Once again, the market’s third constraint—politics—theoretically could widen this market, using insurance policies, as states like Massachusetts already do, to lower prices and expand the patient population. To date, most states have been wary of going this far, and most clinics have been happy to resist. But if pressures along these lines increase, then more of the fertility trade will be pushed toward the volume end of the market, toward that commercial state where, as Boston IVF’s Berger acknowledges, they simply “manufacture embryos.”

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