The U.S. Federal Government and Reproductive Health

Introduction

On April 1, 2025, the Trump Administration initiated sweeping workforce reductions across federal administrative agencies. According to workforce data from the United States (U.S.) Office of Personnel Management (OPM), the Administration eliminated an estimated 18,000 positions, representing an 18 percent reduction, at the U.S. Department of Health and Human Services (HHS) (24, 25). This included over 3,000 cut positions, or a 22 percent reduction, at the Centers for Disease Control and Prevention (CDC) (24, 25). As demonstrated by the charts below, these cuts broke with workforce growth trends at CDC and HHS and represent a substantial reduction in the overall federal workforce.

The cuts at the CDC included substantial reductions to its Division of Reproductive Health (DRH) (18, 20, 21, 31), which has, for nearly six decades, led federal initiatives to improve women’s health, reproductive health, and pregnancy outcomes in the U.S. Among those laid off were all members of the CDC’s Assisted Reproductive Technology (ART) Surveillance Team, responsible for collecting, analyzing, and publishing national in vitro fertilization (IVF) outcome data under the Fertility Clinic Success Rate and Certification Act (FCSRCA) enacted in 1992 (9, 11, 18).

Similarly, the Food and Drug Administration (FDA) lost 20% of its staff, totaling over 3,500 positions (25). The Administration also eliminated 4,000 positions at the National Institutes of Health (NIH), representing an 18 percent reduction in total staff, and the Centers for Medicare and Medicaid Services (CMS) lost an estimated 1,000 positions, representing a 15 percent reduction in staff (6, 20, 21, 25). Charts 3 and 4 highlight major workforce cuts to the NIH and FDA in 2025 and the beginning of 2026.

Together, these reductions significantly diminished the federal scientific and medical workforce responsible for research, regulatory oversight, public health education, and the distribution of critical health resources.

Workforce reductions occurred alongside aggressive cuts to research funding. In 2025, the Trump White House Office of Management and Budget (OMB) temporarily halted NIH grant disbursements nationwide. Although this move was quickly rescinded following public and institutional criticism, additional cuts followed (13). By the end of 2025, an estimated 2,500 NIH grants, representing approximately $2.3 billion in funding, had been frozen or terminated (4).

These research disruptions span numerous fields, including cancer treatment, immunization, and reproductive health, and threaten to slow biomedical innovation more broadly (4, 7, 10, 18, 31).

Researchers and scientists in reproductive biology, infertility, maternal health, and women’s health have experienced delayed funding, cancelled programs, and destabilizing effects across academic institutions, laboratories, and clinics.

Reproductive health outcomes shape labor force participation, demographic trends, and long‑term economic productivity. Thus, disruptions to federal reproductive health infrastructure carry implications beyond effects on clinical care.

The full impact of the cuts to research capacity, clinical expertise, and public health data reporting may not be fully measurable for several years. However, this Administration’s approach reflects a clear departure from the federal government’s long-standing commitment to expanding scientific research and strengthening the nation’s biomedical workforce.

These actions are also antithetical to the current Administration’s stated support for IVF. While certain Administration officials have emphasized a commitment to protecting and expanding fertility care, the elimination of the CDC’s ART surveillance team, along with other detrimental actions highlighted in this paper, undermines transparency and patient protections required under FCSRCA and could weaken the broader family‑building infrastructure in the United States.

These developments also raise concerns that progress in science and medicine, particularly in historically underfunded fields, may slow or become more unevenly distributed.

This analysis from The American Society for Reproductive Medicine (ASRM)’s Center for Policy and Leadership (CPL) examines:

1. The role of federal administrative agencies in reproductive health care access,quality, oversight, and education, including the contributions of shuttered teams suchas the CDC’s ART Surveillance Team;
2. The role of federal funding in advancing scientific research related to reproductivemedicine.
3. The impact of reductions in the federal scientific and medical workforce, funding disruptions, and diminished data transparency on innovation in the United States; and
4. Policy considerations for safeguarding scientific progress, reproductive medicine, and access to high-quality reproductive health care moving forward.

The Role of Federal Administrative Agencies in Advancing Reproductive Health and Medicine

Federal administrative agencies, including the CDC, FDA, NIH, and HHS, play a central role in shaping reproductive health care, medical oversight, and scientific research in the United States.

