Hi friends,
We've been thinking a lot this week about the word "access." About 1 in 6 of us will face infertility at some point in our lives, and that number is nearly identical across borders. The statistics don’t discriminate. The systems do.
The two features in this issue explore the issue of fertility care access from very different angles. One looks at what happens when patients leave their home country to find affordable care. The other zooms out to ask why North America, in particular, still has so much trouble offering clinical fertility support evenly. Both, we hope, leave you with a clearer understanding of the issue of access, and provide a bit of inspiration if you're looking for potential solutions.
Let’s dive in.
In this Issue We'll Cover...
Going Abroad for IVF Treatment? When It May Make Sense for You
A single IVF cycle in the U.S. now runs $15,000 to $30,000 with medications, and most patients need more than one. In Spain, donor-egg IVF can land at a third of that, even after factoring in flights and accommodation. We look at the cost gap, the legal landscape (and where Germany's and France's most stringent rules quietly send their own patients), what to vet when choosing a clinic abroad, and the questions to bring to the table before you book a single thing.
"We want to help the North American audience realize that Spain is a real option. The quality of care is high, the pricing is competitive, and unlike some other medical tourism destinations, Spain offers political stability."
Includes a deep look at Spain's legal framework under Law 14/2006, the difference between medical tourism and real continuity of care, and an inside view from Vida Fertility, a Spanish boutique group with three clinics in Madrid, Alicante, and San Sebastián, where 85% of patients come from outside Spain.
What We’re Reading this Week
Fertility care (especially IVF) can be life changing, but it’s also one of the most expensive medical services many people will ever face. Costs, insurance coverage, and policy efforts are changing rapidly, and access still varies widely depending on where you live, your income, and your insurance situation. Here are some recent articles that shed light on the landscape of access and affordability now and into 2026:
TIME. IVF Changed America. But Its Future Is Under Threat Jamie Ducharme's feature anchored on Elizabeth Carr, the first U.S. baby born via IVF in 1981, and what fetal-personhood laws would actually do to American fertility care if they spread. The clearest big-picture read of where this is heading.
Stanford SIEPR / NBER. The Economics of Infertility: Evidence from Reproductive Medicine Petra Persson and Maria Polyakova's landmark working paper. The finding that's stayed with us: the rate of IVF initiations drops by half when treatment isn't covered by insurance, and couples are willing to spend up to a third of their disposable income on a 40% chance at a child.
• NPR. The cost of IVF: How far did you go to pay for your fertility treatment? Reader-submitted stories of second jobs, drained 401(k)s, and what people actually do when the math doesn't math. Quietly devastating, and the most honest baseline we've seen for what "access" looks like in real households.
The Postal Code Lottery
We map the global access gap, look at the countries where universal coverage actually works (Israel, Belgium, France, Denmark), and spotlight the patient-led organizations pushing the system forward, including Fertility Alberta, the non-profit that has spent the last three years advocating for patients in their province.
If you've ever wondered whether the country, state, or province you live in matters more than the biology you're working with: yes, it matters a lot. Here's the map.
👉 Read: The Postal Code Lottery
If you enjoyed this issue of Path to Parenthood, be sure to share with anyone you know who is currently on a TTC journey ❤
