The recent overturning of Roe v. Wade by the Supreme Court threatens the ability to access the treatments people need to build their families.
As physicians, we see the toll of infertility on our patients and our colleagues. As female physicians, we also know it firsthand. Both of us delayed childbearing until after we finished our medical training, and that delay left us suffering from infertility. One of us, with the help of fertility treatments for nearly a decade, has given birth to two children. The other one will need similar treatments to be able to bear her own child.
We have previously asserted everyone should have access to abortion, and we recognize the recent overturning of Roe v. Wade by the Supreme Court threatens the ability to access the treatments people need to build their families.
Infertility Is Common
An estimated one in four women physicians is, like us, at risk of being involuntarily childless due to infertility. The recent overturning of Roe v. Wade by the Supreme Court threatens our ability to access the treatments we need to build our families.
It’s not just doctors who struggle with infertility. Recent estimates suggest 1.9 percent of babies born in the United States are the result of fertility treatments together referred to as assisted reproductive technologies, ART. Indeed, ART is so common that one-third of Americans have either used fertility treatments or know someone who has.
The Threat to IVF Is Real
The threat to IVF is not in some imaginary future; it is here today due to the most conservative Supreme Court in decades. Justice Amy Coney Barrett, the last justice to have been confirmed, has previously signed an ad taken out by St. Joseph County Right to Life, a group that believes life begins at fertilization. The group’s executive director, Jackie Appleman, told The Guardian that discarding embryos during the process of IVF, one of the most common types of ART, was considered abortion.
Furthermore, the group favors the criminalization of doctors who support this type of “abortion” whether an embryo is lost after implantation or is not used for other reasons. This has obvious devastating implications for fertility specialists and anyone with frozen embryos currently in storage.
IVF Success Depends on Abortion Access
One may suggest the solution would be to create fewer embryos, but unfortunately the process of IVF is imprecise. As many eggs as possible are retrieved, and they are exposed to sperm in an effort to make as many embryos as possible. This is an important point. One of the reasons people may need IVF is due to advanced age, in which case the quality of the eggs used for IVF may be suboptimal. In other words, not every embryo generated from IVF will develop into a healthy baby that can survive outside the uterus. Thus, a greater number of embryos is more likely to lead to the desired outcome: a live birth.
Not every embryo generated from IVF will develop into a healthy baby that can survive outside the uterus.
After embryos are made, a decision has to be made about which ones to transfer to the potential mother or gestational carrier’s uterus in the hopes that it will implant and grow. To increase the chances of a successful pregnancy and to reduce risks to the potential recipient, fertility doctors advise implanting the embryos of the highest egg quality and, in some cases, those confirmed to have the correct number of chromosomes. Even with this approach, genetic abnormalities can arise. Sometimes an embryo that has grown inside the uterus may stop growing due to a fatal genetic error. This is devastating for those who are trying to get pregnant. And with the fall of the precedent set by Roe v. Wade, it now poses an ethical dilemma in some states. This potentially life-threatening situation can only be treated with an abortion, but patients and their healthcare team are at risk for being prosecuted for choosing to save the pregnant person’s life.
Criminalizing Abortion Threatens IVF
If physicians are criminalized for discarding embryos or being involved in the care of someone who has a miscarriage, fertility doctors will no longer be able to support people building their families using ART. If that were the case, the 81,000 babies born via ART in the United States in 2018 would never have been born.
If physicians are criminalized for discarding embryos or being involved in the care of someone who has a miscarriage, fertility doctors will no longer be able to support people building their families.
Imagine a world in which people who are unable to conceive children naturally are told they can never have their own biological children. In this world, same-sex couples could never pass their genes on to their children. It is cruel to deny people access to ART which has brought the joy of parenthood to millions of people since its inception. Adoption is, of course, another way to grow a family, but it is not without its own problems. It’s also not the solution, as some have suggested, to infertility.
It is worth noting that when Justice Amy Coney Barrett was asked specifically during her confirmation hearings whether she thought IVF should be criminalized, she refused to answer. This is the reason that the academic journal, Fertility and Sterility, which serves ART doctors and has never made a statement regarding Supreme Court Justices, took a stand opposing Barrett’s nomination.
As doctors and longtime patients of fertility doctors, we believe in science, and we believe everyone deserves a chance at having the family they want. We hope you do, too—and that you’ll write or call your members of Congress to ask them to protect abortion and fertility treatments federally before it’s too late.
Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.
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