The overturning of Roe v. Wade has threatened access to
Over the past 30 years, one million babies have been born in the U.S. with the help of fertility treatments like in vitro fertilization, and that number is only expected to grow. According to the CDC, 6.1 million women struggle to get or stay pregnant, and this doesn’t account for the hundreds of thousands of queer couples hoping to expand their families.
Yet, the Supreme Court's decision to revoke the nation's right to abortions may harm those who want to grow their families, says Dr. Jane Frederick, a reproductive endocrinologist, infertility specialist and medical director at HRC Fertility Clinic in Newport Beach, California. She has helped bring about 2,000 babies into the world throughout her career.
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“We know that abortion is intended to end a pregnancy, whereas IVF is used to bring about a pregnancy, but I think that legal protections for both are threatened now,” says Dr. Frederick. “The whole framework that gives rise to reproductive and sexual privacy may be at risk because of this ruling.”
Dr. Frederick points out that many states that oppose abortion have defined life as beginning at fertilization — meaning that the fertilized eggs created in the process of IVF are supposed to have the same rights as a human being. States like Ohio, Nebraska, Louisiana and Oklahoma have passed or debated legislation that gives life and legal status beginning at fertilization, a big cause for concern for fertility healthcare providers.
“If you’re in Nebraska, and you have embryos in the freezer, what happens when we thaw the embryos and they don't survive?” asks Dr. Frederick. “Is that considered homicide?”
While over 95% of embryos survive the thawing process, according to Johns Hopkins Medicine, there will still be a minority that will not. If a state considers an embryo to be legally a person, this means fertility doctors are committing a crime by helping a person become pregnant.
Dr. Frederick does not consider an embryo on its own as a viable pregnancy, let alone a person; freezing embryos are an essential step in the IVF process, and once thawed, the embryos can be safely implanted into the uterus. She even screens embryos for diseases that the parents would not wish to pass on to their children or that could cause harm to the child-bearing person.
Dr. Frederick underlines that her goal is to help families choose when and how they want to grow. But the Roe v. Wade decision discourages, if not prohibits, agency for families.
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“The moral issue here is the question of when does life begin?” she says. “As someone providing fertility services, I just can't say life begins at fertilization. That's not fair.”
Dr. Frederick questions what will happen to the embryos she cannot transfer to the individual who wishes to become pregnant. Will the embryos have to remain frozen indefinitely, at the cost of patients? Could the very act of freezing embryos be considered child abuse? Dr. Frederick says she and her peers have been grappling with these complex issues while still working in the best interest of their patients.
“People who are providing fertility services don't want to be a test case and violate the law by putting a so-called ‘person’ into a liquid tank of nitrogen,” says Dr. Frederick. “We're helping to produce a pregnancy for patients that struggled to have a child.”
The overturning of Roe v. Wade seems to be the first domino down in restricting a line of rights granted to Americans who wish to build a family with who and how they want. Supreme Court Justice Clarence Thomas has stated that landmark court rulings that gave the right to engage in private sexual acts, same-sex marriage and access to contraceptives should all be reconsidered.
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Still, President Joe Biden is attempting to address the loss of Roe v. Wade. Just last week, the Biden administration told hospitals that under the Emergency Medical Treatment and Labor Act, providers have to perform abortion services if the life of the mother is at risk. The Emergency Medical Treatment and Labor Act should override state laws that have banned abortions with no exceptions.
But Dr. Frederick calls on the federal government to do more to protect reproductive care, from ensuring nationwide access to emergency contraception through the postal service to enacting legislation that specifically grants LGBTQ-identifying individuals sexual and bodily autonomy.
“It seems like the infertility world is the collateral damage to these abortion state laws,” says Dr. Frederick. “But this is a decision between the patient and her physician. There shouldn’t be government intrusion into the medical exam room. It's really not about that. This is about what's best for that patient.”
