New research finds the fertility conversation is broken: most people want comprehensive care beyond IVF, but aren't getting it

Most people navigating fertility journeys want comprehensive and lower-cost options before in vitro fertilization (IVF), including metabolic health, men's health, and less invasive treatment pathways. But the conversations that would connect them to those options aren't happening. A new report from Carrot, a global fertility, family-building, and hormonal health care platform, reveals the gap between what people want and what they're being offered.

The report, "Beyond IVF: What People Really Want from Fertility Care," draws on a survey of 1,010 adults across the United States, United Kingdom, Ireland, and Canada who are currently trying to conceive, have tried in the past five years, or plan to try within the next five years. The findings reveal a consistent pattern: people want more options, earlier guidance, and care that does not default immediately to the most invasive or costly treatments.

"People are telling us exactly what they want — earlier guidance, more options, and care that doesn't default to the most invasive treatment first," said Tammy Sun, Founder and Chief Executive Officer of Carrot. "The gap between that demand and what the system currently delivers is not subtle, and it is not inevitable. Clinicians want to offer comprehensive care. They need benefit structures and care pathways that make room for it."

The report identifies four core gaps shaping the current fertility care experience: high awareness of IVF paired with resistance to pursuing it, strong interest in metabolic and men's health support without corresponding clinical engagement, delayed fertility education, and growing demand for comprehensive fertility benefits.

IVF awareness is high, but so is resistance
While awareness of IVF is nearly universal among those surveyed (89%), willingness to pursue it is significantly lower (58%), representing the largest gap between awareness and consideration of any fertility option included in the study.

Cost and invasiveness are the primary drivers of IVF resistance: 83% of respondents said they would choose lower-cost options first, and 89% of women said they would prefer to try a less invasive option before IVF if supported by clinical guidance. When asked what would shift their path, 78% of respondents said a better understanding of non-IVF options would make them more likely to pursue those alternatives first.

Metabolic and men's health generate interest, but not clinical engagement
Metabolic and men's health support emerged as two of the most sought-after fertility pathways. Of the respondents, 84% said they would consider metabolic health support, and 80% said they would consider men's health support, both exceeding IVF. However, fewer than half of respondents reported discussing these topics with a provider (44% for metabolic health and 43% for men's health), indicating a gap between patient interest and clinical integration.

"These findings confirm what many of us in the field have long observed: factors like metabolic health, nutrition, and lifestyle are central to fertility outcomes yet rarely addressed in a structured, ongoing way. In this report, 84% of people recognize the link between metabolic health and fertility, underscoring the need for care models that integrate evidence-based guidance and longitudinal follow-up into the fertility journey," said Asima Ahmad, Chief Medical Officer at Carrot Fertility.

Fertility education comes too late
Nearly half of respondents (49%) said they first learned about fertility options only after beginning to try to conceive or encountering fertility challenges. In the survey, 58% said they wished they had received more education earlier, rising to 70% among those currently on a fertility journey.

Comprehensive fertility support drives retention
To close the education gap, 84% of respondents also said that access to multiple fertility options would make them feel more confident in their decisions, the most widely endorsed statement in the survey. Among respondents, 80% said they would be more likely to stay with an employer offering comprehensive fertility coverage, and 83% said the same about their health insurer.

Together, the findings indicate that expanding access to a broader range of fertility pathways, and introducing them earlier in the patient journey, may better align care delivery with patient preferences while also supporting workforce and insurer retention.

Read the full report here.