Source: IVF is Healthcare, not Gattaca Publisher: Cartoons Hate Her | Author: Cartoons Hate Her Published: January 14, 2026 | Archived: March 21, 2026

Typically, I enjoy engaging with comments and restacks, even ones that disagree, but I may have to sit this one out, because it’s a topic about which I have a hard time being “chill” for obvious reasons. You’ve been warned! Also, I would be remiss not to link to Ann Ledbetter’s great piece which addressed IVF from a somewhat adjacent perspective.

This is the world IVF enthusiasts want!!!!!

Recent headlines around IVF and the use of super high-tech embryo selection methods have people worried that the future will basically look like the 1997 science fiction movie Gattaca, set in a dystopian future where it’s standard for parents to engineer genetically perfect children. And sure, there are people (usually in the combined pronatalist-tech world) trying to do that. They don’t just want healthy kids—they want tall kids, high-IQ kids, and likely, blue-eyed kids with weird Roman statue avi names. Some people will do IVF specifically for the purpose of selecting their preferred gender. And most people—including myself, an IVF mother—see these stories and get the ick. Even if there are no immediate “victims,” even if you don’t believe IVF is tantamount to abortion (let alone murder), even if you don’t have religious objections to it, the vast majority of people do not love the idea of using it to generate a master race or create a new standard about how humans are made.

Where I part with the narrative is the gloomy and unreasonably confident declarations that this is the future—that someday, everyone will just be reproducing through IVF specifically for the purpose of eugenics, and that we need to just put an end to the whole song and dance before it goes too far and we start “doing Gattaca.” I also reject what this narrative is doing for the reputation of IVF and the people who use it for reasons that have nothing to do with beauty or IQ (aka, almost all of us.) For the vast majority of IVF patients, IVF is healthcare—something that enables them to have biological children because of medical conditions that otherwise prevent reproduction. And having done IVF a few times—three retrievals and three transfers, to be specific, culminating in two live births—I find it very hard to believe that a sizable amount of people would voluntarily choose this hard road for a spurious promise of a 130 IQ baby when they could simply take some backshots for three minutes instead and risk the outcome of a midwit baby.

Before I continue, I will address the fact that a lot of people reading this will probably be religious Catholics who have faith-based opposition to any form of IVF—a cohort extremely prevalent on Substack. I don’t expect to change their minds, and the same way I wouldn’t write an article enticing Muslims to try a dirty martini, I would not attempt to make Catholics turn pro-IVF. Whether or not a couple has a medical issue preventing reproduction wouldn’t matter to them anyway, and I have a feeling they view a woman with severe endometriosis with the same moral lens as a fertile woman who wants to guarantee an “optimized” baby. To them I say: feel free to read this, but I don’t expect you to agree, and convincing you was never my desired outcome.

Anyway, the rest of this piece will not address IVF from a religious lens, given that I’m not Catholic and don’t have religious opposition to it, but it felt silly not to at least address it. I’m talking about the apolitical, secular belief that IVF is “getting out of hand” because it’s barreling toward a future of high-tech eugenics, or that IVF is just another way of “commodifying children,” akin to buying a luxury vehicle or a new Hermes bag.

For the vast majority of people who do IVF today—and I would venture the vast majority of people who are doing IVF in ten or twenty years, perhaps as long as IVF will exist—it’s about remedying severe infertility where all other options have been exhausted, not about creating an army of Aryan superheroes with Chadly chins.

First, for those unfamiliar with my lore, I’ll give a quick refresher: I wanted children very badly for basically my entire life. I could imagine almost nothing worse than a life without motherhood. I didn’t have a strong urge for biological children, but I very much wanted to raise children from infancy to adulthood. I got married young, figuring that this was the “right” thing to do if I wanted to have children within an ideal window. I ruthlessly selected for men who wanted children and didn’t want to wait too long. And what do you know, I married a wonderful, family-oriented Midwestern guy…who I later discovered was born without a vas deferens.

