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The Guardian - US
The Guardian - US
Politics
Carter Sherman

‘My embryos aren’t safe here’: US patients struggling with infertility scramble after Alabama IVF ruling

Woman holds baby wearing brown polka dot beanie
Kristin Dillensnyder holds her daughter she conceived through IVF. Photograph: Stephen Poff/Courtesy Kristin Dillensnyder

Tucker Legerski and his wife, Megan, have spent more than two years and tens of thousands of dollars trying to have a baby.

Married since 2021, the Alabama couple last year embarked on in-vitro fertilization (IVF). After they retrieved eggs, a specialist combined those eggs with sperm to create four quality embryos. Last fall, they successfully transferred one embryo, resulting in a pregnancy – but eight weeks in, it ended in a miscarriage. The couple had planned to attempt another embryo transfer in the fall.

But now, in the wake of an Alabama supreme court decision that ruled that embryos are “extrauterine children”, the Legerskis don’t know what will happen to their hopes of having children in Alabama. At least three Alabama IVF providers, including the Legerskis’, have paused their IVF operations, leaving the Legerskis’ remaining three embryos stuck in icy storage.

“The three embryos that we have, that are frozen right now, that we can’t use as of right now, are very important to us and our best hope,” Tucker Legerski said. “I don’t know if we would be able to afford another egg retrieval and transfer or creating more embryos, because of the emotional and financial costs.”

The Legerskis are far from the only prospective parents wondering what the future of IVF holds, both inside Alabama and beyond its borders. IVF patients and advocates in Alabama are rushing to figure out what the ruling and subsequent cessation of care means for their deeply time-sensitive plans. Outside Alabama, people are petrified that similar restrictions could soon surface in their state now that Alabama has blazed a trail.

Two people wearing glasses embrace each other
Megan and Tucker Legerski. Photograph: Courtesy of Tucker family

For many people struggling with infertility, uncertainty and powerlessness are familiar agonies. But now, in addition to being at the mercy of biological and medical forces, they feel they’re also being buffeted by politicians, jurists and rightwing activists determined to embed their belief that life begins when a sperm fertilizes an egg into every aspect of American life.

“We watched the abortion access get taken away slowly and we’ve heard people say: ‘You don’t have to worry about IVF, IVF is safe and fine.’ And here is an exact story showing how IVF is not fine,” said Kristin Dillensnyder, an infertility coach who underwent IVF in Alabama and subsequently had a daughter.

Since the ruling, Dillensnyder said she’s heard from clients in South Carolina, where she now lives, who are terrified that their state will be next. “If you’re in a red state, it really just feels like it’s just a matter of time,” she said.

Light micrograph of embryo selection for IVF
Light micrograph of embryo selection for IVF. Photograph: ZEPHYR/Getty Images/Science Photo Library RF

Tara Harding, a doctorate family nurse practitioner and fertility coach based in North Dakota, has also heard from clients from across the country since the ruling. They’re no longer sure where to undergo IVF; they’re afraid that their embryos will become trapped in a state that may limit the procedure. On Friday, Resolve: The National Infertility Association announced that nationwide embryo shipping services have indicated that they will stop transporting embryos in and out of Alabama.

Harding previously travelled to Colorado to undergo IVF. “If I have to go through IVF again, I will go back to Colorado, because I know my embryos are safe there,” Harding said. “They’re not safe up here.”

The Alabama ruling enshrines tenets of “fetal personhood” into state law. The push for fetal personhood, which seeks to endow embryos and fetuses with full legal rights and protections, is a long-term goal of many in the anti-abortion movement, given that opposition to abortion is predicated on the belief that life begins at conception.

However, such protections can lead the alleged rights of embryos to clash even with the people who might be carrying them.

Alabama has long been a laboratory for fetal personhood measures. Between 1973 and 2022, when the US supreme court overturned Roe v Wade, Alabama law enforcement criminalized nearly 700 people for allegedly endangering “unborn life” – a record number of cases. In 2018, Alabama became the first state in the country to enshrine a fetal personhood clause into its state constitution after voters supported a measure to recognize “the rights of the unborn child”, including the right to life.

Many within the anti-abortion movement oppose IVF, in part because embryos may be created that are not ultimately used during the complex process. But many IVF patients never realized a process to create families could land in abortion foes’ crosshairs.

“I never ever imagined that IVF would be questioned,” said Gabrielle Goidel, an Alabama woman who started using medications to prepare her body for egg retrieval on Friday, the same day as the supreme court decision.

Goidel and her husband, Spencer, have already confronted some of the consequences of overturning Roe. While the pair were living in Texas, which has banned almost all abortions, Goidel experienced three miscarriages. During her second miscarriage, she went to the hospital and confirmed that the pregnancy no longer had cardiac activity. Goidel wanted a D&C, a common procedure after a miscarriage. But a Texas doctor refused, Goidel said.

“He was very dismissive, said that was a complicated surgical procedure and he wasn’t going to do it – and then asked if he could pray with us,” she recalled.

On Thursday, Goidel’s provider said it would stop performing IVF. She and her husband, Spencer, rushed to hop on a plane to Texas, where they could continue the egg retrieval process.

White woman wearing purple jacket stands at podium
Alabama governor Kay Ivey delivers the state of the state address at the state capitol in Montgomery, on 6 February 2024. Photograph: AP

When Roe was overturned, Spencer Goidel said: “There was at least an ability to believe like: ‘Okay, the side that is against Roe v Wade, the side that wanted Roe v Wade overturned, is just pro-family. That’s what it is. They’re just pro-family.’ And then this happens and you go: ‘Oh. Oh, so you’re not pro-family at all, actually. This is religious fundamentalism.’”

A concurring opinion in the Alabama state supreme court case, written by the court’s chief justice, repeatedly cited the Bible as justification for the court’s reasoning. Liberty Counsel, a conservative Christian legal organization, has already used the Alabama supreme court ruling to argue in a Florida case that Florida’s state constitution, like Alabama’s, protects “an unborn child”.

But not all religious Christians agree with Alabama’s ruling. Rodney Miller is the chairman of the board for Carrywell, a faith-based Alabama group that helps people navigate infertility, including through financial grants to people going through IVF. He says he and his wife relied on their faith to get them through their decade-long struggle with infertility, which culminated in their adoption of frozen embryos that his wife carried and that led to twin toddlers. Over the last week, amid the fallout from the ruling, the couple traveled to Tennessee to transfer embryos in the hopes of having more children.

“Here we are with the advances of medicine and science, discussing in-vitro fertilization and frozen embryos, and I think it is a beautiful thing that God has given us with the science and the medicine and the advancements,” Miller said. “It’s very disheartening to know that, despite all of that, Alabama seems to be going backwards.”

Both Democratic and Republican Alabama state legislators are now in the process of drafting legislation to protect IVF. Alabama governor Kay Ivey, a Republican, has also said that she supports a solution that will shield the procedure.

But it is still unclear what will happen next or how soon change may come. Mallory Wear, the executive director of Carrywell, leads a support group for women dealing with infertility and who have had multiple miscarriages. The ruling has left them devastated, she said.

“It’s been great to see people coming out and voicing their opinions and really bringing awareness to infertility and the IVF process,” Wear said. But, she added: “When you are in the middle of it, every day counts.”

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