Reproductive health encompasses far more than infertility and IVF; it includes maternal health, pregnancy outcomes, contraception, third-party reproduction, and gynecologic conditions, all of which depend on the federal research, surveillance, and regulatory infrastructure described in this paper.

The CDC provides disease surveillance, epidemiologic analysis, and national data reporting on key reproductive and maternal health outcomes, including birth outcomes, risks of infectious diseases during pregnancy, maternal mortality trends, and ART success rates (5, 9, 31).

The FDA approves reproductive health drugs and medical devices and regulates biological materials such as donor oocytes and donor sperm (29). More broadly, HHS, which oversees agencies including the CDC, NIH, and CMS, administers public health education initiatives and establishes reimbursement policies for federally insured and underinsured populations (7, 18).

Historically, these agencies have carried out several core functions essential to reproductive health care and biomedical innovation:

• Disease surveillance, prevention, and epidemiology;
• Clinical data collection, analysis, and public reporting;
• Drug, medical device, and biological material review and approval;
• Research funding, peer review, and scientific standard setting;
• Regulatory oversight of laboratory and clinical activity and outcomes;
• Public health education and communication; and
• Insurance regulation and reimbursement policy execution.

Together, these functions form the backbone of the United States’ reproductive health research, regulatory, and clinical infrastructure. They support the development and delivery of safe, comprehensive, and evidence-based reproductive care while ensuring transparency and accountability within the healthcare system.

The CDC and ART Surveillance

Since its founding in 1946, the CDC has advanced public health through disease surveillance, epidemiologic research, and national health data reporting. This infrastructure is important to the field of reproductive medicine, where transparent reporting helps patients and clinicians evaluate treatment outcomes.

Congress enacted the Fertility Clinic Success Rate and Certification Act (FCSRCA) in 1992 to ensure transparency in IVF outcomes and provide prospective patients with reliable information when selecting fertility care providers (9). The law requires all U.S. fertility clinics to report success rates to the federal government in a standardized format and mandates that this information be made publicly available (9).

Congress assigned responsibility for collecting, analyzing, and publishing these data to the CDC, which established the ART surveillance Team to implement the law (9, 34). The Society for Assisted Reproductive Technology (SART) began collecting clinic-level IVF outcome data in the 1980s and published its first report in 1988, prior to the enactment of federal reporting requirements. Following the passage of FCSRCA in 1992, the CDC’s ART surveillance team published the first federally mandated national ART Success Rates Report in 1997 (34).

Through the National ART Surveillance System (NASS), the CDC collected and reported clinic-level data from 1995 through 2022, typically publishing reports with a 2- to 3-year lag. These reports included clinic success rates, service profiles, and clinic-specific and national summary statistics from fertility clinics across the U.S. (4, 9, 34).

Together, SART’s longstanding voluntary data collection efforts and the CDC’s federally mandated reporting structure created a system widely regarded as a model for transparency and accountability. Patients could review clinic outcomes before seeking care, while clinics benefited from benchmarking data that supported quality improvement and clinical innovation (5).

The elimination of the entire ART Surveillance Team in 2025 abruptly disrupted this federally mandated oversight system (11). SART continues to collect and publish data from its member clinics, having done so for decades. However, it remains unclear what role, if any, the federal government will play in  continuing national ART data reporting following the elimination of the CDC team.

As a result, a significant gap in federally published data reporting and oversight has emerged. No replacement federal reporting mechanism has been publicly announced to fulfill the data collection and reporting requirements outlined in FCSRCA. While SART will continue to provide important information, a private, non-profit organization cannot replicate the scope, authority, or national reach of a federally administered reporting system. This development undermines long-standing patient protections, including informed consent decision-making based on transparent success-rate data, and removes an important tool for quality benchmarking across fertility clinics (1, 5).

The disbandment of this small but highly specialized team, which included clinicians, statisticians, and experts in reproductive and public health, raises broader concerns about the future of national data  transparency, quality oversight, and scientific advancement in reproductive medicine (5).

These actions also stand in tension with the Administration’s public statements expressing support for IVF and fertility care. Eliminating the federal team responsible for implementing the FCSRCA and publishing national IVF outcome data directly undermines the transparency and patient protections that federal law requires (9, 11). The Administration’s stated commitment to safeguarding IVF access is therefore difficult to reconcile with the dismantling of the only federal program designed to ensure accountability and informed decision‑making in fertility care.

