The White House and Bonei Olam: Easing the Financial and Emotional Hardship of Infertility

Tamar Berger Ben Tzvi knew that having children probably wouldn’t be simple. Born with congenital hypothyroidism and diagnosed with diabetes at age 12, her endocrine system is “a little bit complicated,” she said, “but I never, ever, ever thought that we’d be where we are today.” Ben Tzvi married her husband Gidon nine years ago, when she was 23, and since then, the couple has undergone 11 IVF (in vitro fertilization) egg retrievals and 15 embryo transfers, and they have suffered six miscarriages.

Ben Tzvi and her husband live in Ramat Beit Shemesh. Under Israel’s universal healthcare system and with support from organizations like Bonei Olam, which provides financial assistance and other resources for those dealing with infertility, IVF is “very inexpensive, especially considering that America is so expensive,” she said. According to a 2013 study cited by the American Society for Reproductive Medicine, the median cost of one IVF cycle in the United States is $19,234. Some more recent estimates put this figure even higher. Though Ben Tzvi and her husband do not live in the U.S., their struggle with infertility is one that an estimated one in six people globally will face in their lives, according to widely cited numbers from the World Health Organization.

Though infertility brings challenges in a number of different realms, the financial burden is enormous for many. In an announcement made earlier this month, President Donald Trump unveiled a number of efforts aimed at lowering the cost of IVF and other fertility treatments. Part of this plan includes a deal with drug manufacturer EMD Serono to list Gonal-F, a medication commonly used during IVF and other fertility treatments, on TrumpRx.gov. The government website, set to launch in early 2026, will facilitate direct-to-consumer transactions between patients and participating pharmaceutical companies at lower prices. Though critics decry a lack of transparency as to the details of President Trump’s deals with drug-makers, data cited by the Trump administration claims the agreement with EMD Serono will save women up to $2,200 per fertility drug cycle. That same fact sheet says that medications make up close to 20% of the total cost of IVF. EMD Serono has also agreed to offer other medications at a discount, to provides most-favored nations (MFN) pricing on new medications and for Medicaid programs, and invest in manufacturing in the U.S.

The Trump administration also announced a New Benefit Option, which creates a new legal pathway for companies to offer fertility benefits packages to employees, similar to dental or vision insurance options. According to the government, 42% of employers currently offer fertility coverage for employees, while only 32% offer coverage for fertility medications. In regard to non-IVF treatments, even fewer companies offer coverage. Large employers offer coverage more often than smaller ones.

Agudath Israel welcomed President Trump’s announcement in a statement, saying that it “is one more step in the right direction that began with an executive order in February aimed at expanding access to IVF.” In February, the President signed an executive order stating his intention to enact policy to “make IVF treatment drastically more affordable.”

“In our own community, countless couples, acting pursuant to competent rabbinic guidance, have used [IVF] and have been blessed by Hashem with wonderful children,” Agudath Israel added. “The new measures announced by the President will, b’ezras Hashem, help those who undergo the agony of infertility realize their dream of becoming parents.”

Support in the Jewish world for fertility treatments like IVF goes far beyond easing the financial burden, however. For some advocates, their own experiences tell them there is much work to be done not just in the financial realm but in removing the taboo around IVF and other treatments and providing emotional support and community for those dealing with infertility.

Rabbi Yosef Shapiro and his wife Rookie thought growing their family would be simple. After having their first child before their first anniversary, they assumed that having more children after that would be “easy and smooth.” Instead, the couple faced years of infertility and ultimately underwent IVF to have all of their subsequent children. “The average person going through infertility assumes that they are the only one going through it in their community,” said Rabbi Shapiro. When the Shapiros started their journey with infertility, this isolation was a significant challenge. “Every time we went to an appointment, we had no idea what was going to happen. Were there going to be injections, blood work, sonograms, ultrasounds, surgeries?” he recalled. “We literally were clueless every time we walked in the door.”

But when Rabbi Shapiro tried to connect with others in the community before he and his wife started IVF, he found that they were not the only ones navigating this challenge alone. After asking friends of his who did not yet have children if they would be comfortable sharing any aspects of their journey with him, Rabbi Shapiro was told by one of them, “I actually don’t think anyone in our community is going through this right now. So there’s no one I could recommend that you reach out to.” This person did not know that in his own six-unit apartment building there was someone who had been married longer than he was and was struggling to have children. “They didn’t even realize because it’s just such an all-encompassing challenge, and really, people don’t even see that which is right in front of them,” said Rabbi Shapiro. When he reached out to one of the rabbis in the community for guidance, he didn’t know anyone else dealing with infertility either. “It’s a very big community, probably thousands of families…Knowing what I know now, I’m sure there were at least 100 families in that community that had been through fertility treatment, and the rabbi didn’t have any knowledge,” he said.

