen, Lebanon, Jordan, the West Bank, Iraq, Azerbaijan, and Libya), there is a clear negative correlation between fertility and income, as income rises towards $20,000 per person or so.

  • The author argues this is because richer people in these countries are more influenced by global cultural trends. Paradoxically, oil-rich Arab states have been able to insulate themselves culturally more, resulting in more traditional Islamic/Arab cultural norms and more even fertility among social classes.

  • The author concludes: “When whole societies become richer, they do not necessarily have fewer children. Once we control for the basic problem of cultural stratification, the supposed link between low income and high fertility, or high fertility and low income, largely disappears.”

More on population policies and trends:

• “South Korea’s low fertility rate is ‘no joke’”: Shrinking consumer market is pushing a Korean pizza startup to go global fast (Fortune)

Genetic Studies

Humanity’s newest brain gains are most at risk from ageing (Nature)

• In the more than 6 million years since people and chimpanzees split from their common ancestor, human brains have rapidly amassed tissue supporting decision-making and self-control. According to a new study comparing chimp and human brain scans, these regions are also the most at risk of deterioration during ageing.

• Previous studies have shown that regions of the human brain that are the last to mature, such as parts of the frontal lobe, are the first to show signs of ageing. This has led to the “last in, first out” theory of brain development and decay.

• The results support the “important hypothesis that our cortical expansion came at the price of age-related decline”, says Rogier Mars, a neuroscientist at the University of Oxford.

• The researchers also compared chimps with olive baboons (Papio anubis) and rhesus macaques (Macaca mulatta). No link between the areas of the brain that had experienced rapid evolutionary expansion and those that went through accelerated ageing was found, suggesting that this feature could be unique to human brain evolution.

Further Learning

“Two IVF (first) babies have a chat” (Born for This)

• Elisabeth Carr, the first IVF baby born in the United States, interviewed Louise Brown, the first IVF baby born in Britain. Topics discussed include:

  • What it was like growing up with so much media attention.

  • Why they advocate for IVF practitioners and users.

  • Their intense dislike of the term “test tube babies.”

  • What were the 10 most stupid questions asked of them by reporters. (“Do you feel an affinity with Dolly the sheep?”)

More on human nature, evolution, and biotech:

• The Peacock’s Predicament: Steve Stewart-Williams, a professor psychology, at the University of Nottingham Malaysia, is writing a new book on sex differences and why they matter (Steve Stewart-Williams)

• “Beyond gene-edited babies: the possible paths for tinkering with human evolution” (MIT Technology Review)

• “AI and the future of human DNA” (Thomas Frey)

Disclaimer: The Genetic Choice Project cannot fact-check the linked-to stories and studies, nor do the views expressed necessarily reflect our own.