Infertility Patients and Doctors Fear Abortion Bans Could Restrict I.V.F.

Anna Nibley Baker, the mother of four in Salt Lake City, is quite convinced that she and her husband have finished building the family. However, for eight years after the last child born by in vitro fertilization, she gently considered the remaining three embryos, frozen them, and stored them in a university clinic.

Now, after the Supreme Court’s abortion ruling overturns the Roe v. Wade case, 47-year-old Ms. Baker, like countless infertility patients and their doctors across the country, no longer decides the fate of these embryos. I’m wary that it may not be. If the state bans abortions that begin with pregnancy and does not distinguish between in utero and laboratory fertility, the impact on routine procedures for fertility treatment can be extraordinary.

In the in vitro fertilization cycle, 40 years old and over It is also used by hundreds of thousands of heterosexual and homosexual couples, singles and surrogate mothers in the United States and is expected to produce as many healthy embryos as possible for each patient.Doctors generally implant One or two Of those embryos in the womb Freeze what’s left For future use of the patient.

Will patients like Mr. Baker be unable to throw away unwanted embryos and instead be encouraged to donate them for adoption or be forced to store them forever?

Can the clinic face criminal penalties if the embryos do not survive after being thawed for implantation?

In short, many are afraid that restrictions on unwanted pregnancies can unintentionally or otherwise control those who crave for pregnancy.

Since the ruling, fertility clinics have been struck by desperate calls from patients asking whether frozen embryos should be transferred to states where the right to abortion is guaranteed, or whether it is legally possible. Cryobanks and doctors are also considering careful scenarios. A Texas infertility doctor asked if a criminal defense counsel should be hired.

So far, the text of the law in force does not explicitly target embryos produced in the laboratory. A New policy paper Researchers from the American Society for Reproductive Medicine, who represent a range of fertility providers, have analyzed 13 so-called trigger methods and concluded that they do not pose an imminent threat to infertility patients and their healthcare providers. Also in an interview, a major anti-abortion group stated that embryos produced by assisted reproductive technology are not currently a priority.

However, legal experts say that as some states draft the bill, these embryo conditions, as well as patients and donors, become vulnerable, especially if enthusiastic prosecutors decide to test new terrain. I warn you that there is a possibility.

Barbara Korla, President SolutionRepresenting the interests of infertility patients, said the organization has seen many legislative efforts to claim state control over embryos. “Because we counterattacked and there was also a backstop in the Roe v. Wade case,” they failed, she said. “Obviously we don’t have it anymore.”

She continued on the case of the ruling that overturned Rho. “So Dobbs feels like a green light for legislative fanatics who want to take this one step further.”

By using the word “pregnancy”, most trigger bans distinguish targets from embryos stored in the clinic. For example, a ban in Utah, where Mr. Baker lives, constitutes an abortion in the context of “human pregnancy after implantation of a fertilized egg.” This excludes state jurisdiction over the preserved embryos. (Or Trigger method It is temporarily on hold. )

And the abortion law National Right to Life Committee Retaining its position as a model for parliamentarians, parliamentarians refer to “all stages of fetal development in the womb of a pregnant woman from fertilization to childbirth.”

In an interview, representatives of four groups across the country who oppose abortion firmly believe that all embryos are human, but regulating IVF embryos within the scope of an abortion ban was not their first task. Stated.

“There’s a lot more to do in many other areas,” said Laura Eschvaria, a spokeswoman for the National Commission on Right to Life, a parental notification and safety net program for pregnant women and their families. Said by quoting. She said, “IVF isn’t really even on our radar.”

But Christie Hamrick, Students for life actionA national anti-abortion group, said IVF has recently become part of the conversation.

“Protecting life from the beginning is our ultimate goal. In this new legal environment, we are studying issues like IVF, especially the business that ends most of the life we ​​can think of in the lab, by design. I’m considering a model, “she says.