Rabbi Shapiro’s and Ben Tzvi’s experiences have motivated them to promote change. As a result of his and his wife’s own journey, Rabbi Shapiro, the founder and senior rabbi of Atlanta Jewish Xperience, built up a network of medical professionals and rabbanim and now works to facilitate what he calls “ease of access” for others dealing with infertility. When it is difficult to get timely answers to complex medical or halachic questions, people contact Rabbi Shapiro, who utilizes his network to give couples answers or guidance almost immediately. “When I reach out to doctors, it’s not that I have these yearslong, developed relationships,” he said. “It’s really very often just someone who I met through this space, and I just said, ‘Can I take your number, and can I call you when I have questions for people?’ And they always are like, ‘Absolutely, if someone ever is in need, call.’”

A few years ago, Rabbi Shapiro wrote In It Together: A Candid View of Infertility, a book about his and his wife’s personal experiences, along with all of the information that had been helpful to themselves and others.

For the past five years, Ben Tzvi has run an Instagram page called “Tales of Tamar,” dedicated to sharing her and her husband’s journey with infertility and spreading the message of “hope in difficult times.” She shares motivation, is candid about her struggles, and provides educational resources. This work has allowed her to become someone to whom people reach out to for support. “People know that I am a person that has gone through a lot in terms of fertility and can talk to a lot of people in different ways about fertility,” she said. “It’s a lot of conversations, I would say – just making sure that people are listened to, and also not just the people going through infertility, but also helping people that have family members or friends going through infertility.”

Emotional support for those dealing with infertility is something many Jewish organizations have been founded to focus on. After having her first child, Dr. Aimee Baron dealt for years with secondary infertility and multiple pregnancy losses. Though she found great support in terms of medical advice, there “wasn’t a real central place to deal with emotional support for what I was going through,” she said. Dr. Baron, who now has five children, only later became aware of organizations that support those who have experienced pregnancy loss. “I was having second trimester losses where everybody knew I was pregnant, and then everybody knew I was not pregnant, and no one introduced me to any of these organizations,” she said. “It was kind of wild, actually, how much it really wasn’t spoken about.”

So Dr. Baron decided to create I Was Supposed to Have a Baby, an organization that provides mental health support, education, and a community support network for those on a wide range of different fertility journeys. She noticed that no matter what diagnosis someone had, “the core of what you hear, the underlying piece of what you hear every time [you] listen to someone’s story is… pain,” she said. “I hear pain, I hear grief, I hear shame, I hear guilt, I hear anxiety, I hear longing. I hear all of those pieces, and that’s the same – no matter what your specific story is. And I wanted an organization; I wanted a place where I could hold people’s pain no matter what they were coming in with.”

For Gila Muskin Block, co-founder and executive director of Yesh Tikva, her journey also started with an inability to find emotional support through her own infertility journey. She began holding support groups around her dining room table, and this “ballooned into the ability to support other warriors going through their journey,” she said. Yesh Tikva provides emotional support and education around infertility through community-building, a mentorship program pairing those at the end of their fertility journey with those still on theirs, and practical, educational guides called “Tikva Toolkits.”

These advocates have seen firsthand how big a role the financial strain of IVF and other fertility treatments can have on those experiencing infertility. “There are so many people who cannot have children because they can’t afford IVF. That’s just the reality, or that maybe they have one child, or they have two children, and they would love to have more, but they can’t afford that either,” said Dr. Baron. For her, President Trump’s efforts are promising. “I think there is so much…hope for all of those people hearing the news that access is going to be different, that he’s changing things up. Everybody thinks it’s absolutely incredible.”

For Block, although “anything that can be done on a state or on a federal level is incredibly impactful,” there is still much further to go. “[Trump] has not yet passed any federal laws that mandate insurance companies to cover any part of fertility treatments,” she said. Of TrumpRx, she is hopeful, but she is waiting to see if the President will go further. “Right now, it is very hopeful, but we still don’t have any concrete ramifications of it,” she said. “The hope is that he stands behind his word, and he continues to advocate for and make sure that fertility treatments are something that are subsidized by insurance companies and become regulated by insurance companies. But we’re not there yet.” Block noted that in January 2026, when California becomes the newest state to increase its mandate for fertility treatments to be covered by insurance, 22 states will have some mandate surrounding fertility coverage, yet only 15 of those will include IVF in this coverage.

