In 2020, a hospital patient in Alabama wandered into a storage room, removed embryos from tanks of liquid nitrogen, and dropped them on the floor. Couples sued over wrongful death.
In February, the Alabama Supreme Court sided with the couples, ruling that the frozen embryos could legally be considered children.
“Even before birth, all human beings have the image of God, and their lives cannot be destroyed without effacing his glory,” Chief Justice Tom Parker wrote in a concurring opinion.
The ruling not only created chaos for the state’s fertility doctors — it kicked off a national debate over access to IVF.
The treatment helps women get pregnant by combining eggs and sperm in a lab setting. The goal is to create multiple embryos, with the hope of creating just one successful pregnancy. The rest might be thrown away or stored for future use.
But in a world without the protections afforded by Roe v. Wade, many fear “fetal personhood” laws, which give fetuses and potentially embryos the legal rights of a person, could complicate the IVF process for patients by raising the question: does throwing away excess embryos constitute murder?
Solutions like making one embryo at a time, for example, won’t work, Leslie Schrock, an investor, author, and fertility expert, told BI in an interview. IVF requires making several embryos at once, as it mimics the very inefficiency that takes place naturally in our own bodies.
Natural human biology isn’t perfect
Last week, Senate Republicans voted against a bill that would protect IVF access. At the same time, Southern Baptists, at their national conference, voted to oppose the use of IVF, but the resolution didn’t explicitly oppose the creation of embryos that way — just their destruction.
All of these organizations have signaled that they believe life begins when “sperm meets egg,” Schrock said. If you look at IVF through that lens alone, you would naturally believe that discarding embryos isn’t okay. “There’s no way around that,” she said.
But our natural biology discards embryos all the time.
Most embryos conceived naturally don’t survive in the human body. Among those that become successful pregnancies, one in four end in miscarriage.
“The biology of creating humans is fundamentally flawed,” Schrock said. “It’s not perfect. It’s not like every time a sperm and egg meets, you get a viable pregnancy, much less a live birth.”
IVF mimics this natural funnel. Not every fertilized egg will turn into an embryo; not every embryo will show up normal in genetic testing; and even the embryos that make it that far don’t always transfer into the uterus successfully, Schrock said.
Making one embryo at a time would decrease success rates, extend wait times, and put further demands on IVF’s lab workers, which are already in short supply, per Schrock and BI’s reporting.
“There’s a lot of loss along the way,” she said. “It’s not purposeful loss, it’s not wasteful, it’s not on purpose.”
People aren’t really choosing IVF
In the US, the treatment, which usually isn’t covered by insurance, costs more than a Toyota Corolla. Meaning most IVF patients are either wealthy or taking out loans. (Yes, we live in a society in which your ability to have a baby can depend on your credit score.)
Women usually have to undergo two or three cycles to become pregnant, extending the financial and emotional costs of being a fertility patient.
Conservative groups can misunderstand that people who take this treatment on, per Schrock, are doing so because it’s medically necessary to start a family — not because they want to.
Schrock herself nearly pursued IVF after suffering a miscarriage and medically necessary abortion. In the latter case, the fetus had stopped growing at around twelve weeks. At that point, she hadn’t had children yet, and the choice — or lack thereof, rather — blew her mind.
“It was not something I wanted, it was not something I had ever even imagined was possible, and it was the hardest experience of my life,” she said. “It’s still visceral to this day, but medically speaking, I didn’t have another option.”
Deeply personal challenges are often where the IVF journey begins — and, sadly, ends.
Earlier this year, one patient, who asked not to be named, described her experience with fertility care to BI as a never-ending series of arbitrary choices, marked by a miscarriage and the end of her relationship.
“People don’t just go into the process because it’s fun,” Schrock told BI, adding: “It’s hard, it’s disruptive, it’s emotional. It is painful in many cases. And it does not always end with a healthy pregnancy.”
Schrock, who has written about her experiences in books, felt shame for years, wondering where she went wrong.
“But you know what, it’s just biology at the end of the day,” she said. “It’s taken me years to get to that. But it wasn’t my fault, though. It wasn’t my fault that it happened.”
