Alabama lawmakers on Wednesday passed a bill protecting access to in vitro fertilization (IVF). The measure came two weeks after the state Supreme Court ruled that frozen embryos should be considered unborn children under the law. Three fertility clinics had suspended treatments, citing liability concerns. Would-be parents were caught in limbo.
The court decision, disruptive as it was, stemmed from a tragic case. In 2020, the embryos of three families seeking IVF were accidentally destroyed by a patient who had wandered into an unsecured storage area. The families sued the fertility center under the state’s Wrongful Death of a Minor Act and won on appeal.
The new law, which passed almost unanimously, does not reverse that ruling. Rather, by protecting doctors and people from civil and criminal liability, it allows IVF treatments to continue.
Swift bipartisan legislation on such a divisive issue is encouraging, but Alabama’s work is far from complete. The law expires next year, and it fails to reckon with the larger question of whether IVF can be consistent with the idea that life begins at conception, a position established by law in Alabama and other states. A legal framework that provides more clarity is necessary.
IVF treatment began in the 1970s and has resulted in hundreds of thousands of births in the US. It requires a combination of medication and surgery to extract eggs from a woman’s body, which are then fertilized with sperm in a lab. The fertilized egg becomes a pregnancy when it attaches to the walls of a uterus.
IVF success rates are unpredictable. To improve their chances, many people go through multiple rounds of invasive and at times painful treatment to retrieve as many eggs as possible. Unused embryos are frozen for future use.
With the cost of each round of treatment exceeding US$15,000, IVF is often a last resort for people who struggle to conceive. It is also sought by people with serious medical conditions that could imperil the mother or fetus.
The procedure is not without ethical challenges. Opinions vary about what is to be done with unused embryos, which in the US number about 1.5 million. Some are donated to other parents or scientific research, while others are kept frozen in storage and still others are discarded. That has led to opposition by some who believe life begins at conception, despite support for fertility treatment more broadly.
Ballot measures to establish fetal personhood have been repeatedly rejected, and voters overwhelmingly support IVF. More than a dozen states nonetheless have enacted or introduced legislation granting legal rights to fertilized embryos, which could affect access to IVF treatment.
Legislators in these states must work together to set reasonable terms. They should start by making protections from legal liability permanent. They should also consider expanding insurance coverage to include IVF, which is strictly limited in Alabama.
Doing so could help limit the number of unused embryos by lowering the out-of-pocket cost for each treatment and dampening the incentive to retrieve many more embryos than a patient could reasonably implant.
Germany, for example, caps treatments to three embryos per cycle. This works in part because its health system is more generous. Better oversight of IVF clinics, including stricter security and storage requirements, could prevent lapses like the one in Alabama.
IVF is a critical fertility treatment, and protecting it would require bipartisanship. Ideally, the US Congress would codify protections for it nationwide. For now, Alabama’s lawmakers have taken an important step forward. For the good of people across the nation desperate to conceive, such pragmatism must continue to prevail.
The Editorial Board publishes the views of the editors across a range of national and global affairs.
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