Yeah, my sister and brother in law needed help with IVF for their second child. They could absolutely afford a second child, but $15,000 as a lump sum (a second time) was past their budget. So my parents paid (and refused to let them pay it back). Now they’re actually wealthy, but even if they had stayed in their original income bracket, they could afford to raise two kids. I’m in the US and my state (see username) passed a law requiring that health insurers pay for IVF except in a few specific circumstances.