Republican President Donald Trump, who called himself the “father of IVF” on the campaign trail, issued an executive order in February directing policy advisers to create a report on how to make in vitro fertilization more accessible for Americans.

“Today, many hopeful couples dream of starting a family, but as many as one in seven are unable to conceive a child,” the order read. “Despite their hopes and efforts, infertility struggles can make conception difficult, turning what should be a joyful experience into an emotional and financial struggle.”

Trump gave domestic policy officials a 90-day deadline to send him a list of recommendations on how to protect access to in vitro fertilization (IVF) and reduce out-of-pocket costs for fertility care.

Leaders at the American Society for Reproductive Medicine and Resolve: The National Infertility Association—leading IVF advocacy groups—told States Newsroom they were not consulted by the Trump administration about the IVF plan.

“We’ve been leading the effort for over a decade and passed legislation in state after state that now has improved coverage for 60 million Americans,” said Sean Tipton, American Society for Reproductive Medicine’s chief advocacy and policy officer. “We clearly have the expertise to be of assistance, but they didn’t want to talk to us.”

Resolve President and CEO Barbara Collura said the administration did not consult her organization, either.

The White House did not immediately respond to a request for comment.

Both Collura and Tipton said they hope the administration will call for expansion of IVF insurance coverage for servicemembers, veterans, and other federal employees.

Collura said the U.S. Office of Personnel Management can require health insurance plans to offer comprehensive IVF coverage, the U.S. Department of Health and Human Services could declare IVF an essential health benefit through the Affordable Care Act and the U.S. Department of Defense could mandate coverage under Tricare. Members of the military can only get IVF covered today if they prove infertility stemmed from combat duty.

“The Veterans Health Administration also does not offer IVF as routine care, and we want to change that, but we believe that that has to be done through Congress,” she said.

Congress would also have to direct private insurers to mandate IVF coverage. Trump first raised this idea in August during a Wisconsin town hall, but NBC News reported that GOP members of Congress were skeptical of the costs.

Republicans on Capitol Hill are focused on passing a “big, beautiful bill” that includes tax cuts for the wealthy and a massive decrease in Medicaid funding, according to News From the States‘ D.C. Bureau. It’s unclear if Congress would be open to insurance coverage mandates.

The Trump administration laid off health-care researchers and other government employees this year. HHS fired its six-person Assisted Reproductive Technology team in April.

The advocates are also wary of a faction of conservatives who have pushed a concept called “restorative reproductive medicine,” the notion that providers should treat the root causes of infertility through hormonal therapies, testing, and nutrition, and turn to IVF as a last resort.

“It’s a political term backed by political groups that has nothing to do with medicine,” Tipton said. “When you look at the details, it sounds a lot like what our clinicians would refer to as the diagnostic workup for infertility patients, but make no mistake, this is a term that is pushed by groups who oppose IVF.”

Officials at the Heritage Foundation, a conservative think tank, have backed restorative reproductive medicine. Emma Waters, a policy analyst at the foundation’s Center for Technology and the Human Person, cowrote a report released in March backing the concept and calling for increased regulation of the infertility industry.

Janae Stracke, the vice president of Heritage Action, the foundation’s advocacy arm, praised a law Arkansas passed in April requiring the use of fertility awareness-based methods—checking body temperatures and cervical fluid levels to track menstrual cycles—in Title X programs.

“The RESTORE Act is groundbreaking legislation that champions reproductive health care for women in Arkansas by prioritizing restorative reproductive medicine and empowering women with the tools they need to thrive,” Stracke said in a statement.

Little Rock-based Arkansas Fertility and Gynecology has a header at the top of its website warning against restorative reproductive medicine, saying it’s “not a medically proven alternative to IVF.”

Collura said she fears restorative reproductive medicine could grow in popularity and lead insurance companies to mandate that patients try it before getting approved for fertility treatments.

“That bypasses what the diagnosis is. Reproduction is time-based: The longer you wait, the poorer outcomes you have,” she said. “We certainly don’t want people to be forced into certain treatments that are actually not going to help them.”

Dr. Karenne Fru, a reproductive endocrinologist at Muna Fertility in the Atlanta area, said proponents of restorative reproductive medicine misunderstand what physicians do, and doing tests for patients seeking fertility services is a basic standard of practice.

“It is not a cure-all for someone with a total sperm count of, say, 100,000 or an absent vas deferens—the sperm can’t get out. There’s no way you can exercise, eat right, sleep well and fix that. That is how you’re born,” Fru said.

Her state just passed a law protecting IVF, but she said that conflicts with Georgia’s fetal “personhood” language in the six-week abortion ban that allows prospective parents to claim fetuses on their income taxes. Fru testified before state lawmakers in March during a hearing for a bill that would have banned all abortion and jeopardized fertility care, Georgia Recorder reported.

Trump’s promises about IVF insurance coverage have led some of her patients to postpone their reproductive plans, she said.

“There are a lot of patients who are delaying care because they think that the president is going to make IVF free,” she said. “And I think that playing with people’s hopes and dreams in this way is unnecessarily cruel.”

This article was republished from News From the States, part of States Newsroom. Read the original story by Elisha Brown here.