HHS layoffs undercut Trump’s pledge to be ‘fertilization president’

President Trump has championed access to in vitro fertilization (IVF) and even dubbed himself the "fertilization president" early in his second term.   

But Department of Government Efficiency-induced layoffs at the Department and Health and Human Services (HHS) have decimated maternal health and reproductive medicine programs, including teams that report on fertility outcomes of IVF clinics, as well as those that track maternal health and mortality data. 

Public health experts and reproductive health advocates say the cuts will have lasting consequences and make it more dangerous to be pregnant in the United States. They questioned how Trump’s promises to expand IVF, as well as the White House's reported interest in boosting a lagging domestic birthrate, can be reconciled with the gutting of crucial tools that could help achieve those goals.  

The HHS suddenly laid off 10,000 people at the start of this month, a sweeping move that included about three-quarters of the Centers for Disease Control and Prevention’s (CDC) reproductive health division, former CDC employees told The Hill.  

Former fertility-focused agency employees who lost their jobs April 1 said they thought it was a mistake. 

“Trump said he was the fertility president. How does cutting this program support the administration's position?” one former CDC employee said. 

“We fully expected that the team would be brought back once there was awareness that it had been eliminated. But as time has gone on, apparently there's no intention of bringing anyone back,” said another.  

The CDC’s six-person Assisted Reproductive Technology (ART) Surveillance team was eliminated, as was the 17-person team that worked on the Pregnancy Risk Assessment Monitoring System. The agency also lost teams studying contraception use. 

As a result, couples trying to conceive may not be able to get trustworthy information about IVF clinics or their chances for success. There are now fewer people monitoring pregnancy health outcomes or doing deep research on why some women die in childbirth. 

Sean Tipton, chief advocacy and policy officer at the American Society for Reproductive Medicine, which represents fertility medicine providers, said the loss of those programs and staff will create a massive blind spot for women’s health. 

“I think the women and children of this country are going to be less healthy, going to die sooner, and I think it's going to take us longer to fully understand the ramifications of that,” Tipton said.  

“It is a deep, dark, black hole with no solutions,” he added. “It's hard to reconcile the statements of the self-proclaimed fertility president with the policy moves his administration has implemented.” 

The U.S. has one of the highest maternal mortality rates among high-income countries, with 18.6 deaths per 100,000 live births, according to the most recent data available from the CDC. Many health experts have called maternal mortality in the U.S. a “crisis,” which disproportionally impacts Black and brown communities.  

Maternal mortality rates are particularly high for Black women, rising to 49.5 deaths per 100,000 deaths in 2022 and 50.3 the following year, CDC data show.  

That crisis will only worsen if there are fewer people working to make pregnancies safer, experts said.  

The CDC’s National Center for Health Statistics is still releasing its annual maternal mortality report. But the report provides “surface level” information on maternal deaths that is compiled from death certificate data and does not dive deeply into root causes.

“That’s not looking at deaths among women who are pregnant or why,” one former CDC employee told The Hill.  

That work is up to members of the maternal mortality review committees who could all be laid off as part of proposed HHS budget cuts, a leaked version of the budget shows.  

An HHS official said the work of “critical programs” from the CDC’s Division of Reproductive Health will continue under Secretary Robert F. Kennedy Jr., “alongside multiple agencies and programs to improve coordination of health resources for Americans.” 

But the official did not give details on how the specific functions of those programs would continue, especially when relevant experts have seemingly been fired. 

The CDC’s ART Surveillance team was tasked with collecting and analyzing information on every IVF procedure performed in the country, including patient demographics and success rates. The team had operated under a congressional mandate since 1992. 

“We had 12 projects in the works, which have all just stopped,” a former agency employee said. "There's no one else doing them. There's no one else to do them.” 

Barbara Collura, the president and CEO of Resolve: The National Infertility Association, said the science of IVF is advancing rapidly and the data analyzed by the ART team is a major reason why.  

ART data helped make IVF safer, more efficient and more accessible, Collura said, which is exactly what the Trump administration purportedly wants to do. 

In February, Trump issued an executive order that pledged support for IVF and called for a report on how to make it more accessible and affordable; but there were no funding commitments or specific ideas presented. 

“If I want to put forward policy recommendations on IVF, I want the best people surrounding me, giving me advice and info,” Collura said. “You had them for decades, and now they are gone.” 

There are some nongovernmental efforts to collect and share IVF data. The Society for Assisted Reproductive Technology collects similar information about fertility clinics. But participation is voluntary, and advocates fear without the force of the federal government behind it, there will be fewer and fewer clinics reporting.  

The IVF industry is already facing increased scrutiny, especially in the wake of the Alabama Supreme Court decision last year that found frozen embryos are people.  

But advocates said they worry about growing distrust in the industry if the federal government is no longer tracking patient outcomes and providing some oversight.

"I don't think this [is] a time we want to have less oversight and regulation and data,” Collura said. “If you're all in on [expanding] access, let’s make sure you have great data.”