A state court ruling on IVF is echoing far beyond Alabama

The Alabama Supreme Court's ruling that embryos frozen in test tubes should be considered children has sent shockwaves through the world of reproductive medicine, casting doubt on fertility care for expectant parents in the state and raising complex legal questions involving implications that extend far beyond Alabama. .

White House press secretary Karine Jean-Pierre said Tuesday that the ruling would create “exactly the kind of chaos we expected when the Supreme Court overturned Roe v. Wade and cleared the way for politicians to dictate some of the most personal matters.” . decisions families can make.”

Speaking to reporters aboard Air Force One as President Biden traveled to California, Ms. Jean-Pierre reiterated the Biden administration's call for Congress to codify Roe v. Wade's protections into federal law.

“As a reminder, this is the same state whose attorney general threatened to prosecute people who help women leave the state to seek the care they need,” she said, referring to Alabama, which began enforcing it in June 2022 of a total abortion ban.

The judges have made the ruling Friday in appeals filed by couples whose embryos were destroyed in 2020, when a hospital patient removed frozen embryos from liquid nitrogen tanks in Mobile and dropped them on the ground.

Citing anti-abortion language in the state constitution, the majority of justices said an 1872 statute allowing parents to sue for the wrongful death of a minor child applies to unborn children, with no exception to “ectopic children.” .

“Even before birth, all men have the image of God, and their lives cannot be destroyed without effacing his glory,” Chief Justice Tom Parker wrote in a concurring opinion, citing the Bible.

Infertility specialists and legal experts said the ruling had potentially profound implications that should be of concern to every American who may need access to reproductive services such as in vitro fertilization.

One in six families struggles with infertility, according to Barbara Collura, the president and CEO of Resolve, which represents the interests of infertility patients.

“You have changed the status of a microscopic group of cells into a person or a child,” Ms. Collura said. “They didn't say that in vitro fertilization is illegal, and they didn't say that you can't freeze embryos. It's even worse: there is no road map.”

It has become standard medical protocol during in vitro fertilization to extract as many eggs as possible from a woman and then fertilize them to create embryos before freezing them. Generally, only one embryo is transferred to the uterus at a time to maximize the chances of successful implantation and a full-term pregnancy.

“But what if we can't freeze them?” asked Mrs. Collura. “Are we going to hold people criminally liable because you cannot freeze a 'person'? This raises so many questions.”

Reproductive medicine scientists also rejected the ruling, saying it was a “medically and scientifically unfounded decision.”

“The court ruled that a fertilized frozen egg in a fertility clinic freezer should be treated as the legal equivalent of an actual child or a fetus gestating in utero,” said Dr. Paula Amato, president of the American Society for Reproductive Medicine.

“Science and everyday common sense tell us this is not the case,” she said. Even in the natural world, she added, multiple eggs are often fertilized before one is successfully implanted in the uterus and leads to a pregnancy.

Dr. Amato predicted that in the wake of the ruling, young doctors would stop going to Alabama to train or practice medicine, and that doctors would close fertility clinics in the state if their operations were at risk of prosecution with civil or criminal charges. cost.

“Modern fertility care will not be available to the people of Alabama,” predicted Dr. Amato.

Couples in the midst of grueling and costly infertility treatments in Alabama said they were overwhelmed with questions and concerns, and some said they feared their providers would be forced to close their clinics.

Megan Legerski, 37, of Tuscaloosa, Alabama, who is currently undergoing infertility treatment, said she recently became pregnant after receiving an embryo created through in vitro fertilization, but suffered a miscarriage at eight weeks.

She and her partner still have three frozen embryos they can implant, she said.

“For me, the embryos are our best chance at having children, and we are extremely hopeful,” Ms. Legerski said. “But to me, having three embryos in the freezer is not the same as having an embryo that implants and becomes pregnant, and it is not the same as having a child.

“We have three embryos. We don't have three children.”

Katie Rogers contributed reporting from Washington.