Em-URGE-ing Voices

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IVF and Conceptions of Choice

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April 18, 2024

“Olivia, according to your test results and symptoms, I do believe you have Polycystic Ovary Syndrome.” There I was, a sophomore in college having gained over 50 pounds in eight months and no menstrual cycle to be found, wondering what this meant for my future. Will I ever have a regular cycle again? How hard will it be for me to lose weight? What about my chronic pain? I was then given a list of medications and supplements to become familiar with if I wanted my body to reach peak fertility. “For your 25th birthday, I’ll pay for you to freeze your eggs!’ My mother exclaimed to me, in an attempt to lift my spirits. Rolling my eyes, I replied “Thanks” with the thought that I may actually have to take her up on that offer in a few years.

Since that time, the political climate concerning reproductive rights has shifted drastically following the 2022 Dobbs decision. Many believed that the Dobbs decision only impacted abortion services but with healthcare is politicized, the impact on the legal and healthcare systems is much greater. Overturning Roe v. Wade furthered the erosion of reproductive freedoms, cultivating a landscape where anti-abortion activists could push for additional restrictions on contraception, fertility treatments, and other reproductive healthcare services. Due to the newfound lack of federal protections for reproductive rights, the state of reproductive healthcare has been left up to individual states, leading to varying levels of access across the country. 

The legal rights of embryos was first established through the first Human Life Amendment to the Constitution in 1973. “Fetal personhood” is a legal concept asserting that  fetuses possess the same legal rights and protections as a born individual. In this framework, the termination of a pregnancy can be legally made equivalent to taking a human life in the eyes of the state. Anti-abortion activists often use fetal personhood, along with the biblical narrative of personhood beginning at conception to support their beliefs in the need for legal and political intervention. A 2022 survey by the Pew Research Center declared that 56% of Americans believe that “human life begins at conception, so a fetus is a person with rights”, supporting that fetuses are considered children. 

The legal personhood ascribed to fetuses has been used in recent years to villainize the practice of in vitro fertilization (IVF). IVF is the process of joining an egg and sperm cell to create an embryo outside of the human body. The implications of affording embryos and fetuses legal protections becomes clear in this context, employing the possibility of legal strife during the IVF process given that U.S. Constitutional rights become applicable to embryos.

In 2018, Alabama voters amended the state constitution to ensure the rights of an unborn child would be protected, granting fetal personhood. Six years later, this amendment was used in an Alabama Supreme Court ruling, stating that embryos created through in vitro fertilization are considered children, complicating the difficult process beyond measure.

In the IVF process, embryos are often discarded for various reasons such as genetic abnormalities, or if a patient decides the fertilized embryos are no longer needed. This ruling hinges on the Wrongful Death Act, creating monetary penalties for the destruction of an embryo, which is common in the world of IVF. The Supreme Court’s decision was ruled in a case where a patient mishandled embryos from storage, and they were dropped on the floor, resulting in the death of the embryos. This has in turn caused health care professionals in the state of Alabama to halt IVF services while navigating the political field. This decision also raises legal questions for prospective parents about the storing of IVF embryos, which is already an expensive procedure and process. Accompanying the recent criminalization of abortion and even miscarriages, birthing people and their partners are placed within a reproductive limbo, in which rights are endangered, even while trying to produce a life.

Given the nature of the ruling, the hostile landscape places providers in a position of uncertainty. Practitioners are penalized for performing abortions, but they also could face a penalty for providing reproductive care to prospective parents.

I am now 22, and although I am not ready to start a family yet, I am a person with a reproductive disorder. Along with preparing my body for the possibility of conception and pregnancy, I also am plagued with the stress of the ethical, legal and political implications of my mother’s previous offer of paying to freeze my eggs. An offer of love turned criminalized in a matter of months. 

In this hostile landscape, where providers face penalties for both providing and withholding reproductive care, the fundamental right to family planning is under threat. As we grapple with the implications of this ruling, it is crucial to advocate for the rights and autonomy of individuals and couples seeking to build their families, free from legal jeopardy. Ultimately, the question remains of: What does this mean for those who simply wish to have children and expand their families?