Alabama Supreme Court IVF Ruling
On Friday, February 16, Alabama Supreme Court ruled that frozen embryos can be considered “extrauterine children,” which could change the way vitro fertilization, or IVF, is performed. The ruling came from a couple whose frozen embryos were destroyed in an accident at a fertility clinic, and the court agreed that the embryos were protected under the state’s Wrongful Death of a Minor Act. According to NPR, this raises risks and costs for not only IVF patients, but medical practitioners as well. Currently, legal consequences only impact Alabama and at least three Alabama IVF clinics have already paused treatments. Here is why the ruling could affect the future of IVF:
Each round of IVF depends on a patient’s menstrual cycle, which is why timing is crucial. A patient needs to take hormones for a ten to twelve day period, which allows eggs to mature, and then they take a different hormone that allows the eggs to be retrieved. Once the egg is fertilized and grown in a lab for three to seven days, it is implanted or frozen for future use. With the Alabama ruling, it raises the question whether the frozen embryos will have to be stored indefinitely, which decreases the chance of a patient getting pregnant.
Additionally, fertilized eggs often don’t survive in nature and the lab—it’s how fertility works naturally. There are many women every month whose fertilized eggs or embryos do not become pregnancies: the egg has to implant to continue to grow. Even in healthy, 20-something year old women, that only occurs 25 percent of the time. When eggs are fertilized in the lab, only 55 percent make it to the implanting or freezing stage—and that’s in the best IVF clinics. On the authority of the Alabama ruling, medical practitioners could now be charged for wrongful death for an embryo lost at any point during the process. According to the Centers for Disease Control and Prevention, in 2021, more than 97,000 infants born in the US were from more than 400,000 cycles of assisted reproductive technology. This new ruling severely limits the number of possible pregnancies.
Moreover, IVF can be used to avoid genetic diseases. Patients who may carry genetic diseases can choose to undergo genetic testing for embryos before they are implanted. Older patients may utilize testing as well because risk of genetic abnormality increases with age. Waiting for these results can add a substantial amount of time to a round of IVF.
Lastly, a surplus of frozen embryos reduces the costs and risks of IVF, which is why the Alabama ruling is hurtful to those who cannot reproduce naturally. With the new ruling, patients may only be able to provide one embryo at a time, and with the low-rate of survival and long process, couples may never be able to get pregnant. If couples are successful in getting pregnant, however, they might still have to pay a lifelong storage fee for embryos they aren’t allowed to discard, even if they never plan on using them.
However, there is an effort to clarify the legality of IVF treatments in the Alabama house and senate. CNN reports Alabama House Democrats introduced a bill on Thursday, February 22 that would denote fertilized eggs outside of the body to not be considered human beings under state law and Republican senators are expected to follow with similar legislation. The introduction of this protective legislation comes from medical experts’ fear of being held responsible for wrongful death. Furthermore, on Friday, February 23, former President Donald Trump said he supports IVF and that the Alabama legislature should quickly find a solution to preserve the availability of IVF in Alabama.
The ruling in Alabama could create a ripple effect, with other states attempting to codify it into law. And since the ruling does not include an interpretation of the Constitution or federal law, only an interpretation of Alabama’s own constitution, the US Supreme Court is unlikely to review it.