Conservative support builds for IVF guardrails

The big picture: Trump has allied himself with "pro-natalist" policies to encourage a new baby boom and endorse assisted reproductive services in March when he called himself the "fertilization president." Several top GOP leaders have also spoken in support of IVF access.

• But IVF generally involves the creation of more human embryos than are needed, in order to improve the odds of a pregnancy. The surplus embryos can be frozen for future use or to be adopted by other couples, but many are discarded — a practice some anti-abortion forces liken to assisted suicide and abortion.
• The procedure is politically fraught, since polling has found 85% of Americans support access to IVF, Barbara Collura, the president of Resolve: The National Infertility Association, told Axios.

"How in the world are you going to move forward if 85% of Americans like something?" Collura said.

• The answer, she said, appears to be a concept called "ethical IVF" that regulates how many embryos are created.

Between the lines: A report from the Heritage Foundation in April called for lawmakers to tread carefully but set some standards for a fertility industry they view as largely unchecked.

• It raised concerns about "nonregulation of the IVF industry" as well as the "widespread use of ethically questionable nonmedical interventions such as sex selection" as well as the "commodification" of eggs, sperm and embryos.
• It also specifically called for support of "restorative reproductive medicine" built around ideas about healing infertile women through "hormone-balancing, dietary and nutritional adjustments, environmental changes and, in some cases, surgery."

Zoom in: Advocates for reproductive medicine technologies say they're increasingly seeing references to "ethical IVF" pop up in state legislatures — a term they say implies some forms of IVF are somehow unethical — and wonder whether the term may appear in recommendations from the White House.

• The American Society for Reproductive Medicine calls both ethical IVF and restorative medicine "misleading terminology" which "can be used to promote ideologically driven restrictions that could limit patient care."

• Advocates also say they worry IVF coverage could be limited to married heterosexual couples, preventing single people or gay and lesbian partners from pursuing parenthood.
• They also worry mandates for unused embryos to be given to other families, genetic testing bans or restrictions on freezing embryos could be embedded in the recommendations.

Friction point: IVF without surplus embryos is technically possible.

• However, experts say it is exhausting and expensive, and greatly reduces the chances of a successful pregnancy.
• Reproductive health experts say they already make adjustments to help patients navigate particular ethical concerns where possible, but say mandates on a nationwide level would be harmful.

What we're watching: Ideas that have been floated as potential recommendations in the White House report include requiring insurance coverage of IVF for military members and declaring it an "essential health benefit" under the Affordable Care Act, The Hill reported.

• What remains to be seen is how much Trump's recommendations stick to generally accepted medical standard, or seek to temper conflicts with the political right.