The US Supreme Court has overturned the landmark Roe v Wade decision, which could affect the provision of IVF in some states.
The court's decision allows individual states to enact their own legislation regulating abortion before 22 weeks, raising questions about whether fertility treatments such as IVF will be impacted.
'IVF did not exist before Roe v Wade, so we are entering uncharted waters,' said Dr Kara Goldman, associate professor of obstetrics and gynaecology at Northwestern University, Illinois. 'In states where bills are being introduced defining a fetus as a person, or defining life as beginning at fertilisation, this could dramatically change the way in vitro fertilisation is practised.'
A cycle of IVF typically involves the creation of multiple embryos that will not all be used, and any legislation defining life at conception will impact the creation, storage, or destruction of these embryos. Concerns include whether physicians could be prosecuted when embryos fail to implant successfully, or if patients will be forced to pay to store unused embryos indefinitely rather than discarding them.
'We're hearing a lot of concern from patients,' said David Stern, CEO of Boston IVF, who told Bloomberg that his clinic has received numerous calls in the last week from patients asking if they should move their frozen embryos to a 'safer' location.
Others argue that the impact on IVF will be minimal following the reversal of Roe. The authors of a Washington Post analysis outline that historically, many states have specifically exempted IVF in legislation restricting abortion; that there is little state regulation of the fertility industry as a whole; and that there is far more public support for IVF than for abortion in the USA, therefore they argue that is unlikely for IVF to banned or restricted.
However, even if it is unlikely that new legislation would specifically target IVF, the language in which laws are hurriedly written may not clearly exclude IVF, potentially leaving the fertility industry in a legal grey area, leaving patients and clinicians to navigate uncertainty.
The International Federation of Gynecology and Obstetrics (FIGO) and the European Society of Human Reproduction and Embryology (ESHRE) have both issued statements condemning the decision, with ESHRE specifically calling attention to how there could be a restrictive impact on IVF.