Women’s Access to Fertility Services

By
Usha Ranji
Karen Diep
Brittni Frederiksen
Ivette Gomez
Alina Salganicoff
October 8, 2026

Kaiser Family Foundation

Overview

In the 2026 KFF Women’s Health Survey, 15% of women aged 18–49 reported that they or their partner had ever needed fertility services, while 11% reported receiving assistance. Three percent of all women in this age group said they could not obtain needed care; cost was the most frequently cited barrier among those unable to obtain services.

Background

The survey examines access amid high IVF costs, limited insurance coverage, and policy discussions about fertility benefits. No federal requirement for insurance coverage of fertility services was in place, and the article reports that state coverage laws reach only a minority of people with private insurance because most employer-sponsored enrollees are in self-insured plans. The analysis used responses from 3,538 women aged 18–49 in a nationally representative survey conducted online and by telephone from March 11 to April 14, 2026. It describes reported need for and use of fertility services, rather than clinical diagnoses or treatment outcomes.

Data Highlights

Survey measure	Finding	Population
Ever needed fertility services	15%	Women aged 18–49
Ever received fertility assistance	11%	Women aged 18–49
Unable to obtain needed fertility care	3% (one-quarter of those who received assistance, as reported)	Women aged 18–49
Needed services by age	12% aged 18–35; 19% aged 36–49	Women aged 18–49
Needed services by income	12% lower income; 17% higher income	Women aged 18–49
Needed services by insurance	11% Medicaid; 11% uninsured; 17% privately insured	Women aged 18–49
Among those reporting need: received advice	46%	Women or partners who ever needed fertility care
Among those reporting need: received testing	39%	Women or partners who ever needed fertility care
Among those reporting need: received ovulation drugs	34%	Women or partners who ever needed fertility care
Among those reporting need: received IVF / IUI	13% / 16%	Women or partners who ever needed fertility care
IVF receipt by income among those reporting need	17% higher income; 3% low income	Women or partners who ever needed fertility care

Key Findings

Fifteen percent of women aged 18–49 reported that they or their partner had ever needed fertility services to become pregnant or prevent miscarriage; reported need was 12% among those aged 18–35 and 19% among those aged 36–49.
Eleven percent reported receiving fertility assistance, while 3% of all women aged 18–49 reported being unable to obtain care they needed.
Among respondents reporting a need for fertility care, 46% reported receiving advice, 39% testing, and 34% medication to improve ovulation.
Among those reporting need, 13% reported IVF and 16% artificial insemination (IUI); the article states these correspond to 2% of all reproductive-age women reporting receipt of either service.
Cost was the most frequently cited reason for not obtaining needed fertility care, and low-income women were more likely than higher-income women to identify cost as the primary barrier.
Among women reporting need, IVF receipt was reported by 17% of those with higher incomes and 3% of those with low incomes. Reported need was 11% among Black women and 17% among White women, and 11% among women with Medicaid or no insurance versus 17% among privately insured women.

Clinical Implications

The survey reports gaps between perceived need and receipt of fertility services, with cost identified as the most common barrier among those unable to obtain needed care. Its findings are self-reported population estimates and do not establish clinical eligibility for treatment or treatment effectiveness.

Conclusion

The 2026 KFF survey found that fertility-service need was reported by 15% of women aged 18–49, while 3% of all respondents said they could not obtain needed care. Reported service use and barriers varied by income, with cost prominent among those who did not receive needed services.