The U.S. trains only about 60 new fertility doctors each year—just enough to replace those retiring. With demand rising and no increase in fertility doctors, clinics can charge more and waitlists grow longer.

In contrast, countries like Spain and Greece train a surplus, boosting access and lowering costs.

Fertility drugs like Gonal-F, Menopur, and Lupron are the same overseas — same ingredients, same manufacturers — just different language on the box. But they cost far less.

In the U.S., prices are unregulated and inflated by middlemen. For example, in Spain, pricing is simpler and more transparent — a Gonal-F pen that costs over $1,000 in the U.S. is just $250..

In the U.S., every player in the healthcare system has a financial incentive to drive up costs — insurers, hospitals, private equity firms, and pharma companies all profit when prices rise.

Abroad, the focus is often on efficiency and outcomes, not maximizing revenue — making fertility care more affordable and patient-centered.