(He’s fine with me making this joke—he has openly referred to himself as “missing a nutsack piece” so rest assured I’m not committing a HIPPA violation.)

My husband’s infertility stems from an unusual recessive genetic mutation, which he luckily carries little to no risk of passing onto future children (at least with me, because I don’t carry the same mutation.) We tried to conceive for a year before getting this diagnosis, and at that point, our doctor told us that if we wanted biological children, we could do IVF, or we could have my husband’s brother step in as a sperm donor so that the child would still be related to him in some capacity.

Obviously, both of these options were sub-optimal! As much as I believe my brother-in-law is a great guy, I did not want to have his babies, nor did he want me to (we never asked, but I’m assuming he would not have been jazzed about this). And of course I would have rather just had sex with my husband and gotten pregnant effortlessly. Duh. I had kinda been attempting to do that for a year, you know? I still feel sad when I see pregnancy announcements, because my first thought is that these lucky fuckers (quite literally) put a penis in a vagina and got a free baby. I mean, WHAT?! That feels very implausible to me at this point in my life, like a superpower that 85% of the world has. From the vantage point of someone who has never had the privilege: natural reproduction truly is a miracle! I am in (jealous) awe of it every day.

Of course, we looked into adoption. Initially, I thought it was the obvious next step, but eventually decided otherwise. I wrote an extremely detailed piece on why we chose not to adopt, so I won’t be fielding any questions on why we didn’t just go to the Abandoned Baby Store and pick up a healthy newborn that nobody else wanted.

But eventually we decided IVF was the way to go, especially once we got confirmation that my husband did create perfectly fine sperm cells, they just didn’t have a physical route to his semen. And luckily for us, despite the rarity and severity of this infertility, it’s a bit of a best case scenario in the IVF world. The main hurdle is an obvious structural one immediately remedied by the IVF process, where his sperm and my eggs were surgically extracted, combined in a petri dish to create an embryo, and then put back into my uterus (a lot of people creeped out by IVF don’t actually know what it entails other than “needles” and “test tubes” so hopefully that helps clear it up—it’s not really that complicated. It basically just takes fertilization outside of the body, then returns it to the body.)

We did not do IVF to create a perfect baby. And for most people, even most people doing IVF today, that option isn’t available. Our only option for “optimization” was PGT testing, which basically checked for chromosomal conditions that typically guarantee a miscarriage or stillbirth (one of the only survivable chromosomal trisomies is Down Syndrome.) If we had both been a carrier of the same recessive genes that caused a serious life-threatening disease, such as Tay Sachs (rare, but most common among Ashkenazi Jews) we had the option to screen for that as well. For example, TikTok is awash with heartbreaking videos of a form of fatal childhood dementia called Sanfilippo Syndrome. This is yet another example of an autosomal recessive disease that can be screened for in the IVF process.

I know some people believe that choosing not to transfer or to destroy an embryo with a devastating fatal condition is in the same basic camp as abortion, and therefore morally wrong. But the majority do not see a moral problem with this. According to Pew Research, 53% of Americans support abortion in the case of severe fetal defects*.* Most people, even those who support some degree of legalized abortion, see a moral difference (or at least a “this makes me uncomfortable” difference) between an abortion, especially a later-term one, and the discarding of a blastocyst. The main reason most Americans do not get carrier screening in the first place is because they probably don’t even know about these diseases, plus there is the matter of affordability and access. But for those who already have a serious genetic disease in the family—take Huntington’s, for example—the desire to screen for that disease makes sense. This might sound like “eugenics” to some people, but the majority of people are comfortable with this from a moral perspective.

Many of the people who use IVF for non-infertility, purely genetics-based reasons are doing it to prevent devastating genetic diseases that run in their family. This is not Gattaca. This is healthcare. This is not wanting to give birth to a child who is guaranteed to die by age two. And for almost everyone, this is morally preferable to getting an abortion at twenty weeks—heck, even at eight weeks.