Additionally, the CDC’s Division of Reproductive Health, which previously housed the ART surveillance team, conducts maternal morbidity surveillance, pregnancy risk assessments, and birth outcomes monitoring (5,31). Cuts to these programs, therefore, threaten not only fertility care but the broader reproductive health research ecosystem.

The FDA and Access to Reproductive Medicine

The FDA plays an essential role in regulating drugs, biological materials, and medical technologies used in reproductive medicine. As reproductive technologies continue to advance and evolve, the agency ensures that new treatments meet consumer protection standards to protect public health and safety.

In addition to approving medications, the FDA inspects facilities that handle and regulate drugs, medical devices, and human cells, tissues, and cellular and tissue-based products (HCT/Ps) used in fertility treatment (1, 28).

Examples of FDA-regulated components of reproductive medicine include:

• Fertility drugs and hormones such as ovulation stimulators, including clomiphene citrate and gonadotropins (FSH, hMG, hCG) (28, 29);
• IVF laboratory materials, including culture media and cryopreservation solutions;
• ART devices such as embryo transfer catheters, micromanipulators used for handling oocytes, sperm, and embryos under the microscope, and incubators (28, 29);
• Genetic testing technologies used to screen embryos (15); and
• Human reproductive tissues, including sperm, oocytes, and embryos, subject to donor eligibility screening and inspection requirements (1, 2, 28).

Federal law requires any new fertility drugs or devices to undergo FDA review before entering clinical use (28, 29). To carry out these responsibilities, the agency has historically relied on specialized reviewers, inspectors, and compliance officers.

The loss of approximately 3,500 FDA employees has reduced the agency’s capacity across multiple divisions (6, 7). These reductions come on top of longstanding staffing challenges. A 2024 Government Accountability Office (GAO) report found that investigator shortages had already limited the FDA’s ability to conduct drug inspections, contributing to a decline in facility inspections (23).

Further reductions will likely exacerbate these constraints. Experts warn that diminished staffing could lead to delays in inspections, testing, and drug approvals, potentially undermining the agency’s regulatory oversight abilities (6, 7). Additionally, reduced regulatory capacity may also increase costs and slow the development of new medical products that require FDA approval (6).

Within reproductive medicine specifically, these cuts increase the risk of delays in review timelines for fertility drugs, reproductive technologies, and IVF-related medical devices. Although the FDA retains statutory authority over these products, reduced administrative capacity could slow the introduction of new reproductive technologies and weaken oversight of drugs, medical devices, laboratories, and biological materials used in fertility care (1).

FDA oversight also includes contraceptive devices, medications used during pregnancy,and approval of medications like mifepristone, misoprostol, Opill, Zurzuvae, and more. Thisdemonstrates that staffing reductions have implications across the full continuum ofreproductive health, not solely ART-related technologies (28, 29).

The Role of Federal Funding in Advancing Reproductive Health and Medicine

Established through the Ransdell Act of 1930, the National Institutes of Health (NIH) is the world’s largest public funder of biomedical research (27). The agency’s fiscal year 2025 budget totaled approximately $48 billion (8, 17).

Approximately 82 percent of this funding supports extramural research through competitive grants awarded to investigators at universities, medical centers, and research institutions across all fifty states (17).

In fiscal year 2023 alone, the NIH awarded approximately 60,000 grants, supporting more than 300,000 researchers at over 2,500 clinics, hospitals, universities, and research institutions nationwide (17). This funding is integral to the U.S. biomedical research ecosystem and supports the development of  research, medical innovation, and clinical expertise.

Despite its size, the NIH’s investment in women’s health has historically only accounted for a small fraction of the agency’s overall funding. A 2025 congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine (NASEM) found that between 2013 and 2023, NIH spent just 8.8 percent, about $33 billion, of its $376 billion in research funding on women’s health research (14).

The proportion of NIH funding dedicated to women’s health declined during this period to 7.9 percent of NIH total spending in 2023, even as overall NIH appropriations increased (14).

