In Vitro Fertilization Shut Down in Alabama – What’s Next?
In the past month, reproductive rights for US Americans have been jeopardized once more, with the Alabama Supreme Court ruling to shut down in vitro fertilization (IVF). While physically and financially demanding, around 2% of babies born in the US are conceived through IVF. This legal decision will therefore impact thousands of lives within the state and may also expand to facilitate similar legal restrictions across the country. While it is unsurprising that another facet of reproductive healthcare has been targeted in the US, the speed and haste through which this ruling has taken place has not only had repercussions for IVF patients, doctors, and fertility clinics but also has wider implications for the continued decline of reproductive healthcare for Americans.
On the 16th of February 2024, the Alabama Supreme Court declared that embryos produced through IVF should be legally recognized as children. This decision was traced to a court case that began in 2020, when an individual walked into an IVF clinic and dropped a vessel of embryos, leading to their destruction. Three of the impacted patients sued for the ‘wrongful death of a minor’, which was initially dropped, as the court expressed that embryos are regarded as ‘property’, not ‘people.’ Yet, after appealing to the highest court in Alabama, the majority of the justices determined that the wrongful death statute does in fact apply, as it includes “all unborn children, regardless of their location.”
This ruling has led to an immediate backlash, as many medical professionals have been vocal in explaining that the judges based their decision on misunderstandings of reproductive medicine. Granting these embryos the same legal status as people is a very extreme reach, given that embryos produced through IVF are microscopic cells—which cannot be seen with the naked eye. To justify this recognition of IVF embryos as ‘people’, the justices claimed that a full-term infant or toddler could be gestated, or conceived, “in an in vitro environment.” However, this does not align with scientific or medical facts, as it is impossible to develop an embryo outside of the uterus for longer than a week. Furthermore, the case included 41 references to ‘God’ and frequently cited bible passages. The arguments which justified this ruling are working towards a certain political agenda, without considering medical research. Thus, activists and doctors alike are arguing that this ruling is not only illogical but also scientifically incoherent.
With this ruling in place, most fertility clinics in Alabama instantly halted their IVF treatments. Because it is common for IVF patients to have multiple embryos formed and transferred into the uterus, facilities suddenly became aware that if the embryos failed to survive freezing or transferring it could leave the medical professionals in positions of legal wrongdoing. Moreover, because it is common to transfer multiple embryos into a uterus, and later pursue fetal reduction, to “help a person deliver fewer babies with lower health risks”, fertility clinics were suddenly unsure whether this procedure would be considered a mode of ‘wrongful death’ under the new legislation. Yet, 2 weeks after the ruling, on the 7th of March, providers were able to resume some IVF services with the help of a new bill which aimed to protect clinics from legal liability. The clinic at the center of the Supreme Court case, however, has not started up again, as it has told CNN that the new legislation still does not offer enough protection.
The IVF patients impacted have not only spent between $10,000-$20,000 on the treatment and endured emotional trauma due to unexpected changes to their procedures but many are left feeling uncertain as to whether they will be able to follow through with their pregnancies. While some have considered shipping their embryos to a different state, embryo shipping companies have also halted their services, due to fear of being held legally liable for any damages. Thus, embryos are not being transported and they are not being used. These legal roadblocks, despite being aimed at protecting the ‘lives’ of these ‘potential children’, are so restrictive that many of the embryos that have already been created will be wasted.
Image of Embryo Shipping Company, Cryoport,-- has halted and resumed shipping of embryos
This ruling is part of a larger ‘personhood movement’ occurring in the US. Supporters of this movement highlight that rights should be extended to the “fetus or embryo before viability”, legally protecting the ‘life’ of the unborn. While this line of reasoning seems self-contradictory, as it prioritizes the ‘life’ of something that has yet to become ‘alive’, its rationale served to be successful in overturning Roe v Wade, restricting abortion in various states across the country and continues to be used through this ruling on IVF. Many involved in this movement argue that they are protecting the most vulnerable by aiming to prioritize innocent ‘children’. Yet, rather than protecting children, this movement is primarily harming and restricting the lives of women and all people with uteruses, as it is limiting the extent to which they can make personal reproductive decisions.
Recently, other states have begun to follow the trajectory of Alabama, with Iowa passing a new bill which classifies the death of an ‘unborn person’ without the consent of the pregnant person as a ‘class A felony.’ While the implications and nuances within this ruling are still unclear, the impacts of the Alabama ruling will inevitably continue to influence Republican-dominated states.
The avowal of fetal personhood laws in over 25 states has instigated fear for many that more restrictions will continue to arise. With the personhood movement starting with nationwide abortion bans, and then targeting IVF, it is unclear which facet of reproductive rights will be next. Some politicians, including Hillary Clinton, believe that contraception methods, including birth control, IUDs, or Plan B will be impacted. The criminalization and prosecution of basic reproductive healthcare is increasingly jeopardizing the lives of people with uteruses, and it is crucial—now more than ever—to continue fighting against and rejecting these ever-present restrictions which do not protect unborn ‘lives’, but damage and destabilize the lives that already exist.
Tweet by Hillary Clinton
Sources:
Advanced Fertility Clinic Chicago. (2024). IVF embryo quality and day 3 embryo grading after in vitro fertilization Cleavage stage embryo grading. https://advancedfertility.com/fertility-gallery/embryo-quality/
Baker, C. (2024, March 1). Alabama IVF Ruling Imperils Contraception. Ms. Magazine. https://msmagazine.com/2024/03/01/alabama-ivf-birth-control-contraception-fetal-personhood-iud-abortion/
Carlisle, M. (2022, June 28). Fetal Personhood Laws Are a New Frontier in the Battle Over Reproductive Rights. Times. https://time.com/6191886/fetal-personhood-laws-roe-abortion/
Cryoport Systems. (2024). Who is Cryoport Systems?. https://cryoport.com/about-us/
Edelman, A. (2024, March 8). Iowa Republicans pass personhood bill that critics say could threaten IVF care. NBC News. https://www.nbcnews.com/politics/iowa-republicans-pass-personhood-bill-critics-say-threaten-ivf-care-rcna142458
Glenza, J. (2024, Feb 23). Doctors shocked and angry as Alabama ruling throws IVF care into turmoil, Guardian. https://www.theguardian.com/society/2024/feb/23/fertility-doctors-reaction-alabama-embryo-ruling
Mascarenhas, L. and Rosales, I. (2024, March 7). Alabama clinics resume treatment under IVF law, but experts say it will take more work to protect fertility services. CNN. https://edition.cnn.com/2024/03/06/us/alabama-ivf-fertility-protection/index.html#:~:text=Providers%20in%20Alabama%20are%20resuming,controversial%20state%20Supreme%20Court%20ruling.
Mayo Clinic. (2024). In vitro fertilization (IVF). https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716
Sharfstein, J. (2024, Feb 27). The Alabama Supreme Court’s Ruling on Frozen Embryos. Johnss Hopkins.
https://publichealth.jhu.edu/2024/the-alabama-supreme-courts-ruling-on-frozen-embryos
Southern California Reproductive Center. (2024) IVF Side Effects: Understanding the Risks. https://www.scrcivf.com/ivf-side-effects-understanding-the-risks/
Walker, A. (2024, Feb 23). Embryo shipping services to halt business in Alabama after IVF ruling. Guardian. https://www.theguardian.com/us-news/2024/feb/23/embryo-shipping-alabama-ivf-ruling