Clinics do not need to report the number of frozen embryos in storage, so it is not possible to confirm reliable figures in the United States. The Most quoted number, 400,000 is from a 2002 RAND Corporation survey, but the updated total is much larger.

Within the past year, Republicans in at least 10 states have proposed a bill that would give these frozen embryos legal “personality” status. record Held by Resolve. I haven’t passed. However, policy analysts at the American Society for Reproductive Medicine said these laws, which give both embryos and fetuses the legal status of living humans, “may become more common in the post-law world.” Stated.

Hamrick of the Student for Life Action said there is a “bright future” in the “protection from conception” or “personality” law.

And while trigger bans generally define abortion in relation to pregnancy, some languages ​​resonate with anxiety in the world of infertility. For example, Arkansas defines a fetus as “an individual organism of the Homo sapiens species from fertilization to childbirth.”

Sara Kraner, legal adviser to Fairfax Cryobank, which operates embryo storage facilities in six states, said: We can have a good debate as to why the various bans do not apply to preserved embryos, but we cannot guarantee that the judge will support me if I am taken to court. “

Sean Tipton, American Society for Reproductive MedicinePredicted that patients and healthcare providers would remain uncertain for a long time when lawmakers enacted laws and prosecutors tried them.

“It’s like Dobbs’ decision removed the condom,” Tipton said. “And if you practice legislation without proper precautions, you will make some mistakes.”

The threat posed by future abortion bans to infertility patients and healthcare providers is unclear, but preemptive measures are under discussion. However, it turns out that each proposal has a problem.

Judith Dahl, If you are the Dean of the Salmon P. Chase Faculty of Law at Northern Kentucky University and an Assisted Reproductive Technology expert, passing state legislation that distinguishes between infertility patients and those seeking abortion risks having a discriminatory impact. I said there is. Although IVF patients are Caucasian, most of all abortions in the United States are made up of colored women. “

Some medical and legal professionals have proposed another type of hit-and-run. Create one embryo at a time by storing sperm and eggs separately and thawing them only to create individual embryos as needed. Strictly speaking, that approach will avoid some of the potential legal issues posed by preserved embryos and the statutory wording prohibiting post-fertilization abortion.

However, such practices are inefficient given the time and cost, and unethical given that women need to be given medicines and undergo surgical procedures for each embryo transfer. It is a target.

The third option that has been discussed between doctors and patients over the past few years is “Compassionate transfer.” According to the 2020 Position Paper by the American Society for Reproductive Medicine, the term is used to allow patients to transplant embryos into their bodies “when pregnancy is very unlikely to occur and pregnancy is not the intended result.” Refers to requesting. For those who consider frozen embryos to be human life, compassionate transplantation is a type of natural death of the embryo, rather than destroying it in the laboratory.

Catherine KraschelA reproductive health expert at Yale Law School said that embryos that scholars have determined are unlikely to lead to pregnancy may be forced to be stored in the clinic.

“It may also mean that a’compassionate transfer’is recommended because the state imposes a moral assessment on them, rather than respecting the moral assessment of the patient’s embryos. “She said.

Baker, the mother of adoption and in vitro fertilization, is deeply attached to the three frozen embryos. She is particularly struggling to find a way forward, especially now, as the Supreme Court’s abortion ruling casts a shadow over their future.

She can’t imagine donating them to another couple. In effect, letting a stranger give birth and raise a child. This is a process that many of the right to life movements call “snowflake adoption.”

She cannot afford to pay for their permanent storage, financially or psychologically.

Also, she wasn’t ready to thaw them, and as she said, “arrest on the plate.”

What is important for Baker, a critical care nurse, is that she has the right to make choices that she considers to be intimate and very individual. She doesn’t believe she can have an abortion unless her life is at stake, but she also believes that her decision should be hers.

That’s why she doesn’t want state legislators to specify the fate of her embryo.

“They are part of me,” Baker said. “Everyone except my husband and I should have the right to decide what will happen to them.”