From left to right: Cody Carnley of Crenshaw County, Alabama; Carrie McNair of Mobile; Veronica Wehby-Upchurch of Birmingham and Lindsey Shaw of Birmingham hold signs at a rally in support of legislation to protect in vitro fertilization on Feb. 28, 2024 in Montgomery, Alabama. (Brian Lyman/Alabama Reflector)
When I drove to Montgomery a year ago to join other fertility patients, doctors, and advocates at the Alabama Statehouse fighting to protect in vitro fertilization, I first stopped at my fertility clinic to track the progress of my miscarriage.
As I sat in cramped offices listening to my state lawmakers, who ranged from kind to clueless to condescending, my thoughts drifted to the fading embryo inside me. The Alabama Supreme Court had just ruled that frozen embryos are children in the eyes of the law, shutting down nearly all IVF services in the state. I wondered if the last treatment remaining to give me a child in my arms would ever again be available in Alabama.
Our legislators came through for us that day and passed Band-Aid legislation that allowed IVF to resume. However, they did not change the legal status of frozen embryos as children, and so withheld full and permanent protection for IVF, leaving families like mine in uncertainty for over a year.
There has since been discussion of “regulating” IVF. Proposals include limiting the number of eggs retrieved or embryos created. Regulations like these would have tragic consequences for IVF patients in Alabama, forcing their doctors to deviate from the standard of care and increasing the number of IVF cycles required to take home a baby, at great physical, emotional, and financial cost to women and their families.
Currently, even one IVF cycle costs $15,000 to $30,000; is not typically covered by Alabama employers’ health insurance policies; may require multiple days off from work, and carries a heavy emotional burden. Increasing the number of IVF cycles a family has to go through will make this miraculous treatment practically less accessible in our state, even if it remains nominally available.
Suggested regulations like these rely on a happy fantasy: every egg will be fertilized successfully, every embryo will grow into a successfully implanted blastocyst, and every pregnancy will come to a joyful end with a cuddly, chubby-cheeked baby in the arms of its proud parents. The reality, however, is that human reproduction is a tragically imperfect process. Even in the general population, 1 in 5 known pregnancies, and up to 30% of all pregnancies, ends in miscarriage.
For IVF patients, the rate of a live birth from a single embryo transfer can range from under 10% to 50%, depending on factors including the patient’s age and whether they used genetic testing to identify the embryos most likely to succeed.
In my own case, my first egg retrieval resulted in 18 eggs but only one embryo. Receiving that call from my doctor was one of the most devastating moments of my life. I have been pregnant three times, and two of those pregnancies ended in miscarriage. My journey has been relatively short and easy compared with others I’ve met along the way. No one wishes frozen embryos were children more than fertility patients. But we know from bitter experience that they are not.
This week, I am returning to the Alabama Statehouse, seven months pregnant thanks to IVF. Along with other advocates, I will be thanking my legislators for the start they made to protecting IVF families last year, and asking them to extend full and permanent protection for IVF in our state by leaving treatment decisions to the doctors and patients who understand the incredibly high and heartbreaking stakes of this process.
It is time to follow up on the promises of the last legislative session and ensure that IVF remains available and accessible to the Alabama families who need it.
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