These findings reflect a broader pattern of gender disparities in biomedical research funding. A 2021 study found that in approximately 75 percent of cases wherein a disease predominantly impacts people who identify as one gender, NIH funding distribution favored conditions affecting men relative to disease burden, while conditions disproportionately affecting women were underfunded (12). This disparity is particularly relevant to the field of reproductive medicine, which faces unique barriers to research investment due to statutory limitations, politicization of reproductive health policy, and longstanding gender bias in medical research funding. 

Federal Spending for Reproductive Health Research

Even before the Administration's 2025 funding disruptions, reproductive health research faced structural constraints that limited the scope of federal investment.

Beginning with a 1974 moratorium on federal funding for fetal and embryo research and continuing through the 1995 enactment of the Dickey–Wicker Amendment, which prohibits the use of federal funds for research that creates or intentionally destroys human embryos, Congress has repeatedly limited the scope of federally supported reproductive research (26). As a result, many forms of embryo‑based research, including studies on early embryonic development and IVF laboratory techniques, remain largely excluded from NIH funding.

These limitations restrict the federal government’s ability to support foundational research in reproductive biology. This work remains essential to scientific progress in areas such as IVF outcomes, embryonic development and implantation, and the prevention of biological and genetic diseases.

Beyond statutory constraints, reproductive health and medical research are also shaped by political volatility surrounding IVF, contraception, and abortion policy; cultural and ideological debates influencing congressional appropriations; and chronic underinvestment in women’s health research relative to population need. These structural challenges are reflected in federal funding patterns.

Table 1 displays trends in NIH funding in millions of dollars from 2008 to 2024 for specific research areas related to reproductive medicine. As displayed in Table 1, NIH’s 2024 budget allocated approximately $221 million for infertility research and $9 million for polycystic ovary syndrome (PCOS), a condition affecting millions of women worldwide with significant implications for fertility, while substantially larger sums were directed toward the broad category of “women’s health” and other biomedical fields such as genetics, infectious diseases, and neuroscience (17). These figures highlight a federal funding gap that many observers consider disproportionate to disease burden and the public health impact of reproductive disorders.



Despite political hurdles, NIH funding has played a critical role in advancing reproductive medicine. For example, NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and other institutes have supported the development of contraceptive technologies, clinical trials addressing infertility, and research on pregnancy outcomes.

Even with these significant investments, reproductive and women’s health research account for only a narrow share of NIH funding, given that women make up approximately 51 percent of the population in the United States. Recent funding reductions by the Administration further constrain an already limited research pipeline (14, 17). Recognizing these existing imbalances under an administration that has
reduced scientific research funding is essential for policymakers seeking to sustain scientific progress and protect the nation’s biomedical innovation capacity and leadership.

Analysis of the Administration’s Cuts to Scientific and Medical Governance and Research 

As of early 2026, the Administration continues to implement workforce reductions and funding restrictions across federal health agencies. These actions directly affected agencies responsible for reproductive health surveillance, biomedical research, drug and device regulation, and the broader oversight of reproductive health care (7, 10).

In January 2026, the NIH announced it would no longer support research involving human fetal tissue, a policy change that followed earlier funding restrictions implemented in 2025 (16). Together, these developments represent a significant shift in the federal government’s role in supporting and regulating reproductive health research.

Table 2 summarizes specific federal funding and workforce changes to date and their potential impact on the field of reproductive medicine.

Long-Term Impact of Cuts on Scientific and Medical Research in Reproductive Health and Medicine

The workforce reductions and funding restrictions implemented by the Administration are likely to produce long-term consequences that may not be fully visible for several years. However, the immediate loss of personnel, research capacity, and public health infrastructure is likely to have cascading effects on patients, providers, and the broader field of reproductive medicine.

Several areas of concern have already emerged and include:

Data and Oversight Gaps ~ The elimination of the CDC’s ART data collection program means that national IVF outcome reports will no longer be published by a federal entity. Although SART continues to collect and publish data from its member clinics, its dataset does not include all U.S. fertility clinics and is not a substitute for comprehensive federal reporting. As a result, national surveillance gaps are likely to emerge.

These gaps reduce transparency for prospective patients seeking fertility treatment and limit the availability of standardized clinical outcome data that supports informed decision-making. The loss of federal oversight also weakens benchmarking tools that have historically supported quality improvement across fertility clinics.

