Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-05-20T02:43:26.425Z Has data issue: false hasContentIssue false

Where Does Life Begin? Discerning the Impact of Dobbs on Assisted Reproductive Technologies

Published online by Cambridge University Press:  13 December 2023

Judith Daar*
Affiliation:
NORTHERN KENTUCKY UNIVERSITY, HIGHLAND HEIGHTS, KY, USA.

Abstract

This article explores the impact of Dobbs on access to assisted reproductive technologies. Clinical aspects of IVF, including embryo discard and cryopreservation, preimplantation genetic testing, and selective reduction of multiple pregnancy are potentially jeopardized by a new legal landscape that protects embryos over the interest of infertility patients.

Type
Symposium Articles
Copyright
© 2023 The Author(s)

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

142 S. Ct. 2228 (2022).Google Scholar
Id. at 2242.Google Scholar
See, e.g., Editorial Board, “The Ruling Overturning Roe is an Insult to Women and the Judicial System,” New York Times, June 24, 2022; Editors, “Lawmakers v. The Scientific Realities of Human Reproduction,” New England Journal of Medicine 387 (2022): 367-368, at 367; D.S. Cohen, G. Donley, and R. Rebouché, “Rethinking Strategy After Dobbs,” Stanford Law Review 75 Online (2022).Google Scholar
Guttmacher Institute, An Overview of Abortion Laws, available at <https://www.guttmacher.org/state-policy/explore/overview-abortion-laws> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See, e.g., I.G. Cohen, J. Daar, E.Y. Adashi, “What Overturning Roe v. Wade May Mean for Assisted Reproductive Technologies in the US,” Journal of American Medical Association 328, no. 1 (2022) 15-16.Google Scholar
142 S. Ct. at 2277-78.Google Scholar
See generally, J. Daar, I.G. Cohen, S. Mohapatra, S. Suter, Reproductive Technologies and The Law (Carolina Academic Press, 3d. ed. 2022).Google Scholar
See A. Magnusson, et al., “The Number of Oocytes Retrieved During IVF: A Balance Between Efficacy and Safety,” Human Reproduction 33, no. 1 (2018) 58-64; B. McAvey, et al., “How Many Eggs Are Needed to Produce an Assisted Reproductive Technology Baby: Is More Always Better?” Fertility and Sterility 96, no. 2 (2011) 332-35.Google Scholar
See Simopoulou, M., et al., “Discarding IVF Embryos: Reporting on Global Practices,” Journal of Assisted Reproduction and Genetics 36, no. 12 (2019): 24472457 .CrossRefGoogle Scholar
See Ozgur, K., et al., “Prediction of Live Birth and Cumulative Life Birth Rates in Freeze-All-IVF Treatment in a General Population,” Journal of Assisted Reproduction and Genetics 36, no. 4 (2019): 685696 .CrossRefGoogle Scholar
See S.K. Boys and J.S. Walsh, “The Dilemma of Spare Embryos After IVF Success: Social Workers’ Role in Helping Clients Consider Disposition Options,” Advances in Social Work 18, no. 2 (2017) 583-94.Google Scholar
ASRM Center for Policy and Leadership, “States’ Abortion Laws: Potential Implications for Reproductive Medicine,” October 2022, available at <https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/dobbs/state_abortion_laws_p2_oct_22.pdf> (last visited February 8, 2023). +(last+visited+February+8,+2023).>Google Scholar
See, e.g., Ark. Act 180, SB 194 (2019) (abortion defined as termination of pregnancy); Ky. Rev. Stat. Sec. 311.772 (2019) (criminalizes activities performed on pregnant woman); Tex. HB 1280, Chap. 170A (2021) (requires intent to cause death of unborn child of pregnant woman).Google Scholar
Utah SB 174, Sec. 76-7a-101 (2020).CrossRefGoogle Scholar
142 S. Ct. at 2256.Google Scholar
