How Do Brazilian Fertility Regulations Compare to US State Laws?

Medically Reviewed by Dr. Silvana Chedid on September 1, 2026

Brazil regulates fertility clinics through one national medical ethics body that applies the same rules to every clinic in the country, while the United States splits oversight across multiple federal agencies and a patchwork of state laws that vary considerably depending on where you live. Neither system is simpler across the board, but Brazil’s single standard is generally easier for a patient to understand up front than the mix of rules a US patient may need to sort through.

At Chedid Grieco, we have operated within both the Brazilian and American regulatory frameworks for more than 30 years. Our consultations happen in Miami and treatment takes place at our FDA- and NYDH-licensed facility in Sao Paulo. This overview is general information about how each system is structured. It is not legal advice, and it does not describe any court case, law firm, or individual’s specific legal situation, so patients with questions about their own circumstances should speak with a qualified attorney licensed in their state. If you are exploring fertility tourism and this is one of your open questions, here is how we typically cover it.

How Brazil Oversees Fertility Clinics

When patients ask how our Sao Paulo clinic is held accountable, the first thing we explain is that Brazil’s approach runs through a medical ethics body rather than through legislation. The Federal Council of Medicine, or CFM, issues binding clinical resolutions that govern what we do: documentation we are required to maintain, which procedures we are authorized to perform, and the conditions under which each is permitted. Brazil has not codified this into statutory law the way some US states have, but the CFM’s authority over clinical practice is genuine and applied uniformly across the country. A 2025 academic review of the Latin American fertility market, published in JBRA Assisted Reproduction, describes Brazil as one of the region’s largest contributors to assisted reproduction while also noting that cost and limited insurance coverage remain real barriers domestically, which tracks with what we see in practice.

The practical result is that a fertility clinic in Sao Paulo answers to the same framework as one anywhere else in Brazil. On the question of eligibility, the CFM is direct: single individuals and same-sex couples are explicitly included, which patients in non-traditional family-building situations typically ask about before committing to travel.

Which Procedures Are Available

Patients asking this question want to know whether they would have access to the same range of treatments in Brazil that they would have at home. Egg donation, embryo cryopreservation, and preimplantation genetic testing are all within what the CFM framework allows, each with documentation and ethical review requirements built in. We go through whichever of these applies to a specific patient’s situation during the consultation. What Brazil does not have is a mandate requiring insurance coverage for fertility care, which matters for cost planning even if it does not affect clinical access.

How US Fertility Care Is Regulated

What we hear most from patients who have tried to work through fertility care within the US is that the regulatory picture is more variable than they expected. Regulation of assisted reproduction is split across multiple federal agencies: the FDA handles donor tissue oversight, the CDC tracks and publishes clinic outcomes through the Society for Assisted Reproductive Technology, and CMS covers reimbursement standards. These agencies operate under different mandates, and there is no single body that sets unified clinical rules for how fertility clinics across the US must operate.

Insurance coverage follows the same pattern. As of 2025, 25 states and Washington, D.C. require some form of insurance coverage for fertility care, though the specific mandates vary considerably in who and what they cover. The American Society for Reproductive Medicine has identified access as among the most persistent challenges in US fertility care. Coverage for in vitro fertilization is required by law in some states and entirely absent in others, and rules around embryo disposition, surrogacy, and donor anonymity vary by state in ways that catch patients off guard.

What Changed in State Fertility Law in 2025

State legislatures stayed active on fertility care throughout 2025, and the year’s activity illustrates how uneven the US regulatory picture is compared with Brazil’s single national standard:

• Colorado, Tennessee, and Georgia each passed legislation affirming fertility care rights and protections during the year.
• Louisiana modernized its IVF statutes to add updated provider protections.
• Arkansas became the first state to pass restorative reproductive medicine legislation, which promotes natural fertility approaches while allowing providers to decline assisted reproduction services on religious grounds.

None of this activity changes how our Sao Paulo facility operates, since Brazilian clinical practice answers to the CFM regardless of what any individual US state does. We raise it because patients considering treatment abroad often want to understand why the domestic picture keeps shifting, and a single-standard system is part of what draws some of them to evaluate options outside the US in the first place.

Where the Two Systems Diverge

When patients ask us which system is more straightforward to work within, the honest answer is Brazil, for the specific reason that there is one standard and every clinic in the country answers to it. The US produces a mix of state laws, federal agency mandates, and professional guidelines that interact differently depending on where a patient lives, and even experienced providers sometimes have to work through those interactions carefully.

For most patients doing this research seriously, cost is also part of what they are comparing. IVF cycles in Brazil come in considerably below US pricing, and that gap holds up after accounting for travel in most situations. The ethical and legal aspects of assisted reproduction in Brazil are also more clearly settled in certain areas, particularly around donor gametes and embryo use, which removes a layer of uncertainty that some US patients encounter when trying to plan.

What Our Licenses Reflect

Chedid Grieco holds FDA licensing and a New York Department of Health tissue license, placing us among a small number of facilities outside the United States with that combination. Our licenses and associations exist because we have built the clinic to meet both frameworks, not just the one where treatment takes place. For patients specifically looking for a facility that is accountable to US-recognized standards in addition to Brazilian ones, that is what the licensing represents.

Dr. Silvana Chedid has practiced reproductive medicine for more than 25 years across both systems and introduced ICSI to Brazil, which shapes how our clinical team approaches every case regardless of which country’s rules apply to a given procedure. Whether you are just beginning to sort out how the regulatory side works or you are ready to take the next step, our team can walk you through what treatment at our Sao Paulo facility involves. Contact us to schedule your consultation in Miami.

Frequently Asked Questions About Brazilian and US Fertility Regulation