The questions about ethics are a little trickier when it comes to medical conditions that aren’t fatal. Blind people can still live very full lives. Blindness is generally not life-threatening. If you had to choose between being blind and being able to see, basically everyone would choose the latter, but a lot of people (including me) would find it morally wrong to abort an otherwise healthy fetus who was confirmed to be blind. Perhaps fewer people find it questionable to intentionally discard a blind embryo, but I see the argument against that too. Personally, I would not screen for blindness even if I had the option, but perhaps some parents would. However, I stand by my point that almost nobody who didn’t already need IVF would shell out the money, time, blood and sweat to ensure their baby wasn’t blind, especially if they had no reason to think that he or she would be.

A future that necessitates Gattaca-esque IVF techniques is also a future where IVF is so affordable and accessible that middle-class or working-class people who can easily procreate for free would opt for it. That’s not even touching the fact that IVF is not only expensive, but unpleasant and somewhat medically risky. Given the state of our healthcare system, a lot would have to change for IVF to become a just-for-funsies choice for most otherwise fertile people, to the point that we would be living in a world unrecognizable to us today. Perhaps one day we’ll live in this world, but I imagine if we did, we would be living in a veritable utopia of prosperity and technological advancements that I actually wouldn’t care very much if people were using IVF when they didn’t need it. A world where IVF is so easy to access that everyone is doing it for relatively silly reasons is probably also a world where cancer has been cured and nobody has to work. It goes without saying that I don’t think this world will ever exist, but clearly if it did, it wouldn’t be so bad.

Setting aside the reasons one might use IVF to screen embryos, many people (none of whom have ever needed IVF in any capacity) shy away from the idea that IVF is healthcare because it doesn’t actually “cure” the cause of infertility. In 2019, I announced on my public Facebook page that my husband and I were starting IVF. I did this mostly to raise awareness around rare causes of infertility and help other young infertility patients feel less alone. A bunch of people, most of whom were rabidly childfree, descended upon me with a wave of harassment because IVF is actually not medically necessary and “nobody will die if they don’t get to have biological children.” The desire for biological children—something basically every living species in history has had—was framed as a frivolous, “first world” desire for a luxury car. One person likened it to a BBL. And from a less extreme POV, I have heard people say that IVF isn’t healthcare because it doesn’t actually cure whatever is causing the infertility and that the ART industry has steered people away from what would actually cure them, like, I don’t know, losing weight or eating spiral carrot salad.

First, I will address the “actually, they should tackle the root cause of infertility” argument.

I can tell you with confidence that almost every person I encountered in my IVF support groups had already done all the “right” things. They had often exhausted every possible option before turning to IVF, and many of them had severe infertility with a root cause that could not be treated, or worse, unexplained infertility for many years that did not respond to many less invasive remedies and interventions. Again: IVF is a huge pain in the ass (literally—you have to inject your ass for ten weeks.) IVF is not the easy route to a baby that people take because they’re too weak to stick to a healthy lifestyle. In fact, many of the other IVF moms I’ve seen on my various groups have bemoaned the fact that their lifestyles are significantly more healthy than other women they know, who never gave a second thought to their health, but seem to have constant unplanned pregnancies. They have taken all the supplements, eaten the right foods, and in many cases, didn’t even “wait too long.” They just got unlucky. People don’t like to think about this because they don’t want to think that they could ever be unlucky, and they don’t want to think that maybe they have four beautiful and healthy children simply because they’re lucky enough not to be born with a bicornuate uterus.

Second, let’s discuss the idea that IVF isn’t healthcare because it isn’t medically necessary, because having biological children is a luxury.

There are many things classified as healthcare—even covered fully by insurance—that aren’t medically necessary. Insurance covers my tretinoin prescription, and I am using tretinoin to prevent or treat wrinkles. Will I die if I have wrinkles? Well, eventually, but not from the wrinkles. Viagra is healthcare, and covered by insurance, because erectile dysfunction is a medical condition. Nobody complains that Viagra fails to “address the root cause” of ED, or argues that it’s “not healthcare” because people don’t need to have sex to survive.