Y. Lindgren, “Dobbs v. Jackson Women’s Health and the Post-Roe Landscape,” Journal of American Academy of Matrimonial Lawyers 35 (2022): 235-283.CrossRefGoogle Scholar
See The Personhood Movement, available at <https://www.propublica.org/article/the-personhood-movement-timeline> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See M. Manian, “Lessons from Personhood’s Defeat: Abortion, Restrictions and Side Effects on Women’s Health,” Ohio State Law Journal 74 (2013) 75-123. (reporting personhood laws defeated based on impacts on IVF).Google Scholar
See, e.g., Sen. Bill 1, amending Ind. Code tit. 16 art. 34 (2022)(expressly stating abortion law does not apply to IVF); Kan. Stat. Ann. Sec. 65-6703-6743 (2022) (providing “disposition of the product of in vitro fertilization prior to implantation” lawful).Google Scholar
See M. von Wolf, “The Role of Natural Cycle IVF in Assisted Reproduction,” Best Practice & Research Clinical Endocrinology & Metabolism 33 (2019): 35-45.CrossRefGoogle Scholar
See B. Bagnarelli, “Nation’s Fertility Clinics Struggle with a Growing Number of Abandoned Embryos,” NBC News, August 2, 2019, available at <https://www.nbcnews.com/health/features/nation-s-fertility-clinics-struggle-growing-number-abandoned-embryos-n1040806> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See S. Crockin, A.B. Altman, L. Reinhart, “Post-Dobbs Legal Conundrums Surrounding Preimplantation In Vitro Fertilization Embryo Dispositions,” Fertility and Sterility 119, no. 1 (2023): 21-26.CrossRefGoogle Scholar
Id. (discussing laws outside U.S. that limit embryo cryopreservation time periods).Google Scholar
Centers for Disease Control and Prevention, Assisted Reproductive Technology, Fertility Clinic and National Summary Report 26 (2019), available at <https://www.cdc.gov/art/reports/2019/pdf/2019-Report-ART-Fertility-Clinic-National-Summary-h.pdf> (last visited February 8, 2023). +(last+visited+February+8,+2023).>Google Scholar
Human Fertilisation and Embryology Authority,“Approved PFT-M and PTT Conditions,” available at <https://www.hfea.gov.uk/treatments/embryo-testing-and-treatments-for-disease/approved-pgt-m-and-ptt-conditions/> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See L. Huang, “Noninvasive Preimplantation Genetic Testing for Aneuploidy in Spent Medium may be more Reliable than Trophectoderm Biopsy,” Proceedings of the National Academy of Sciences 116, no. 28 (2019): 14105-14112.Google Scholar
See D. Sanghavi, “Wanting Babies Like Themselves, Some Parents Choose Genetic Defects,” New York Times, Dec. 5, 2006 at F5 (reporting most patients with genetically anomalous embryos choose not to transfer, electing either discard or cryopreservation).Google Scholar
See Cohen, I. G. and Adashi, E., “The FDA Is Prohibited From Going Germline,” Science 353, no. 6299 (2016) 545546 .Google Scholar
See Crockin, supra note 25.Google Scholar
See H.T. Greely, “The Death of Roe and the Future of Ex Vivo Embryos,” Journal of Law and The Biosciences 9, no. 2 (2022).CrossRefGoogle Scholar
See, e.g., J. Daar, “Federalizing Embryo Transfer: Taming the Wild West of Reproductive Medicine?” Columbia Journal of Gender & Law 23, no. 2 (2012) 257-325.Google Scholar
See, e.g., Daar, J. and Mutcherson, K., “Intersections in Reproduction: Perspectives on Abortion and Assisted Reproductive Technologies,” Journal of Law, Medicine & Ethics 43, no. 2 (2015):174178 .CrossRefGoogle Scholar
Centers for Disease Control and Prevention, “State-Specific Assisted Reproductive Technology Surveillance,” available at <https://www.cdc.gov/art/state-specific-surveillance/index.html> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See American College of Obstetrics and Gynecology, Committee on Ethics, “Multifetal Pregnancy Reduction,” Committee Opinion No. 719 (September 2017).Google Scholar
