Is Fertility Treatment A Human Right?

As assisted reproductive technology (ART) becomes an increasingly common and accepted way of creating families, a growing movement calls for ART to be available to anyone who needs it, regardless of sexual orientation, gender identity or marital status. But does the legal “right to procreate,” established decades ago in U.S. and international law, include the right to leading-edge fertility treatments such as egg donation, in vitro fertilization and cryopreservation? If so, who has the right to use those technologies, under what circumstances, and who pays for them? With the ongoing challenge to women’s abortion rights at the U.S. Supreme Court, the debate over human reproductive rights is just getting started.

Modern reproductive technology makes it possible for couples experiencing infertility, same-sex couples and single people to become biological parents. But laws governing reproduction and family establishment, and on which modern case law rests, were established long before assisted reproduction technologies were in common use.

War led to establishment of human right to procreate

Following World War II, the European Convention on Human Rights codified humans’ right to establish families free from coercion by or interference from the government, in response to forced sterilizations carried out by the Nazi regime. The law banned the state from preventing procreation through sterilization and from forcing people to procreate by denying access to contraception. Thus the human right to establish a family was a reproductive right.

In the United States, the Supreme Court first established the right to procreate under the 14th Amendment to the U.S. Constitution in 1942, in Skinner v. Oklahoma, in which it overturned a state law requiring the forced sterilization of some habitual criminals. The right to procreate was reinforced in decisions over the years, including establishing the rights of married people (1965) and single people (1972) to have information about and access to contraceptives. In its historic 2015 decision in Obergefell v. Hodges, which legalized same-sex marriage in the United States, the Supreme Court ruled that married same-sex couples must receive the same rights and privileges as heterosexual couples under the law.

But much has changed in the years since the right to procreate was established. Then, “family” was understood to mean a married man and woman with one child or more; today, a “family” might be a single parent or a same-sex couple with children or an unmarried straight couple.

And the means for creating a family have changed, expanding to include medical interventions ranging from hormone treatment to egg harvesting, IVF and surrogacy. Then, the right to procreate meant the right to reproduce, without interference from the government, via sexual intercourse. Now that we have the ability to make babies using reproductive technology, should everyone have the same right to utilize that technology?

Improved reproductive technology drives costs down

Emerging healthcare technologies tend to be costly; assisted reproductive technologies are no exception. But several trends are acting to push costs down. One is simply the improvement of the technology with time and frequency. When my husband and I began the process of becoming dads to twin boys using egg donation, IVF and surrogacy, it was not uncommon to implant multiple embryos per cycle, in order to up the odds that at least one would survive. Fourteen years later, and success rates have improved so much that the accepted best practice is to implant just one embryo at a time—safer for both surrogate and baby than risking a multiple birth. The improved success rate of the procedure also means fewer attempts, potentially saving intended parents thousands of dollars per round.

Another trend putting downward pressure on costs is the growing availability of insurance coverage for fertility services.

As reproductive technology became more reliable, cost-effective and accessible, many companies began offering fertility insurance coverage as an employee benefit. In recent years, many companies have added fertility preservation and other reproductive health services as an employee perk and recruitment tool, particularly appealing to millennials who may want to delay parenthood in pursuit of career goals. In 2018, 44 percent of U.S. companies employing more than 20,000 peoples offered some IVF benefits in 2018, up from 37 percent in 2017, according to Benefit News.

According to RESOLVE (The National Infertility Association), at least 19 states have passed laws requiring insurers to provide or offer some type of coverage for infertility treatment.

But even those limited measures often fall short of providing equal access to all employees,  thanks to outdated institutional definitions of “infertility” that discriminate against singles and gay men. For example, Illinois’ Fertility Mandate requires that all group insurance policies covering more than 25 people must include infertility screening and treatment. But the criteria for eligibility rely on a definition of infertility—“the inability to get pregnant after one year of unprotected sex or the inability to carry a pregnancy to term”—that seems to eliminate lesbian and gay couples. Even in states where fertility coverage is mandated, an individual’s ability to access the benefit often depends on the policies of each insurer.

Affordable access to reproductive technology is not a fringe issue. According to the U.S. National Institutes for Health, approximately 9 percent of men and 11 percent of women of reproductive age—some 66 million Americans—have dealt with some type of fertility impairment.

Movement for reproductive equality grows

As The New York Times reported in December 2020, a growing number of advocates say that access to such essential, life-affirming treatment should be available to everyone, regardless of gender, sexual orientation or bank account. “This is about society extending equality to its final and logical conclusion,” Ron Poole-Dayan, founder and executive director of New York parenting organization Men Having Babies, told the Times. “True equality doesn’t stop at marriage. It recognizes the barriers LGBTs face in forming families and proposes solutions to overcome these obstacles.”

Historical, near-universal definitions of infertility reflect a “very hetero-centric viewpoint,” Catherine Sakimura of the National Center for Lesbian Rights told the Times. “We must shift our thinking so that the need for assisted reproductive technologies is not a condition, but simply a fact.”

