I haven't looked into it personally, but from every account I've heard, it sounds like a horror show. Admittedly, there's probably some confirmation bias in there, but I'm also thinking about it from an anthropological perspective.

If adopting a child were equivalent to giving birth to your own child, why would people still go through the torture that is pregnancy? We know that there have been orphanages for centuries, so this seems to be a long running thread in the history of humanity.

From a behavioral economics standpoint, it seems presumptuous to suggest that more couples ought to change their preference from what they're predisposed to choose naturally, especially without an explanation for why they are likely to have this preference to begin with.

Once you start speculating on the reasons why people prefer adoption only as a fallback option, you'll likely find that the answer is complicated and personal to every couple, but in aggregate the average couple isn't thinking about adoption as a plan A.

Even when it comes to same sex couples - they're working on technology to be able to combine dna from two same sex parents and create an embryo that is truly a child of two people of the same sex.

Not that there's anything wrong with that, I'm just thinking of examples where adoption seems to run counter to people's revealed preferences.