Similar vulnerabilities exist in other CDC DRH-supported surveillance programs, including maternal morbidity tracking, pregnancy risk assessments, and birth outcomes monitoring, which rely on the same epidemiologic and analytic workforce (5, 29).

Slowed Medical and Scientific Innovation ~ Reductions in NIH funding and research workforce capacity threaten to slow the development pipeline for new reproductive technologies and fertility treatments. Investigators exploring novel assisted reproduction technologies, fertility preservation techniques, and maternal health interventions may lose years of progress if funding interruptions halt ongoing research.

NIH-funded research in maternal health, pregnancy complications, contraception development, and gynecologic disorders also faces delays when grants are frozen or terminated, further slowing progress in areas already identified as underfunded relative to disease burden (14).

At the same time, reduced staffing at the FDA could delay review timelines for advanced diagnostics or emerging reproductive biologics. When regulatory review slows, the introduction of innovative medical technologies may also slow, affecting both clinical practice and patient access to emerging treatments.

Loss of Clinical and Scientific Expertise ~ NIH and CDC-funded training programs play an indispensable role in developing the next generation of reproductive endocrinologists, scientists, clinicians, and fertility specialists. Academic programs in reproductive endocrinology and related disciplines may face greater difficulty sustaining research programs without stable federal funding and collaboration with federal scientific agencies.

Additionally, shifts in research investment shape long-term scientific capacity and leadership. Analysis examining worldwide output across major research institutions shows that growth in clinically oriented, hospital‑based research has accelerated over the past two decades, driven in part by substantial increases in biomedical funding in countries such as China (32). As these nations expand their research infrastructure and training pipelines, their visibility in medical and clinical science has risen correspondingly (32).

These trends reinforce concerns that reductions in federal investment can shift research output and scientific leadership toward nations that continue to expand their research capacity. Without stable federal support, the United States risks losing ground in key biomedical fields, including reproductive science and medicine.

Public Health Consequences ~ Reduced surveillance and diminished research funding impair evidence-based policymaking. Without federally published ART outcome data, states, insurers, and policymakers lose an important source of objective metrics to evaluate and shape treatment coverage and regulatory policy. Ultimately, these cuts and reductions to federal data collection pose a systemic risk to reproductive healthcare and may hinder efforts to address persistent disparities in pregnancy outcomes.

Taken together, these actions signal a clear departure from decades of federal investment in reproductive science and public health infrastructure. Policymakers must recognize that these sweeping changes and reductions in federal programs not only undermine research and innovation but also threaten patient access to safe and effective reproductive health and fertility care.

Key Takeaways and Policy Considerations

The federal workforce reductions and disruptions in research funding described above threaten the infrastructure that supports reproductive medicine research, innovation, andclinical standards of care in the United States. Policymakers and stakeholders should consider the following directives to mitigate these risks.

• Reinstate Federal ART Surveillance. Policymakers should prioritize restoring the CDC’s ART surveillance system or assign the statutory reporting responsibilities elsewhere in the federal government. Maintaining a national reporting system is required by statute and essential to preserving the transparency requirements established under FCSRCA,ensuring that patients can access reliable clinic outcome data.
• Protect and Stabilize Research Funding. Congress should, at a minimum, swiftly stabilize NIH research funding. Congress should also take decisive action to prevent abrupt grant suspensions or large-scale terminations that destabilize ongoing research. The temporary nationwide pause in NIH grant payments and the reported freezing ofapproximately 2,500 grants disrupted billions of dollars in biomedical research (4, 13).Women’s and reproductive health research already represents a relatively small proportion of total NIH funding. Further contraction, therefore, disproportionately affects infertility, maternal health, and reproductive biology research, which were targeted by cuts. Congress should protect multi year awards, require transparent justification for terminations, and consider targeted appropriations to address documented funding disparities.
• Federal Workforce Capacity. Restoring workforce capacity at the FDA, CDC, and NIH is essential for maintaining regulatory timelines, scientific oversight, and patient safety. The FDA alone lost more than 3,500 employees during the recent restructuring, exacerbating preexisting investigator shortages documented by the GAO (21, 23). Reproductive medicine relies heavily on FDA oversight of fertility drugs, laboratory devices, cryopreservation systems, and human reproductive tissue regulation (2). Reduced staffing risks, delays in product approvals, slower inspections of reproductive laboratories and tissue banks, and weakened compliance monitoring. Similarly, reductions in CDC reproductive epidemiology capacity limit the federal government’s ability to track maternal outcomes and ART utilization trends.
• Recognize Reproductive Medicine as Public Health Infrastructure. Infertility affects millions of individuals each year, while maternal morbidity and mortality remain a persistent national public health challenge (33). Assisted reproductive technologies now account for a growing percentage of U.S. births (3). Reproductive medicine is, therefore, not a niche subspecialty. It represents a central component of national demographic, economic, and public health stability. Additionally, supporting infertility research could help address population decline. Policymakers should treat reproductive health research, surveillance, and regulatory oversight as essential public health infrastructure rather than discretionary spending.
• Prepare for Continued Policy Shifts to Science and Medicine. There may be more funding cuts to come. In January 2026, the NIH announced it would no longer support research utilizing human fetal tissue (16), a decision that followed earlier funding cuts implemented in 2025. These developments highlight the importance of sustained engagement by researchers, clinicians, professional societies, and public health stakeholders in supporting federal investments in public health, scientific research, and medical innovation. Coordinated public and institutional advocacy plays a critical role in shaping executive branch decision-making. A recent relevant example is the administration’s reversal of its nationwide NIH grant pause following widespread scrutiny in 2025, which reflects the impact of strategic advocacy (13).