Those advocating for fertility equality are asking that insurers cover procedures such as sperm and egg donation and IVF for all intended parents, whether they are heterosexual and married, a same-sex couple or a single person using a surrogate. Some young activists consider access to reproductive technologies an issue of social equity, potentially reserving the right to procreate for those who can pay for it and effectively disenfranchising young, low-income intended parents for whom treatment is financially out of reach.

One of the things I love about fertility law is that it is constantly evolving, just as assisted reproductive technology is constantly evolving, becoming more reliable, more cost-effective and more prevalent with each scientific advance. We still live in a world where some people cannot afford or do not have access to computers, even as our communal lives and economies are increasingly carried out online. But we also live in a world where governments are increasingly investing in broadband access as a public utility in order to extend online access to more people. Similarly, I am optimistic we as a society will eventually expand the access to reproductive technology, so that everyone has an equal opportunity to benefit.




Richard Vaughn

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya moved to the United States in 2012 to attend Northeastern University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015, received her paralegal certification from UCLA Extension, and obtained her second Master of Science degree in Legal Studies from Loyola Law School. Peiya relocated back to her hometown, Beijing, China in 2019 and works from IFLG’s Beijing office. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University which he received in 2013, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. Luis has worked for IFLG in both Los Angeles as well as San Francisco, and is currently based in Dallas, Texas. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”


Kim has over 30 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

Los Angeles

5757 Wilshire Blvd., Suite 645

Los Angeles, CA 90036

Phone:  +1 323 331 9343

Email:  info@iflg.net

Website:  www.iflg.net

New York

501 Fifth Avenue, Suite 1900

New York, NY 10017

Phone:  +1 844 400 2016

Email:  info@iflg.net

Website:  www.iflg.net

Molly O'Brien

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.

Phoebe Sadler

Fertility law attorney Phoebe Sadler has a background in family law and has been practicing exclusively in the area of assisted reproduction technology (ART) law since 2018.

Rubina Aslanyan

Rubina has an extensive background in the legal field as a paralegal in Family Law and has worked in surrogacy and assisted reproduction law since 2012. Her area of focus is in managing and assisting clients with surrogacy, egg donation, and parental establishment cases for many of IFLG’s domestic and international clients. During her spare time, Rubina enjoys spending time with her family and dog Bella, traveling and cooking.

Alexander Espinoza
Legal Assistant

Alexander joined IFLG as a legal assistant in 2019, where he manages surrogacy, egg donation and parental establishment cases. Alex is bilingual in English and Spanish and has been in the legal field for 23 years. Alex is excited to join the IFLG team and pursuing his will to help others in the reproductive law process. In his spare time he loves spending time with his family and friends, being outdoors, road trips, loves music and dancing.

Cara Stecker
Senior Paralegal

After receiving her paralegal certificate in 2005, Cara began working in assisted reproductive law. During the fifteen years Cara has worked in this field, she has gained a wide range of experience and knowledge that she uses to help better assist clients and those involved in the assisted reproductive journey. Cara’s primary roles involve managing parental establishment matters and coordination with IFLG’s Of Counsel attorney network, drafting contracts and parental establishment court documents and providing support to other team members. Cara finds great joy in being a small part of a team of caring people who help others achieve their dream of having a family. In her spare time, Cara enjoys spending time with her husband and three children, watching her children play the sports they love, and she enjoys, running, cycling and exploring the outdoors in the sun.

Stephanie Kimble

Stephanie received her BS in History and Political Thought from Concordia University Irvine in 2015 and her Paralegal Certificate from University of San Diego later that same year. She has been working as a Paralegal since 2016 in Family and Reproductive Law. She is excited to be part of International Fertility Law Group working on managing Surrogacy, Egg donation and Parental Establishment Cases.

Trish Pittman
Assistant Financial Coordinator

With more than 20 years of experience in the field of accounting, Trish joined the IFLG team in 2019 as Assistant Financial Coordinator. Her client-facing focus at IFLG is to assist with all client trust accounting. Trish is the mother of two daughters and enjoys spending time teaching and learning new things from them. In her free time, she loves long walks in the park and reading suspense and mystery novels.

Katie Deaquino
Senior Paralegal

Katie is a Senior Paralegal with IFLG and has dedicated over sixteen years to the areas of surrogacy and reproductive law. She received her Paralegal Certificate from Coastline Community College and has worked with some of the top law firms in the assisted reproduction community. Katie is also a commissioned Notary Public. With IFLG, Katie manages Surrogacy, Egg Donation, and Parental Establishment cases and provides support to other IFLG team members. Katie truly enjoys helping others build their families through assisted reproduction and is thankful she has had the rewarding experience of assisting IFLG clients. Katie often spends her free time with her Husband, four young children and her bulldog “Bella”.

Elsa Jimenez
Legal Assistant

Elsa joined IFLG as a Legal Assistant in 2019, bringing more than 35 years of experience working in the legal profession (concentrating in tort and litigation matters). At IFLG she assists surrogates with their surrogacy and parental matters. The oldest of five siblings, born and raised in East Los Angeles to Mexican immigrant parents, Elsa loves “seeing the beauty of families forming” through assisted reproductive technology. She and her husband Carlos have four children and one grandson. Elsa enjoys jazz and ’80s music, being outdoors in nature, collecting teacups and tea pots, and spending time with her close-knit family.