2025 In Review

2025 marked a pivotal period for reproductive rights and access to fertility care, defined by legislative changes, heightened political attention, and growing public engagement in the United States and beyond. From landmark surrogacy and parentage reforms to renewed debates about personhood and insurance coverage for fertility treatment, developments throughout the globe continue to reshape the landscape of reproductive care and family formation for individuals everywhere. This short review highlights the most significant legal milestones, policy debates, and advocacy efforts that influenced fertility care and reproductive rights throughout 2025 and sets the stage for challenges and opportunities in 2026 and beyond.

January-March 2025 – Federal Spark

• January 1, 2025: Massachusetts’ Long awaited parentage law (The Massachusetts Parentage Act) became effective clarifying legal parentage for children born through assisted reproduction and surrogacy, giving clear legal pathways for families growing through assisted reproduction including pre-birth orders and recognition of compensated gestational surrogacy.

• February 18, 2025: Trump Signs Executive Order 14216 “Expanding Access to In Vitro Fertilization” signaling the first time a President has addressed IVF in an executive order and sparking national conversation about Americans’ access to fertility care. The Executive Order was focused on policy recommendations directing the Domestic Policy Council to deliver actionable policy suggestions to lower costs and remove barriers to care rather than mandating actual benefits or demanding insurance coverage.

• March 5, 2025: IVF Access and Affordability Act introduced in the House (HR 1878). A Republican-led bill introduced by Rep. Mike Lawler aimed to expand IVF access by offering federal tax credits to offset the cost of fertility treatment including IVF. This bill was set forth as an answer by the Republicans who blocked Democrat led bills codifying a right to access IVF, including Sen. Tammy Duckworth’s Right to IVF Act and Access to Family Building Act.

• March 25, 2025: Nevada lawmakers consider bills solidifying access to contraception, family planning, and IVF, and providing protections for providers as part of broader reproductive care legislation. These efforts were in a direct response to Governor Joe Lombardo’s veto of progressive reproductive rights bills including one bill establishing rights for assisted reproduction.

April-June 2025 – State Movement

• April 2, 2025: Michigan legalizes compensated gestational surrogacy with the enactment of the Michigan Family Protection Act establishing clear legal protections for both intended parents and surrogates, allowing for enforceable gestational surrogacy agreements, and providing clear pathways to legal parentage for children born through assisted reproduction or gestational surrogacy.

• April 2025: Pennsylvania lawmakers push legislative IVF protections including a fertility insurance mandate and an act protecting access to assisted reproductive technology in response to threats to IVF access including the 2024 Alabama Supreme Court case granting embryos the same legal rights and protections afforded to children.

• June 30, 2025: Arkansas passes the RESTORE Act, requiring insurance companies to cover “Restorative Reproductive Medicine” (RRM). Professional medical organizations respond by warning that this law may undercut evidence-based infertility care by promoting alternative approaches not grounded in political and religious beliefs instead of scientific research.

July-September – National Stage: Insurance & Professional Organizations

• July 23, 2025: Access to Fertility Treatment and Care Act (HR 4648) was introduced in the House. This legislation is a comprehensive bill addressing access to fertility care signifying legislative interest in federal fertility policy. The legislation, if enacted, would require most private and federal health insurance plans including Medicaid, TRICARE< and the VA, to cover fertility treatment and medically necessary fertility preservation services. This bill is currently in committee review and has not yet been passed by either the House or Senate.

• August 14, 2025: The American Society for Reproductive Medicine (ASRM), the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) issue a letter urging lawmakers to reject all legislative efforts to promote Restorative Reproductive Medicine as the standard of care, and defending access to IVF based in scientific research.

October-December 2025 – Continued Friction and Policy Divide

• October 16, 2025: President Trump announces action to lower cost and expand access to IVF in a press release by providing discounts on IVF medications and a proposed online platform to reduce out-of-pocket costs for fertility patients. Note: The President asked that employers consider offering fertility coverage but he did not mandate that they provide such coverage.

  • States Gaining Traction: Georgia, Florida, Tennessee all pass laws in 2025 to explicitly protect access to IVF, and Colorado, Louisiana, and Arkansas enact legislation to expand and protect fertility coverage. Currently, 25 states and Washington DC require insurance coverage for fertility care (though specific mandates regarding cope of who they cover and what services are covered vary state to state).

• December 4, 2025: Western Australia passes laws aimed at improving assisted reproductive and surrogacy access, expanding rights to parents, and mandating regulation of third party reproductive arrangements scheduled to take effect in 2027.

Context and Ongoing Issues Throughout 2025

• Although the Alabama Supreme Court ruling imbuing embryos with the same legal status of children occurred in 2024, the ruling reverberated in policy arguments, clinic operations, and state legislatures throughout 2025 and will continue into2026. The personhood movement as a whole gained traction, seemingly at odds with the current administration’s verbal commitment to support IVF.

  • Personhood: defined as the philosophical and legal concept of defining an entity as a “person” and granting it the same rights to the entity as those afforded to people. For purposes of this article, “personhood” is used with reference to both fetal personhood and embryonic personhood.

• The news exploded with stories exposing gaps in regulatory protections for surrogates and intended parents working with surrogates throughout the United States and beyond. A call for more regulation and oversight in the surrogacy community will continue in 2026.

• Advocacy groups emphasized racial and socioeconomics disparities in access to fertility care, highlighting disproportionate barriers for black and brown women, rural communities, and other marginalized communities.

• National reproductive rights debates and legal battles over access to abortion continued to share policy for all reproductive health services, intersecting with discussions about IVF, contraception, and the legal status of embryos. This is primed to be a topic of heightened priority in 2026.

Key Takeaways

• Federal vs State Crosscurrents

  • The Trump administration’s Executive Order and IVF cost initiatives contrasted with the pro-life movement that has historically aligned with this administration. Federal action in 2025 reflected a fragmented approach with executive efforts aimed to lower the out-of-pocket cost of IVF signaling support for fertility care occurring alongside personhood initiatives and anti-abortion rhetoric at the federal level.

  • State legislatures remained the primary focus of fertility policy, with some states advancing surrogacy legislation, creating protections for IVF, and mandating insurance coverage for fertility care.

• Medical Community Engagement

  • Professional medical societies played a critical role in defending evidence-based fertility care, pushing back against regulatory proposals that deviate from established clinical standard

• Global Momentum

  • While Europe has been moving in a more restrictive approach to IVF and third party reproductive arrangements, Australia demonstrated growing alignment toward modernizing fertility and surrogacy laws and increasing access to care.