Conclusion

For decades, the federal government has acted to solidify the U.S. as a global leader in scientific and medical innovation through sustained investment in biomedical research and strong regulatory oversight. Agencies, including the CDC, FDA, and NIH, have supported essential reproductive health research and worked with health experts and advocates to build systems that ensure transparency, safety, and accountability in reproductive medicine.

Federal workforce reductions, grant freezes, and policy changes implemented in 2025–2026 mark a significant departure from America's longstanding model as a leader in this space with federal support. Recent actions by the current Administration reduce scientific capacity at a time when reproductive health challenges, including infertility, maternal mortality, and access to comprehensive reproductive health care, remain urgent national concerns. These policy shifts are also antithetical to the Trump Administration’s publicly stated commitment to expanding fertility care, which the vast majority of Americans support (35).

The long-term effects of these decisions will likely emerge gradually in delayed drug approvals, fewer clinical trials, diminished training pipelines, reduced patient transparency, and slower progress in reproductive health research.

The quality and accessibility of reproductive medical care in the United States depend on stable and supportive scientific governance and sustained public investment. Policymakers should work to restore the institutional capacity that underpins patient safety, medical innovation, and public trust. Sustained investment in reproductive health research, surveillance, and regulatory oversight remains essential to protecting public health and advancing reproductive medicine.

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Cover Image Credit: U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra participates in a roundtable discussion with members of Congress in his conference room at the Hubert H. Humphrey Building in Washington, D.C. (Official HHS Photo by Amy Rossetti).

Acknowledgements

This research was led by ASRM Center for Policy and Leadership Associate Amelia Letson, with support from ASRM Center for Policy and Leadership Director Rebecca W. O’Connor, JD, ASRM Chief Policy and Advocacy Officer Sean Tipton, MA, and ASRM Chief Executive Officer Jared Robins, MD, MBA. Special thanks to ASRM members Marcelle Cedars, MD; Jennifer F. Kawwass, MD, FACOG; James Segars, MD; and Jim Toner, MD, PhD, for their shared insights and expertise.

ASRM commends members of the CDC’s shuttered ART Surveillance Team for their invaluable contributions to IVF and reproductive medicine.

About the ASRM Center for Policy & Leadership

The American Society for Reproductive Medicine (ASRM) is the global leader in multidisciplinary reproductive medicine research, ethical practice, and education. ASRM impacts reproductive care and science worldwide by creating funding opportunities for advancing reproduction research and discovery, by providing evidence-based education and public health information, and by advocating for reproductive health care professionals and the patients they serve.

The ASRM Center for Policy and Leadership (CPL) is a nonpartisan think tank that advances reproductive health, medicine, and science by delivering fact-driven and scientifically based legal and policy analysis to inform the public and decision-makers as they navigate the landscape of reproductive health lawmaking and policy implementation.

Please contact cpl@asrm.org for inquiries about this report.