Over the summer, Hungary’s nationalist leader Viktor Orban was busy meeting fellow strongmen. After jetting to Moscow to sit down with Vladimir Putin in a meeting condemned by other European leaders, he crossed the Atlantic to visit former President Donald Trump.
In their July meeting at Trump’s Mar-a-Lago residence in Florida, the two men discussed peace between Russia and Ukraine. They posed in front of the cameras with broad grins and gestured with their thumbs up. Orban, whose hard-line policies on immigration and anti-LGBTQ+ laws have made him a favorite of the far right, has since promised to “open several bottles of champagne” if Trump wins the presidential election next month.
The outsize influence of the small European country on Trump and his policies is somewhat extraordinary: Hungary has a population of some 9 million, roughly the same number of people who live in the U.S. state of New Jersey. Yet whether he is talking about China or sending aid to Kyiv, Trump often chooses to reference his most fervent supporter in Europe and, perhaps, the world.
Trump, who once described the Hungarian leader as “his twin,” has appeared at Orban’s events via video in recent years, and referred to him in multiple speeches, including in the first televised debate with Vice President Kamala Harris in September, when he told the audience, “Let me just say about world leaders, Viktor Orban, one of the most respected men, they call him a strongman. He’s a tough person.” The praise earned Trump scorn from other Republicans, including Senate Minority Leader Mitch McConnell, who criticized the “cult of personality” around Orban, a leader whom many in the United States see as actively aiding Moscow.
And beneath the men’s mutual love for each other lie Orban’s policies and methods of rule, which Trump appears to think the American right could productively learn from.
In the most recent example, Trump seems to have taken a leaf out of Orban’s natalist playbook. Both leaders want more native-born children as they aim to halt population decline without relying on immigration. In the same television debate with Harris, Trump promised that if he becomes president again his administration will fund the costly treatment of in vitro fertilization (IVF) for American couples, or mandate that insurance companies pay. Last month he went a step further, describing himself as “the father of IVF” during an all-female campaign event in the battleground state of Georgia, while also admitting he only recently learned what the procedure actually entailed. (Harris described his remarks as “quite bizarre.”)
In Hungary, women already access IVF treatment without paying. Or rather, they do pay, by sacrificing the quality of care. Just over two years ago, around the same time that the U.S. Supreme Court overturned Roe v. Wade, thrusting government control over women’s bodies into the global spotlight, Orban’s ruling Fidesz party outlawed the provision of IVF by private institutions. It was part of a controversial strategy to halt population decline by making fertility treatment more accessible to all — as long as you were a married woman under the age of 45. But the plan backfired: Success rates fell and monthslong queues ensued.
“In Hungary or in the U.S., women’s lives don’t matter. Politics and religion do,” says Steven Kaali, a Hungarian-American doctor and businessperson who set up a string of private IVF clinics in the country. “Up to 11,000 children weren’t born due to this new system,” Kaali tells New Lines in his hilltop home in the Hungarian capital of Budapest, opposite Buda Castle and overlooking Orban’s residence.
“The mothers are on the losing side of the new system, and the unborn children are the victims,” he says.
A native Hungarian, Kaali escaped the Soviet regime and fled to the West in 1969, becoming a doctor in New York. After the fall of the Iron Curtain in the late 1980s, he returned home and opened Hungary’s first private IVF clinic in 1992, which grew into a successful chain across the country. He estimates that the Kaali Institute, named after his father, who was also a doctor, enabled the conception of 30,000 Hungarian babies.
In 2019, the Fidesz government purchased his five clinics as part of its strategy to combat the the decline in the country’s population, which has been shrinking since 1980. They also put pressure on the remaining clinics before passing a law in 2022 banning private practice altogether, forcing the two remaining private clinics to shut down.
Some clinics still offer some services before recommending that couples go abroad to complete their treatment. On the seventh floor of an office building on the outskirts of Budapest, the Versys Clinic just about operates, though its equipment is gathering dust.
Founded in 2012 by Attila Vereczkey, a doctor who trained in the U.K., it boasted that its success rates from IVF reached 50%. Today, rooms sit empty, and the IVF laboratory equipment is stored under sheets in dark rooms. The staff still perform examinations and surgical procedures.
“I believe that the government means well,” Vereczkey says. “But how they do it is flawed.”
Despite promises for the launch of more fertility centers, currently only seven of Hungary’s 19 regions have hospitals performing IVF. “The hospital is like an assembly line. We get no support,” says Erika, a 41-year-old woman who speaks to New Lines without giving her last name in order to be open about her IVF treatment, which she hasn’t disclosed to friends and colleagues. “One doctor told me to watch a YouTube video about how to give myself (hormone) injections.”
