Economic and Social Barriers to Fertility Treatment

Infertility as an Economic Issue, Not Just a Financial Barrier

When people talk about infertility, the conversation is usually framed as a simple financial barrier. But for Beth Frattura, founder and executive director of the Stork Foundation, infertility is also something much bigger: an economic issue that could lead to the future of fertility treatment being accessible only to those with higher privilege.

Frattura comes to this work from two worlds. Professionally, she spent nearly two decades in wealth management at Morgan Stanley, helping families manage complex financial lives and ensure their money was working toward what mattered most to them. In her personal life, she and her husband are parents to three children thanks to IVF.

“When I went through fertility treatments, I was shocked not just by the emotional toll of the process, which is immense, but by the cost and how little insurance coverage existed,” she explains. “It became clear very quickly that access to fertility care in this country is largely determined by your income and your employer’s benefits.”

Why Infertility Rates Are Rising Worldwide

The World Health Organization estimates that one in six adults worldwide experience infertility during their lifetime. When asked about these numbers, Frattura mentioned an aging population as a possible contributing factor.

“When people hear the statistic that one in six adults worldwide experience infertility during their lifetime, it can feel surprising,” Frattura says. “But when you step back, it actually makes a lot of sense.”

Delayed Family Building and Fertility Timelines

A major driver is timing. People today are waiting longer than ever to start families. Biologically, women’s fertility peaks in the late twenties, yet modern life pushes marriage, home ownership, and family building into the thirties and beyond. Education, career advancement, and financial stability are prioritized. Fertility has not yet adjusted to modern timelines.

“We have this growing mismatch between how we live and how our bodies were set up to work,” she explains.

Medical and Environmental Factors Affecting Fertility

On top of that, there are medical and environmental factors. Conditions like PCOS and endometriosis are more commonly diagnosed. Stress levels are higher. Environmental exposures play a role. And improved diagnostics mean infertility is now identified rather than silently endured.

“As more people need medical help to build their families, access hasn’t kept up,” Frattura says. “And that’s where the real issue lies.”

Infertility’s Impact on the U.S. Economy

From her financial background, Frattura sees infertility not just as a healthcare challenge, but as an economic one. Birth rates in the United States are falling sharply. Today, the country sits at roughly 1.6 births per woman, an all-time low and well below replacement level.

“Over time, this leads to an aging population, workforce strain, and long-term pressure on systems like Social Security,” she explains. “We’ve gone from over five workers per retiree in the 1960s to about 2.7 workers per beneficiary today.”

IVF Costs and Access Disparities

These demographic shifts have long-term financial consequences that rarely show up in conversations about fertility care, financial planning, or public policy. At the same time, IVF is becoming increasingly necessary and remains financially out of reach for most families.

“When fertility care depends on your income or your employer’s benefits, it stops being healthcare and starts being a privilege,” Frattura says.

IVF treatment can cost between $15,000 and $20,000 per cycle, with an estimated 85% of costs in the U.S. paid out of pocket. Insurance coverage varies widely by state and employer, and even in states with fertility mandates, loopholes often leave families without meaningful support.

The Need for Fertility Education and Financial Planning

“What’s missing is education, planning, and policy,” Frattura explains. “We talk all the time about saving for retirement in your twenties or planning for college. But we don’t talk about fertility timelines, fertility preservation options, or the true cost of care.”

This mismatch between modern life timelines, biology, and affordability is leaving millions behind.

From a financial planning perspective, that absence is significant. Without early education or preparation, many families are forced into crisis-mode decisions later in life, when time, money, and medical options are already limited.

The Educational Gap in Fertility Knowledge

The Stork Foundation exists to bridge a gap that, according to Frattura, should not exist at all. By providing grants and financial support for fertility treatment, the organization steps in where insurance and policy fall short. The Stork Foundation works relentlessly to spread awareness of access to treatment and to provide hope for future families.

Fertility coaches such as those on MissPoppins are always readily available to answer questions and guide you through the fertility process and follow due diligence to effectively go through the process. Certified fertility coaches support individuals and families across the entire reproductive journey, offering guidance on fertility and family planning, IVF and treatment support, birth planning, doula-related care, prenatal nutrition, and overall pregnancy wellness.

“My hope is that one day our work won’t be necessary,” Frattura says. “Access to fertility healthcare should be standard, not exceptional. Building a family shouldn’t depend on your zip code, your paycheck, or your employer’s insurance plan.”

Until then, reframing infertility as an economic issue and not just a personal struggle may be the first step toward meaningful, systemic change.