Infertility is the Breast Cancer of Our Generation

An open letter to Vince Haley, Director of Domestic Policy, in advance of this week's policy recommendation on expanding IVF access.

Most people associate Betty Ford with her openness about addiction and the treatment center that bears her name. Many don't know that in 1974, just after her husband, Gerald Ford, became president, she was diagnosed with breast cancer. Her illness came at a time when the word breast was considered impolite to say and too lewd to print. Patients were treated with radical mastectomies that left them disfigured without the option of reconstruction. She went on national TV to disclose her diagnosis. Her openness was a watershed moment for women's health. The following year ushered in the "Betty Ford Blip", a massive increase in women seeking breast cancer screenings, which resulted in a 15% increase in diagnoses. Early detection saved many lives back then, as it does today; my life is one of them.

Betty Ford began a movement universally known by its pink ribbons. It took twenty-four years, until 1998, to pass the Women's Health and Cancer Rights Act, which requires insurers in all fifty states to cover not only medical treatments, but reconstructive surgery. Today, the anxiety of a breast cancer diagnosis is tempered by the fact that information, support, and innovative medical treatments are readily available. The latest statistics show the five-year survival rate for women diagnosed with breast cancer is 91%. In the 1970s, it was 75%.

Betty Ford with Gerald Ford following her breast cancer surgery. Photo from the White House archives.

We need a Betty Ford moment for infertility.

The first baby born through In Vitro Fertilization (IVF) in the United States, Elizabeth Carr, was born in December 1981. Since then, the field has made incredible progress in understanding and treating infertility. Organizations like Resolve.org and the American Society for Reproductive Medicine (ASRM) have advocated to increase insurance coverage on a state-by-state basis. However, it's been nearly forty-four years, and there's still a long way to go.

I'm a part of the 1 in 6 people impacted by infertility. Today, 42% of adults say they have used fertility treatments or personally know someone who has. Many people have a misconception that IVF will solve their infertility issues, but even today's medical advances, data shows that, at best (i.e., under age 35), 50% of egg retrieval cycles result in a live birth.

I am one of the lucky ones; I have a child. Yet my path to parenthood was marked with tragedy. After three rounds of Intrauterine Insemination (IUI), my husband and I conceived. Our son was stillborn. Next, our daughter (conceived through IVF) died of a perinatal heart condition. I always imagined motherhood as a part of my life; yet we were out of money and seemingly out of options. Then, I learned my corporate health insurance would cover one more round of IVF. Without that benefit, we wouldn't have tried again, and my six-year-old, Carolina, wouldn't be here today.

My husband and I channeling positivity at the hospital during our embryo transfer.

The World Health Organization (WHO) defines infertility as "a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse." Yet, insurers in the United States consider infertility "not medically necessary," and without Federal mandates, insurance coverage will continue to be inconsistent and absent in many states.

If you're trying to have a baby, twelve attempts at conception resulting in a negative pregnancy test or miscarriages are heartbreaking enough. Being faced with the realization that you need to seek treatment and the overwhelming costs—financial and emotional—that lie ahead are daunting. Infertility has a devastating toll on mental health. A survey of fertility patients found that 90% of people facing long-term infertility said they experienced depression; 42% reported feeling suicidal.

Link to the IVF executive order is here.

On February 18th, 2025, President Trump signed an Executive Order asking the Director of Domestic Policy, Vince Haley, whose duty is to "make life better for ALL Americans," to issue a recommendation on expanding access to infertility treatment within ninety days. The ninety-day mark is the week of May 19th. It is also the week that Resolve and ASRM are hosting a Federal Advocacy Day, where hundreds of volunteers in all fifty states—from patients (including myself) to providers—will speak to members of Congress and share their stories to help politicians better understand the human impact of infertility.

The basics of what we're advocating for are affordable access to care and the ability for practitioners to support patients without the fear of legal repercussions. Personhood bills, which define embryos as humans, stand in the way of IVF.

In February 2024, Alabama's Supreme Court ruled that frozen embryos were "unborn children," which effectively forced clinics to shut their doors and left patients who had been waiting for years and had invested tens of thousands of dollars in treatments in limbo. In June, Southern Baptists voted to oppose IVF largely because the process often creates more embryos than are ultimately used. There have been calls for increased regulation and the establishment of "ethical IVF," which, although murkily defined, suggests limiting egg retrievals and fertilization—something that would render IVF futile.

In recent years, infertility has emerged from the shadows of secrecy. Prominent figures—from Michelle Obama to Amy Schumer—have openly discussed their struggles with IVF. Some, like Jennifer Aniston, have bravely shared that after years of trying, she was unable to have a child. Today, people find each other through social media hashtags like #TTC (trying to conceive) and support groups.

Now is the moment in history when a big change can be made. As a father of four children, I'm hopeful Mr. Hayley will stand in solidarity with those who want to be parents and face an uphill battle. Without expanding access to treatment and protecting the practitioners, couples with medically diagnosed infertility who dream of having a family will be left childless. No one needs a child to survive, just as no one needs reconstructed breasts to live — but both speak to something deeper: our basic human dignity. I don’t know Vince Haley and haven’t been able to figure out how to reach him, but if you know how to contact him, please let me know.

Thanks for reading!

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Words of the Week

“We need a Betty Ford moment for infertility.” —Lia Buffa De Feo

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Photo of the Week

Peeling paint on a door at St. Luke’s in the Fields Garden.

A weathered door at St. Luke’s in the Fields Garden, a in the West Village. I paused to photograph it, drawn to the construction of the door and the patterns left behind by peeling paint.

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