She has undergone three rounds of IVF treatment at her local hospital. She became pregnant in the last round, but had to surgically terminate after eight weeks as the fetus wasn’t developing. Erika, who works at a multinational company, is now struggling to stay positive as her savings wane. She estimates she has spent around $1,000 on examinations in private clinics, to try to glean more information about her fertility.
There are only 13 clinics across the country catering for an estimated 170,000 couples experiencing infertility. Patients also complain about a lack of information and inhumane or humiliating treatment. Before the state takeover of IVF, the Hungarian health sector was woefully underfunded, with insufficient equipment and staff shortages.
IVF success rates in public hospitals have deteriorated, falling from 19% in 2019 to 16% in 2021, compared to a 33% average in the European Union and 51% in the U.S.
Like in most Western countries, Hungarian women are having children later. While, in 2000, the average Hungarian woman had her first baby a few months after she turned 25, by 2023 the average age of first-time mothers was nearing 30. “We want to leave the country to our own children, not to foreigners. If there are children, there is a future,” Orban said in a 2022 radio interview.
The Fidesz government has also implemented various financial incentives for families, including monetary help for home renovations and car purchases, and large loans and tax reductions for mothers. Despite these, in 2023 the Central Statistics Office registered a historic low of 85,000 births, a far cry from the 93,000 in 2021 or the 96,000 in 2009, the year before Fidesz came to power.
In the United States, the birth rate has been declining rapidly for decades since peaking in the 1960s. Last year, the number of births in the U.S. decreased by 3% from 2022, according to government data, with people delaying parenthood for a variety of reasons, including less economic growth and a smaller and older workforce. Immigration is widely seen as the only way to ensure that the replacement rate of 2.1 births per woman can be maintained.
And while IVF is the most efficient of the fertility procedures, in the U.S. it is costly; at an average of $20,000 per round, the treatment is out of many people’s reach. The conservative Cato Institute was quick to criticize Trump’s pro-natal proposal, saying it would cost the U.S. government $7 billion a year. “For someone who has referred to Kamala Harris as ‘a socialist lunatic,’ this is more than a little hypocritical,” its senior fellow Jeffrey Singer wrote.
The fertility treatment has also come under threat in the U.S. following the decision to overturn Roe v. Wade, becoming a flashpoint in the national debate over abortion and reproductive rights earlier this year when the Supreme Court of the state of Alabama said that frozen embryos count as children, and that destroying them could count as manslaughter. Though Trump has come out in favor of IVF, Harris’ campaign has argued that the ruling offered an insight into the kinds of policies the Republican nominee could endorse should he become president again.
Thousands of Hungarian couples who are unable to procure the state-provided treatment travel to nearby Slovakia and the Czech Republic in the hopes it will be more efficient. Clinics in both countries have Hungarian websites, and many employ Hungarian-speaking coordinators. LGBTQ+ couples are denied treatment in all of these countries but can access it in Austria, equally close but more expensive.
“In the state hospitals, they humiliated me,” says Julia, who lives in Budapest and was 40 years old when she first tried IVF. “[They] made me feel small, criticized me or tried to invite me to their private practice for examinations to make more money,” she tells New Lines. Ultimately, she applied for treatment in the Czech Republic.
According to Hungarian doctor Judit Zsemley, who works across the border at the ReproGenesis Clinic in Brno in the Czech Republic, around 70% of her clients reported bad experiences in the Hungarian system. She has been approached by other clinics too, to treat Hungarian patients who have been arriving in larger numbers since 2019.
ReproGenesis is among the most popular of the Hungarian clinics. They offer full IVF treatment from $3,300, excluding accommodation and travel, a sum four times more than the average monthly rent in Budapest.
“We made our trip into a weeklong date,” says Robert, 41. His wife, 37, decided to pursue treatment in Brno after two unsuccessful rounds in Budapest in 2022. “In the Hungarian hospital, our experience was anything but positive. We felt abandoned by the system.” They had to complete the journey only once, and their first treatment was successful. Robert says that now they are planning their second child with the same clinic, without even considering a Hungarian institution.
Kaali has not set foot in any of his clinics since the government takeover. Instead, he spends his time in Dorgicse, a town near the “Hungarian Riviera” on the shores of Lake Balaton, where he set up a museum of classic cars. In one room, he has a bronze statue of himself, and he often surprises the visitors by appearing at the end of their tour.
When he saw Orban a few years ago, the prime minister was the first of the men to say hello, Kaali remembers. “Now, I’m not sure he would greet me,” he says.
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