Anksakliv, A. and Anastasakis, E., “Selective Reduction in Twins and Multiple Pregnancies,” Journal of Perinatal Medicine 39, no. 1 (2011): 1521 .CrossRefGoogle Scholar
Ky. Rev. Stat. §311.720(1) (2019).Google Scholar
Ky. Rev. Stat. §311.772 (2019).Google Scholar
J. Sonka, “Jewish Women Sue to Block Kentucky Abortion Ban, Say It Violates Religious Freedom,” Louisville Courier Journal (2022).Google Scholar
Nájar, A. Gutiérrez et al., “Pregnancy and Birth After Assisted Conception,” Reproductive BioMedicine Online 5, no. 1 (2002): 7888 .CrossRefGoogle Scholar
Webster v. Reproductive Health Services, 492 U.S. 490, 560 (1989).Google Scholar
See, e.g., J.A. Robertson, Children of Choice: Freedom and The New Reproductive Technologies (1994) (arguing right to procreate via ART is constitutionally equal to right attached to natural conception and childbirth); S.M. Suter, “The “Repugnance” Lens of Gonzales v. Carhart and Other Theories of Reproductive Rights: Evaluating Advanced Reproductive Technologies,” George Washington Law Review 76 (2008), 1515-98 (right to ART potentially supported by theories based on procreative liberty and autonomy, equality and family privacy).Google Scholar
See, e.g., Idaho Code Ann. §18-622 (2023) (criminalizing activity of every person who uses any means to intentionally terminate clinically diagnosable pregnancy); Mo. Ann. Stat. §§188.015, 188.017 (2022) (abortion defined as intentional termination of pregnancy of a mother).Google Scholar
Stanford Encyclopedia of Philosophy, “Doctrine of Double Effect,” December 2018 version, available at <https://plato.stanford.edu/entries/double-effect/> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
M. A.C. Newsome, “Abortion and Double Effect,” Catholic Answers, September 1, 2006, available at <https://www.catholic.com/magazine/print-edition/abortion-and-double-effect> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
Stanford Encyclopedia, supra note 48.Google Scholar
142 S. Ct. 2259.Google Scholar
497 U.S. 261 (1990).Google Scholar
Supra text surrounding notes 14 to 16.Google Scholar
Greely, supra note 33.Google Scholar
Id., citing A.B.Wang, F. Sonmez, and C. Kitchener, “Oklahoma Lawmakers Pass Bill Banning Abortion After ‘Fertilization,’” Washington Post, May 19, 2022.Google Scholar
R. Garbus, “Georgia’s ‘Fetal Personhood’ Statue is Uncharted Territory,” Atlanta Magazine, August 23, 2022.Google Scholar
Kan. Stat. Ann. §65-6702 (2022).Google Scholar
See, e.g., K. Kruesi, “AG: Disposing Embryos Outside Uterus Not Against Tenn. Law,” Associated Press News, November 4, 2022.Google Scholar
“See More than 8 Million Babies Born from IVF Since the World’s First in 1978,” Science Daily, July 3, 2018.Google Scholar
See Centers for Disease Control & Prevention, U.S. Department of Health and Human Services, 2019 Assisted Reproductive Technology: National Summary Report 25 (2021).Google Scholar
Guttmacher Institute, “Abortion is a Common Experience for Women, Despite Declines in Rates,” October 17, 2017, available at <https://www.guttmacher.org/news-release/2017/abortion-common-experience-us-women-despite-dramatic-declines-rates> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See, e.g., G. Marx, “The ‘Prochoice’ Movement is Selfish,” US News, January 22, 2013, available at <https://www.usnews.com/debate-club/should-abortion-be-illegal/the-prochoice-movement-is-selfish> (last visited February 8, 2023); A. Patel, et al., “In Cycles of Dreams, Despair, and Desperation:” Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments,” Journal of Human Reproductive Sciences 11, no. 4 (2018): 320-328 at 320.CrossRef+(last+visited+February+8,+2023);+A.+Patel,+et+al.,+“In+Cycles+of+Dreams,+Despair,+and+Desperation:”+Research+Perspectives+on+Infertility+Specific+Distress+in+Patients+Undergoing+Fertility+Treatments,”+Journal+of+Human+Reproductive+Sciences+11,+no.+4+(2018):+320-328+at+320.>Google Scholar
