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Alabama Supreme Court threatens future of IVF treatment in the US

Amidst the evolving landscape of reproductive rights, a recent ruling by the Alabama Supreme Court has thrust the practice of IVF into the spotlight, prompting widespread concern and debate over its implications for fertility treatment nationwide.

In Vitro Fertilization (IVF) is a widely used fertility treatment that helps individuals or couples conceive a child.

The process involves stimulating the ovaries to produce multiple eggs, retrieving the eggs, fertilizing them with sperm in a laboratory, and transferring one or more fertilized eggs (embryos) to the uterus.

The global use of IVF has seen a steady rise, reflecting its widespread acceptance and effectiveness in addressing various causes of infertility.

The availability and accessibility of IVF has expanded, making it a widely sought-after option for those navigating the complexities of infertility. Over 10 million babies have been born worldwide through IVF since its inception over four decades ago.

However, a recent Alabama Supreme Court ruling, stating that frozen embryos are to be legally considered children, has sent shockwaves through the realm of fertility treatments, particularly impacting IVF procedures.

This decision, rooted in Alabama statute and its constitution, has raised concerns about the future of IVF treatments in the state and beyond.


Details of the lawsuit

The case stems from three couples who underwent IVF treatment at a fertility clinic in Alabama. All three, thanks to the treatment received, managed to conceive and give birth to healthy babies.

The IVF procedure requires additional embryos to be produced as some eggs may not develop or fertilize well after they’re combined with the sperm. Hence, these additional embryos that are not used are frozen and preserved by the fertility clinic. Nevertheless, when the patient has no need for the embryos or if it presents with genetic abnormalities, it is discarded.

In the context of this lawsuit, the couple’s embryos had been cryogenically preserved at the fertility clinic. However, in late 2020, a patient of the hospital where the clinic is located opened the tanks where the embryos were stored.

Due to the sub-freezing temperatures, a patient burned themselves upon failing to take safety precautions during collection and ultimately dropped the embryos, destroying them.

Out of the two lawsuits filed, the one that created a major storm lamented the hospital and clinic citing the ‘Wrongful Death of a Minor Act’, which was initially dismissed at the trial court.

Unsatisfied, the couples appealed to the Supreme Court of Alabama which ruled otherwise, stating that the Act ‘includes unborn children who are not located in utero at the time they are killed’.

Shortly after the ruling, out of eight of the main fertility clinics in Alabama, three decided to halt IVF treatments including the state’s largest hospital, the University of Alabama at Birmingham.


Implications of the ruling

Essentially, the court has ruled that frozen embryos created during fertility treatments should be considered children under state law. The decision that was based on the aforementioned Act dates back to 1872, making it the first time that the statute included an embryo existing in a lab.

This has significant implications for the availability and cost of fertility treatments in Alabama, as well as the Assisted Reproductive Technology (ART) industry.

Other Alabama IVF providers have stated they will continue to provide services, but plan to take certain precautions, such as modifying their consent forms to make patients aware of the potential implications of the Alabama Supreme Court’s ruling.

Such decisions make it increasingly difficult for those who suffer from infertility to start a family of their own. Traveling across state lines is not a viable solution for many patients due to medical complexity – the requirement to remain close to their medical team for specialized care, and cost.

Additionally, reproductive healthcare providers and patients are left wondering if legal charges could be brought if an implanted embryo fails.

It is vital to note that the ruling’s implications extend beyond Alabama, potentially influencing IVF practices and regulations in other states. The decision could set a precedent that impacts how IVF clinics operate nationwide, affecting the rights and choices of those undergoing fertility treatments.


The picture of IVF in the US

To add to that, about 11% of women and 9% of men of childbearing age have infertility, with up to 15% of couples being impacted. Additionally, an estimated 1-2% of all US births per year are attributed to IVF.

After the ruling was made, a poll revealed that 66% of Americans opposed the Alabama Supreme Court’s decision. ART refers to the various medical procedures and treatments used to help people with fertility issues conceive a child, with the most common type of this technology being IVF.

After Roe v Wade was overturned, access to fertility care and treatments in the US has become increasingly complex and uncertain.

The legal landscape post-Roe v. Wade has led to a patchwork of laws across different states, with some enacting laws that protect abortion access and others imposing restrictions that make it challenging for patients to access treatments, including IVF.

The continued disparity in laws and access is likely to exacerbate healthcare divides across the country. Time will tell if the Alabama case muddies the waters even further.

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