IVF Under Fire - Examining the Latest Front in Reproductive Health Debates
H. Duncan is a writer and copy editor of THE REPRODUCTIVE TIMES
September 4, 2024. Revised from the CHR VOICE.
BRIEFING: In the U.S., IVF access is increasingly seen as the next battle in the culture wars regarding reproductive rights. So-called “fetal personhood laws” raise worrying questions about access to fertility treatments. In this election year, both major political parties are scrambling to respond to the spotlight on IVF, a procedure largely supported by the American public.
In February, the Alabama Supreme Court ruled that frozen embryos are considered persons with a constitutional right to life. The case in question was brought by parents whose embryos created through IVF at a reproductive medicine center were accidentally destroyed; in its decision, the Court cited the state’s 2018 constitutional amendment affirming the rights of “unborn children.”
The decision sparked a nationwide outcry and prompted IVF clinics in the state to close, leaving couples undergoing fertility treatment in limbo; the following month, the Alabama legislature passed a law instituting protections to ensure clinics could resume operations without fear of liability. The ruling and the backlash against it thrust the practice of IVF, increasingly used by people experiencing fertility challenges, into the national spotlight in an election year in which reproductive freedoms remain a hot-button issue after the 2022 fall of Roe v. Wade and the legal ramifications of “fetal personhood” are under more and more scrutiny.
Since the first birth of an IVF-conceived baby in 1978, the procedure has brought more than ten million children into the world, and today it accounts for about two percent of U.S. births. As more and more women delay childbirth, IVF is a vital tool, and one generally viewed favorably: according to Pew Research Center, more than 4 in 10 adults say they’ve used fertility services or personally know someone who has, and a majority believe fertility treatment should be covered by insurance. Another poll found that more than sixty percent of Americans support protecting IVF access.
At the heart of the conservative push against IVF lies the destruction of embryos that’s inherent to the procedure: it usually takes multiple embryos before achieving a successful pregnancy, and the unused embryos are most often discarded. This is where the notions of fetal and embryonic personhood come into play: According to a 2023 report by advocacy group Pregnancy Justice, which sounds the alarm that “fetal personhood” is no longer a fringe idea, “at least 11 states have extremely broad personhood language that could be read to affect all state law” in conveying rights to embryos or fetuses.
Though most Americans support IVF, and voters often reject new fetal personhood ballot measures, there is still ambivalence. In June, the 13-million-member Southern Baptist Convention, considered “a bellwether of American evangelicalism,” voted to condemn the practice of IVF. During debates on the resolution, many members acknowledged the pain and struggle of those facing infertility, but maintained that they could not condone what they saw as the destruction of human life.
This points to an important contradiction at the heart of the matter: As The Economist journalist Sacha Nauta has noted, “Over 8 in 10 Americans think IVF is morally acceptable, but only about half of Americans think it is morally acceptable to destroy these excess embryos. So that’s an inconsistent view”.
A few salient points help put today’s debates over IVF into context and illuminate whether Americans seeking the treatment should fear restrictions.
First, political views about the use of embryos have been affecting IVF for decades, starting with the sphere of research. Since 1996, a federal appropriations amendment signed into law by President Bill Clinton has banned federal funding from being used for human embryo experimentation.
As noted by a Medical News Today special report, “a convoluted state-by-state system means that embryo research is only legal in five states and ‘vaguely’ legal in another 13”; as well, less than three percent of unused frozen embryos sitting in storage throughout the country are available for research, hampering the progress that could be made on the procedure with more widespread access to embryos.
Second, Republicans are distancing themselves from backlash to anti-IVF measures. Republican Presidential nominee Donald Trump, after the Alabama ruling, said he supports IVF. His running mate, Senator J.D. Vance, a conservative on issues of reproductive rights, voted against the federal Right to IVF Act in June, but in the wake of increased attention to his pronatalist viewpoints and verbal attacks on childless women, he has attempted to clarify that he supports fertility treatments despite his vote.
The Republican Party platform is murky on the issue. It calls for “supporting mothers and policies that advance Prenatal Care, access to Birth Control, and IVF (fertility treatments)”, yet it endorses that states can use the 14th Amendment to ensure fetal personhood—another contradictory position given that the notion of fetal personhood is incompatible with the practice of IVF. Likewise, Project 2025, a policy handbook for the Republican Party that was written by the conservative Heritage Foundation and is seen as a right-wing wish list for a second Trump term, does not call for restrictions to IVF but contains language supportive of human rights beginning at conception. (The Trump campaign has disavowed Project 2025.)
Democrats are seizing the moment to capitalize on the growing alarm over anti-IVF rhetoric and restrictions to women’s rights more broadly. President Biden, when still campaigning for re-election, released a campaign ad featuring an infertility patient stating that “Thanks to Donald Trump, IVF is now at risk.” Now the Democratic Presidential nominee, Vice President Kamala Harris–long a vocal advocate for reproductive rights–has become outspoken about protecting IVF access, slamming the Alabama ruling, issuing a campaign statement on World IVF Day in July and inviting an Alabama IVF patient to share her experiences at the White House. And Democratic elected officials themselves are sharing their personal stories of relying on IVF. Harris’s running mate, Minnesota Governor Tim Walz, has spoken about using IVF to build his family, and Arizona Senator Mark Kelly penned a People Magazine op-ed on the topic with his wife, former U.S. Representative Gabby Giffords.
Finally, even without the vicissitudes of the national political theater, access to IVF is already uneven. The high cost of IVF and widespread lack of health insurance coverage for the procedure is an existing barrier for many Americans, with more and more patients resorting to going abroad for cheaper treatment (see our article on Inequality in IVF Coverage). It is clear that in some regards, Americans’ access to IVF could begin to mirror abortion access, in that it may come to depend on the laws of the state one lives in and how much money one has to pursue the procedure.
The extent to which the political climate could further erode Americans’ access to IVF remains to be seen, and will depend upon the decisions of courts, the results of the November elections, and the efforts of advocates to position IVF as an essential family-building tool.
Cover Image Credit: Tim Walz Agrees to Debate J.D. Vance: 'If He Shows Up' (rollingstone.com)