The Iran War, ongoing since February 28, 2026, is impacting global fertility markets, primarily through indirect effects on pharmaceutical supply chains, air and sea freight, and energy and commodity prices. The global fertility market, estimated at around $39.27 billion USD in 2025 and projected to grow to approximately $92.60 billion USD by 2035 at a compound annual growth rate of 8.96 percent, faces delays in temperature-controlled products, increased logistics costs, and potential shortages of hormone preparations. The IVF sector alone, a key component, was valued between $21.74 billion and $28.31 billion USD in 2025 and was expected to grow to $44.68 to $49.12 billion USD by 2035 at CAGRs of 7.13 to 7.47 percent.
The fertility treatment market includes IVF, intracytoplasmic sperm injection (ICSI), hormone therapies, and related services. Pre-war, rising infertility prevalence—globally, infertility affects about one in six adults of reproductive age—drove demand. North America held a large share, Europe accounted for about 33 to 36 percent in some segments, and Asia-Pacific showed the fastest growth. The USA led with high cycle volumes, followed by countries like Spain, China, and Japan. Medical tourism and cross-border care expanded access, with many patients from high-cost countries seeking more affordable options in Asia or Eastern Europe.
The conflict has impacted key routes of global pharmaceutical logistics. The effective blockade of the Strait of Hormuz reduced shipping traffic to about ten percent of pre-war levels. The Gulf region served as a crucial transit hub for medicines and precursor products from India, China, and Europe to Africa, Asia, and the USA. Air cargo capacity in the region plummeted by up to 79 percent in the initial days of the war, leading to a 22 percent global decline. Many fertility drugs—including gonadotropins such as FSH preparations (e.g., Menopur), hCG, and GnRH analogs—are biologics or require strict cold chains between 2 and 8 degrees Celsius. These products are particularly vulnerable to delays.
India, which supplies a significant portion of active pharmaceutical ingredients (APIs) for generics and fertility drugs, is indirectly affected. The country imports about 40 percent of its crude oil imports via routes that skirt the Persian Gulf. Petrochemical precursors for drug synthesis are becoming more expensive, and rerouting via longer sea lanes or alternative air corridors increase costs and delivery times by up to 30 percent. Experts warn that if the conflict is prolonged, this will lead to higher prices for generics, which make up a large part of global fertility medication. Clinical trials for new fertility treatments, including improved embryo selection technologies or personalized protocols, are facing delays in reagents and testing materials. Thousands worldwide study sites are affected by Middle East disruptions.
Helium shortages, caused by attacks on the Ras Laffan gas field in Qatar – which before the war covered about a third of the global production of around 190 million cubic meters annually – have additional impacts. Helium cools superconducting magnets in MRI devices used in reproductive medicine for diagnostics and research. Although cryopreservation of eggs, sperm, and embryos is primarily done with liquid nitrogen, labs rely on helium-cooled analysis equipment or stable gas supplies. Price increases and shortages could delay maintenance and increase operating costs in IVF clinics. Repairs in Qatar could take years, with a permanent reduction in export capacity by up to 14 percent.
Regional markets are reacting differently. In North America, where the IVF market was estimated at about 7.6 billion US dollars in 2025 and was projected to grow to 15.2 billion by 2035, higher import costs are leading to price adjustments for treatments that cost an average of $12,000 to $20,000 per cycle. Clinics are stocking up and diversifying suppliers, but patients are experiencing rising out-of-pocket expenses. Europe, with strong public funding in countries like Denmark, Belgium, or Spain, is seeing delays in imported preparations, which is extending waiting times. Asia-Pacific, the fastest-growing segment, is suffering from transit disruptions through Gulf hubs; India and China, as producers and consumers, are doubly affected – by their own supply chains and export delays.
Developing and emerging countries in Africa, Southeast Asia, and Latin America are feeling the effects more strongly. Many import fertility medications and relief supplies via Gulf routes. The WHO has pointed to rising transport costs of up to 30 percent and reported risks to essential supplies. In countries with existing shortages, delays in hormone preparations could interrupt treatment cycles and lower success rates. Medical fertility tourism, a growing part of the market worth billions and with annual growth rates of up to 25 percent in some segments, is being dampened by flight restrictions and uncertainty. Patients from Europe and North America heading to destinations in Spain, the Czech Republic, or Georgia are facing higher costs and logistical hurdles.
In the long term, the conflict could increase the vulnerability of the global fertility supply chain. The industry depends on international supply chains for APIs, culture media, catheters, and cryo-equipment. Higher energy prices due to the war are driving up production and operating costs in clinics and laboratories. Brain drain or investment reluctance in uncertain regions could slow down innovation. At the same time, disruptions are accelerating diversification efforts: more domestic production of APIs, improved recycling systems for gases, and regional hubs outside the Gulf.
Despite the strains, underlying demand remains high. Later parenthood, lifestyle factors, and declining natural fertility rates – globally from about 5 births per woman in the 1960s to around 2.2 in 2024 – are driving the need for assisted reproduction. Clinics in stable markets are adapting by building buffer stocks and using alternative routes. Pharmaceutical companies such as Ferring or other providers of gonadotropins have not yet reported acute global shortages, but warn of long-term risks if the conflict persists.
The impact on knowledge transfer and innovation in reproductive medicine is noticeable. Delayed clinical trials are hindering progress in techniques such as genetic screening, AI-assisted embryo assessment, or new stimulation protocols. International collaborations, which rely on sample and data exchange, are suffering from transport problems. In the Gulf region itself, which was considered an emerging hub before the war, projects have come to a complete standstill.
In summary, the Iran war has shifted global fertility markets from a path of dynamic growth into a phase of increased costs and logistical uncertainty. With a market volume of around $39 billion in 2025 and ambitious forecasts up to over $90 billion, delays in the delivery of hormone preparations, rising treatment prices, and slowed innovations threaten. The combination of the blockade of the Strait of Hormuz, air freight disruptions, and helium shortages underscores the dependence of sensitive medical areas on stable global routes. While short-term adjustments may mitigate the most acute risks, a prolongation of the conflict could make access to fertility treatments worldwide more difficult – especially in resource-poor regions. The developments surrounding President Trump's ultimatum on April 7, 2026, show that de-escalation would be crucial to avoid further burdens for millions of couples who rely on assisted reproduction. In the long term, the industry must build more resilient supply chains to cushion future geopolitical shocks.