Wang, supra note 56.Google Scholar
M. Quinn, “Pence Says Fertility Treatments “Deserve Protection of the Law,” CBS Face the Nation, available at <https://www.cbsnews.com/news/mike-pence-fertility-treatments-ivf-supreme-court-face-the-nation/> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See C. Owens and O. Gonzales, “Republicans’ Thorny Path Ahead on Fertility Policy,” Axios, November 29, 2022, available at <https://www.axios.com/2022/11/29/republicans-abortion-fertility-ivf-pence> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
See O. Gonzales, Democrats Look to Protect Fertility Treatments in Post-Roe Era, Axios, December 15, 2022, available at <https://www.axios.com/2022/12/15/fertility-ivf-abortion-post-roe-duckworth-murray> (last visited February 8, 2023) (citing fetal personhood bills being considered in Virginia and Florida, and a bill introduced in Congress in December 2022 creating a federal right to fertility treatment).+(last+visited+February+8,+2023)+(citing+fetal+personhood+bills+being+considered+in+Virginia+and+Florida,+and+a+bill+introduced+in+Congress+in+December+2022+creating+a+federal+right+to+fertility+treatment).>Google Scholar
See Manian, supra note 21.Google Scholar
Guttmacher Institute, “U.S. Abortion Demographics,” available at <https://www.guttmacher.org/united-states/abortion/demographics> (last visited February 8, 2023) (reporting 75% of abortion patients are poor or low income, over 60% are a race other than white); Galic, I., et al., “Disparities in Access to Fertility Care: Who’s In and Who’s Out,” Fertility & Sterility Reports 2, no. 1 (2021): 109117 , (reporting 75% fertility patients are white, 81% with household income over $100k).Google Scholar
Sistersong, “Reproductive Justice,” available at <https://www.sistersong.net/reproductive-justice> (last visited February 8, 2023).+(last+visited+February+8,+2023).>Google Scholar
Laws that attempt to force transfer of frozen embryos are not out of the question. In Arizona, a law effectively abrogates preconception agreements by couples who divorce and directs courts to award embryos “to the spouse who intends to allow the in vitro human embryos to develop to birth.” Ariz. Rev. Stat. §25-318.03 (2019).Google Scholar
See, e.g., Druckenmiller, S. S., et al., “Fifteen Years of Autologous Oocyte Thaw Outcomes from a Large University-Based Fertility Center,” Fertility and Sterility 118, no.1 (2022): 158166, at 158.CrossRefGoogle Scholar
See Lyerly, A. Drapkin, et al., “Fertility Patients’ Views About Frozen Embryo Disposition: Results of a Multi-Institutional US Survey,” Fertility and Sterility 98, no. 2 (2010): 449509 .CrossRefGoogle Scholar
See Bagnarelli, supra note 24.Google Scholar
See National Conference of State Legislatures, “State Laws Related to Insurance Coverage for Infertility Treatment,” available at <https://www.ncsl.org/research/health/insurance-coverage-for-infertility-laws.aspx> (last visited February 8, 2023) (reporting only 17 states mandated insurance companies to cover or offer to cover fertility treatment).+(last+visited+February+8,+2023)+(reporting+only+17+states+mandated+insurance+companies+to+cover+or+offer+to+cover+fertility+treatment).>Google Scholar