The financial burden of infertility treatments impacts one’s emotional and psychological experience as well. “In addition to dealing with the stress of not having a child, [there is] the physical pain… Add to that that a couple has to suddenly come up with 20, 30, 50, 100, 200 thousand dollars – these are not numbers that are unheard of at all within the space,” he said, adding, “So I think that access to things that are more affordable would be an enormous benefit, not just that it alleviates the financial burden, but it allows a person to have a little bit of space to see beyond their pain and maybe notice and realize how many others are going through this, and really feel comforted.”

In their years of work in this realm, these advocates have seen important changes not just in easing the financial burden, but in other areas as well. “I think that we are light years away from the time that I started my fertility journey 20 years ago,” said Dr. Baron. “I mean it is absolutely incredible…that you and I are having this conversation… Some people would say that that’s revolutionary.” Conversations, say all of these advocates, are happening far more openly than they did in the past.

Still, there is work to be done. This work must center around not just those dealing with infertility but their communities as well. “If the community at large doesn’t have a deeper understanding as to why this is so painful for people, then it’s wonderful that [I Was Supposed to Have a Baby is] supporting that person or that couple. But at the end of the day, we don’t live in isolation,” said Dr. Baron. She thinks part of this communal work includes more awareness and sensitivity. Asking, for example, how many children someone has can be “deeply painful” if they are struggling with infertility.

Ben Tzvi said that while her community is incredibly supportive of her and her husband, “at the same time, though, I think that even the people with the best intentions in the world can ask really stupid questions sometimes,” she said. “Questions like, ‘Oh, how many kids do you have?’ Or saying things about their kids… I’m okay with my friends complaining about their kids, but kind of sounding ungrateful for their kids – it’s a very frustrating thing...” She added that when someone says something insensitive, “I’ll tell them, ‘Hey, I’m totally fine that you just said that, but just so you know, somebody else may really be hurt that you said that.’” Ben Tzvi personally appreciates comments like “I’m davening for you” but said others may not, so people should always be careful.

Yesh Tikva focuses on education because of how important this communal element is, according to Block. “Change happens when, as a community, we work together to make that change happen, and the onus doesn’t fall on the individuals who are facing a fertility journey,” she said. “And that’s why we focus so heavily on education for what we call the five and six individuals who are not diagnosed with infertility.” These “Tikva Toolkits,” titled things like “Supporting in the High Holidays Season” and “My Child is Facing Infertility: For Grandparents-in-Waiting,” guide and support not only those dealing with infertility but their families and communities as well.

“The more we learn about it, the more we equip ourselves with the tools, and the more that we can learn to ‘Yes, and,’” said Block, explaining, “Yes, we’re a Jewish community that, thank G-d, is di and revolves around family units and children, and there are individuals who are still dreaming of growing that family.”

People want to be helpful, said Dr. Baron, but they don’t always know how. She gets texts like, “My friend has been struggling to have a baby. She’s been struggling for years already, and I just found out I’m pregnant, and I want to know the best way, the most sensitive way that I can tell her.” This tells her that “we’re already changing the way the community is thinking about it.”

Ben Tzvi recalled that on Yom Kippur, 15 or 16 families got together and bought her husband peticha for Ne’ilah. Her community often organizes meal trains for her during the physically exhausting IVF cycles. She also relies on her own inner strength. “It has been really horrible, but at the same time… my father passed away when I was eight years old, and resilience is kind of in my veins,” she said. “So I think that for me, my biggest goal is to not let it overpower me and overpower my relationships and overpower my friendships and overpower everything that I do and everything that I am.”

Despite everything, “me and my husband both feel closer to Hashem than ever before,” she said. Knowing that people are davening for them gives her hope. “I always tell my husband, I always tell everybody, ‘Hashem can say no to me, but He can’t say no to everybody that’s davening for us, and eventually He’ll have to say yes.’”

When Rabbi Shapiro and his wife went in for an embryo transfer while undergoing IVF, they told the doctor that they wanted two embryos transferred. Because they had previously failed in transfers with only one embryo and because his wife was still in her 20s, their doctor refused. “We were beyond desperate, and he still said there’s no way,” Rabbi Shapiro recalled.

The doctor transferred one embryo. Then, it split, and the couple later welcomed identical twins. “People feel so limited often by what someone tells them – whether it’s a doctor, whether it’s a parent, whether it’s a co-worker, and someone tells you, ‘This is you, you’ll never do X, you’ll never have twins.’ Whatever it is,” he said. “And ultimately, if Hashem wants that to happen, you will have that thing.” He said that no one can box someone in, apart from G-d.

“That was what really motivated us – when we saw so clearly that we were desperate for something, [and] we were told repeatedly, ‘You’re not getting that,’” he said. “And then Hashem ultimately decided we were going to have that.”