Israel's In Vitro Baby Boom: What Happens When Fertility Is Free?

Israel's In Vitro Baby Boom

For most childless couples, in vitro fertilization is an effective but prohibitively expensive road to motherhood that dangles tantalizingly out of reach.

Not so in Israel, the New York Times reports. As the "world capital" of in vitro fertilization, the country provides free IVF procedures for up to two "take home babies" for every woman under the age of 45.

It's a policy that has earned Israel the title of number one country for the procedure, with surveys showing that the country has 1,657 IVF procedures per million people per year -- a number that dwarfs second place Iceland's 899. The United States, on the other hand, has one of the lowest IVF rates -- 126 annually -- due at least in part to the fact that the procedure costs significantly more here than in any other country. A standard round of IVF therapy costs around $13,775 in the U.S.; in Japan, it's $4,012, and in Belgium, it's $3,109.

While some bemoan the high cost of IVF in the United States and praise other countries for keeping the cost there down, others argue that the procedure's high cost in the U.S. serves an important purpose. David Fleming, director of the Center for Health Ethics at the University of Missouri, told Newsweek that steep pricing helps avoid the "commoditization” of infants and said, "The more you have access, the more people will do it."

Babble's Sierra Black suggests that Israel's free IVF policy is a gift to would-be mothers. "For women experiencing infertility, a chance at making a family can be everything," she writes. Others aren't convinced the policy is all that great for women. Over at Slate's XX Factor, KJ Dell Antonia wonders if it isn't so much "family-friendly" as it is "government-subsidized peer pressure." Noting that child-care options for Israel's working moms are expensive when they aren't completely nonexistent, Antonia argues that many women are 'nudged' towards becoming primary caregiver and taken out of the work force in the process.

"The U.S.'s cultural belief that women are responsible for our own reproductive systems (with the one obvious, minority-view exception) and families are responsible for their own children in nearly every way leads us into some backwards policies, like the refusals to fund Planned Parenthood or Head Start in some communities. But in spite of all that's sometimes said about societal and family pressure on women of reproductive age, it's impossible to imagine an American sociologist saying we're 'expected to have children.' It's a silver lining we didn't even know we had."

Perhaps that view is unique to American culture, which on balance places less value on the importance of family. As a cultural stance, it contrasts starkly with Israel's historical and political imperative to bear children. Though Israelis and Arabs living in Israel are given the same rights to IVF, Israel has worked relentlessly to promote birthrates in an effort to counterbalance the high fertility rates of families in Palestinian territories. In a nod to modernity, the country now encourages gay and single women, when sanctioned by their rabbis, to receive the procedure; there's also a growing movement to make IVF available to gay men using a surrogate.

Another factor probably contributing to Israel's willingness to fund IVF -- and the U.S.' reluctance to -- is a difference of opinion about whether infertility is a disease. Like many countries, Israel defines barrenness as a medical condition. In the United States, health insurers see childbearing as a "socially constructed need," not a necessity. And since the American health care system struggles to provide even the most basic care for all, the chances that IVF might someday be covered by insurance here seem slim at best.

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