Frozen embryos are now considered children under Alabama state law, a decision that could have far-reaching implications for people seeking medical treatments in order to conceive.
Even though the Alabama Supreme Court ruling does not affect other states, it has shaken up the world of reproductive care providers, including those in Vermont.
“I never thought I’d see the day,” said Dr. Peter Casson, a reproductive endocrinologist at Northeastern Reproductive Medicine in Colchester. “We’re all kind of gobsmacked.”
Alabama’s ruling will have no effect on reproductive care in Vermont. But due to the nature of how in vitro fertilization (IVF) works, some reproductive health care providers in Vermont have begun fielding questions from concerned patients.
During an IVF cycle, a woman takes hormones to produce additional eggs. A doctor retrieves as many eggs as possible, then injects them with sperm in a lab to create embryos.
An IVF cycle can produce several embryos. Typically, one embryo will be implanted at a time, and the remaining ones are frozen and held at a storage facility for potential future use. That facility is typically in the patient’s home state.
The only reason embryos from Vermont would be in Alabama, Casson explained, is if a Vermonter undergoing fertility treatments were to move to Alabama.
Kate Weldon LeBlanc still thinks the ruling could have an effect on out-of-staters. “There are people who might now be in Vermont who have embryos stored in Alabama,” she explained.
LeBlanc is the executive director of Resolve New England, a nonprofit that supports people with family building challenges and advocates for abortion access and other types of reproductive health care.
She cited an example of a couple who lives in Alabama but has embryos stored in Massachusetts, because that’s where they started their fertility treatments. “Their clinical teams in Massachusetts are saying, keep them here,” she said.
Resolve New England supports a pair of fertility insurance bills introduced in Vermont’s House and Senate that would require private and public insurance carriers to cover the cost of fertility treatment. The cost of an IVF cycle and genetic testing of embryos can quickly exceed tens of thousands of dollars.
“That’s part of what's been so challenging,” LeBlanc said. Instead of focusing on expanding access to reproductive care, her team has had to shift part of its focus towards protecting some of those rights.
Monday’s ruling is a major win for the fetal personhood movement, which seeks to legally recognize any fertilized embryo as a person.
“It saddens me that the politicization and unsubtle politician responses to nuanced private medical issues is making it harder for our neighbors to access needed care,” said Dr. Tim Lahey, the medical ethics director at the University of Vermont Medical Center.
Vermont is home to just a handful of reproductive care clinics, including Northeastern Reproductive Medicine in Colchester and the University of Vermont Medical Center’s Reproductive Medicine and Infertility Center in Burlington. Private clinics and hospital affiliated programs rely on the cash flow from IVF to be financially successful.
The field of reproductive endocrinology is relatively small and close-knit, and many Vermont providers know people who practice in Alabama. They worry for their colleagues and their patients.
Casson has been practicing reproductive endocrinology since 1990 and knows many Alabama reproductive endocrinologists. He’s concerned that the ruling will have a chilling effect on their practices.
At least three IVF providers in Alabama have already stopped providing treatments since the ruling.
“I'm sure that others will follow suit soon,” Casson said, “to avoid medical legal liability, and under pressure from their malpractice carrier.”
“I suspect IVF, including frozen embryo transfers, will stop happening in Alabama fairly soon.”
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