Here’s how it could impact fertility treatments and IVF

Topline

The Supreme Court on Friday overturned Roe v. Wade, a monumental decision that is already rolling back abortion rights in many states and could potentially make it harder for Americans to access other areas of reproductive medicine, including fertility treatments like infertility. in vitro (IVF).

Highlights

Although the reversal of Roe v. Wade does not automatically restrict access to assisted reproductive technologies (ART) like IVF, experts say Forbes the broad or imprecise language used in some state-level abortion bans could potentially include procedures.

The wording of some state laws risk unintentionally hindering access to ART because they “do not reflect the biological reality” or do not consider the implications of the law beyond abortion, Sean Tipton, head of the advocacy, policy and development of the American Society for Reproductive Medicine (ASRM), says Forbes.

The wording or interpretation of some state laws could call into question the legality of IVF – where excess embryos are frozen or discarded – in the event of Roe cancellation, particularly in states that are striving to granting fetuses, embryos, or fertilized eggs similar rights to children, usually through so-called fetal “personality” bills.

The laws also pose a threat to standard IVF procedures designed to protect both parents and the unborn child like selective reduction, which reduces the number of fetuses in a single pregnancy to increase the chances of success, said Seema Mohapatra, health law and bioethics expert at Southern Methodist University.

While many professionals don’t consider these procedures an abortion — the pregnancy and a live fetus remain — Mohapatra said selective reduction would certainly count as an abortion in some states like Texas, adding that there is an “immediate risk “to lose access. .

Tangent

Overthrowing Roe could also worsen existing inequalities in access to reproductive medicine, warns Mohapatra, and not just for people struggling with infertility. Black women, for example, live higher levels of infertility than white women and seek fertility treatment less often. Restrictions could make access to IVF more expensive, for example by limiting the number of embryos made or implanted, which would reduce the chances of successful pregnancy, increase IVF cycles and increase costs. Other people, such as members of the LGBT+ community, will often use ART to have children.

Key context

The annulment of Roe v. Wade won’t automatically ban ART and IVF. However, a number of states have “trigger laws” in place that could ban abortion if Roe v. Wade is cancelled, including Kentucky, Texas and Louisiana. These states intend to explicitly ban abortion at any time after fertilization and will define the life of an “unborn child” or an “unborn human being” as beginning at fertilization. While some state bills explicitly exempt birth control measures from the application of the abortion ban, they do not explicitly exempt IVF in name. (Alabama adopted a ban on abortion which is now blocked but will likely take effect if Roe is knocked down, which was built for Exempt IVF.) Oklahoma, which became the first state to completely ban abortion in May, now also bans the procedure from fertilization, which has already raised concerns among fertility experts even as the bill’s sponsor said lawmakers had no intention of targeting IVF. Beyond simple abortion bans, the “fetal personality” bills which grant fetuses and embryos the same legal rights that humans have outside the womb, could become more common if Roe v. Wade is overruled, which could provide another avenue to target IVF if the laws don’t specifically exempt it. Pro-Abortion Rights Guttmacher Institute reports six states have so far introduced personality bills in 2022.

What we don’t know

The status of embryos. The wording of some state laws restricting abortion could possibly be read to encompass embryos ex vivo — outside of the living body — said Stanford Law School professor Hank Greely. Forbes. This could potentially restrict access to IVF or preimplantation genetic testing used to select embryos based on disability. Greely said it was “unlikely” that a judge would be inclined to such a reading, although selecting embryos based on the absence of disabilities, including Down’s syndrome or Down’s syndrome, could be a exception possible. New legislative efforts to protect ex vivo embryos are possible but unlikely to succeed, Greely added. IVF and other ARTs are generally accepted politically, and “most anti-abortion people don’t care about ex vivo embryos,” especially when they’re created to help people have children, Greely explained. “They like people having babies.”

Contra

Lawmakers behind the bills that have been flagged for their potential impacts on IVF have so far denied that banning abortion could impact the procedure. “The bill clearly defines abortion as the termination of a woman’s pregnancy. So there’s no way it could be construed as affecting what happens in a lab,” said Oklahoma State Rep. Wendy Stearman (R), who sponsored the ban on abortion by the state which has already come into force. Politics. “It’s not something that has ever been considered as far as I know. … I don’t expect that to be the case, and if for some reason it was brought up, I don’t think it would be a success.

Large number

83,946. This is the number of infants born in the United States in 2019 who were conceived by ART, including IVF, according at the Centers for Disease Control and Prevention, accounting for 2.1% of all infant births that year.

Peg News

The Supreme Court on Friday overturned Roe v. Wade in a case about Mississippi’s 15-week abortion ban and whether states can restrict the procedure before a fetus is even viable. Judge Samuel Alito delivered the court’s opinion, which said Roe was “grossly wrong” and argued that the case should be overturned because the right to an abortion is not expressly stated in the Constitution or “deeply rooted in the history and tradition of this nation”. Four justices – Clarence Thomas, Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett – signed Alito’s opinion, Chief Justice John Roberts issued a separate agreement accepting the judgment and the court’s three liberal justices dissented . The decision came after Politics leaked a draft opinion from February suggesting that the court would take such a step and completely overturn Roe, sparking outcry from abortion rights advocates and increased efforts by states to restrict and strengthen the access to abortion.

Further reading

What Americans Really Think About Abortion: Sometimes Startling Poll Results as Supreme Court Overturns Roe V. Wade (Forbes)

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