Take nearsightedness. Glasses do not “cure” the root cause of nearsightedness, which is usually an eyeball that’s a little too long. But glasses make it easier for someone with nearsightedness to see. Someone with nearsightedness could still survive without glasses. Prescription glasses are still healthcare. Nobody argues that a nearsighted person should have addressed the “root cause” instead of getting glasses.

Now, what about LASIK? Nobody needs LASIK, for the most part. Isn’t it kind of a luxury? You can just wear glasses, of course. But many people prefer LASIK, especially if they don’t want to wear glasses forever. LASIK doesn’t save lives, but it does make life easier for people with vision impairments. LASIK is healthcare.

IVF is a bit like a combo of glasses and LASIK—it is not required for you to live, it doesn’t permanently fix a medical problem directly, but it enables the body to do something it should be able to do, but can’t. The physical inability to procreate is more or less a disability. It’s not a disability that prevents you from leaving your house or going to work, but it’s quite literally the medical absence of a bodily function that most people have by default—something everyone’s body is supposed to be able to do. It is classified as a disability by the ADA. And the desire to procreate is hardly a frivolous rich-person thing when basically every animal and every human up until apparently recently saw procreation as the whole point of being alive. Certainly, procreation is far more essential to most people than the ability to have smooth, blemish-free skin or a dandruff-free scalp.

I also reject the idea that IVF turns children into “commodities.” If anything, domestic infant adoption, which is seen as a loving, selfless act, does that—you are paying $50,000 or more for a baby who isn’t biologically yours or your partner’s! But with IVF, provided you are using your own egg and/or sperm, you are paying for a physical process that enables your bodies to do what they were always supposed to do. Hopefully, if that works out, you get a baby. You did not pay for a baby; you paid for disability assistance to enable you to create that baby yourself. If the fact that people pay for it freaks you out, then maybe it should just be universally covered by insurance. But you are not “buying” a baby. You are buying healthcare. You are buying facilitation of things that a disability prevents.

(I understand IVF is also used for reasons other than Gattaca or infertility, such as in same-sex relationships. I’m obviously fine with that too.)

If you’re still with me, you’re probably someone who supports IVF in general, and all of this might seem a bit Captain Obvious to you. But the stories about the (very small!) percentage of people who do IVF for “creepy” reasons is, bafflingly, allowed to set the stage for all conversations about IVF and the ART industry. Just because some people do IVF for weird or immoral reasons doesn’t mean that IVF in general is bad, or eugenic, or needs to be done away with. It doesn’t mean that miraculous technology to aid people with a disability has “gone too far” and must be stopped.

Let’s go back to LASIK. What if someone created a type of LASIK that let people see through other people’s clothes, and it cost $100,000? This would be really bad, of course, but most perverts wouldn’t be able to afford it. Let’s say a small percentage of degenerates were able to pay for this weird creepy version of LASIK. Obviously, the correct course of action would be to pass some kind of law or restriction saying that you would need to have documented evidence of a vision impairment to qualify for LASIK, or just outlawing the use of the new type of LASIK that let you see under people’s clothes. But it would be a complete overreaction to declare that nobody should ever get LASIK, or that everyone who got LASIK was a pervert. If someone said they were getting LASIK, you wouldn’t accuse them of only doing it to see people’s underpants. It would be absurd to declare that the entire ophthalmology industry was engaged in peeping tommery.

When it comes to IVF, it’s important not to get wrapped up in isolated and bizarre stories of disturbed women in their sixties who used it to keep having newborns forever, or weirdos trying to create a master race. Instead, we should focus on the 500,000 babies who are born every year worldwide who come from this miraculous technology, almost all of whom have parents who simply needed medical assistance to do something that most of the world can do without help.