Since the ended the federal right to abortion, legislative attention has extended to many other aspects of reproductive rights, including access to assisted reproductive technologies such as in vitro fertilization, or IVF, after an Alabama Supreme Court ruling in February 2024.
Author
Heidi Collins Fantasia
Associate Professor of Nursing, UMass Lowell
University of Massachusetts Lowell associate professor and department chair of the school of nursing explains how this decades-old procedure works and what its tenuous legal status means for prospective parents.
What is IVF?
IVF is a type of artificial reproductive technology that allows people with a range of fertility issues to conceive a child. It involves fertilizing an egg with sperm to form an embryo that is then transferred into the uterus to develop.
IVF is used as a treatment , which the defines as an inability to achieve pregnancy “based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing” or the “need for medical intervention.”
While originally developed as a fertility treatment for , IVF is currently used for other conditions such as low sperm count or when the cause for infertility can’t be determined. and can also use IVF and other reproductive technologies to grow their families.
How does IVF work?
Typically during IVF, a patient takes hormones to stimulate the ovaries to produce eggs. Once a health professional retrieves the eggs using an ultrasound and a thin needle, they either incubate the sperm with the egg or in the lab to fertilize it. Which specific type of IVF procedure a patient undergoes is determined on an individual basis with a health care provider.
Scientists began to develop IVF in the 1930s, beginning with the through the procedure. This research eventually led to the birth of the in 1978. Physiologist Robert Edwards received the for his research on IVF.
The technology has rapidly expanded since the first live human birth from IVF. The , or the freezing of human eggs and embryos, has enabled people to pursue pregnancy later in life. of cells from a developing embryo can identify genetic diseases and abnormalities.
The chance of a successful live birth through assisted reproductive technologies varies. depend on many factors, such as underlying cause of infertility, age and type of technology used.
Who currently has access to IVF?
Use of IVF has steadily increased since it was first introduced. In 2015, about in the U.S. were conceived as a result of IVF, and overall.
Approximately have used some type of to achieve a pregnancy. This includes fertility advice, medications to increase ovulation, fertility testing, surgery and IVF.
Because infertility increases with age, typically use these services more often than younger women. Women in the U.S. who are often non-U.S. citizens and uninsured, and they typically have lower income and less education than women who do.
also affect IVF access. In 2021, over 5% of all infants in Massachusetts were conceived from IVF, but this dropped to less than 1% in New Mexico, Arkansas and Mississippi.
Service availability and insurance coverage for IVF procedures differ by state, which could account for some of the differences in use. Only a mandate that private insurers cover IVF. for infertility services is even lower.
The has been the greatest barrier to infertility care. for people without insurance coverage can range from over US$10,000 to $25,000 per cycle, with rising costs per cycle.
How do debates about when life begins affect IVF?
Political views vary around reproductive rights, and is likely to become an issue in upcoming election cycles.
The in February 2024 that frozen embryos created during the process of IVF were people. While the ruling currently applies only to Alabama, it has caused among health care providers.
As a result of the ruling, two major have paused infertility care because of potential legal risk to health care providers. The main concern is whether providers can be held if frozen embryos don’t survive the thawing process.
Since the elimination of federal protection of abortion in 2022 with the overturning of Roe v. Wade, individual states have made their . Many patients, health care providers, researchers and legislators see the Alabama decision regarding IVF as a continuation of the increasing .
Heidi Collins Fantasia is the editor for Nursing for Women’s Health.
