Around the globe, 1 in 6 individuals experience the crushing reality of infertility. Being unable to carry a biological child can cause significant grief, leading many families to seek out in vitro fertilization (IVF) or other artificial reproductive technologies (ART).
Recently, President Donald Trump signed an unprecedented executive order, directing policy recommendations aimed at expanding IVF access. While the order seeks laudable policies that “make it easier for loving and longing mothers and fathers to have children,” it is imperative that such policies also ensure the law safeguards the health of these families and their newly forming children.
What starts with a desire to have a child has turned into over a million embryonic children left in an indefinite frozen state, sex-based discrimination and selective reduction (i.e., abortion) of “undesired” embryos, and women left in the dark because they haven’t received proper counseling about the long-term health and legal risks. The largely unregulated IVF industry raises profound moral and ethical questions that the Trump administration should consider as it seeks to expand the practice. Otherwise, these grave harms will continue to persist, leaving many women with regret and mental anguish over their IVF-related decisions.
Right now, most states do not require fertility providers to walk women through the potential ethical dilemmas of IVF or other potential physical or psychological ramifications. As a result, the fertility industry has failed to ensure women exploring IVF receive all the information they need to make an informed decision, which is a core principle of ethical medical practice. Before any medical intervention, every patient has a right to receive and understand pertinent information about the nature, risks, and alternatives of the medical intervention. This is especially true with ART, which is unique because it involves a third party—the preborn child—who raises important bioethical and legal considerations.
Yet, as women who’ve gone through the IVF process have shared, fertility specialists are not properly counseling them. Thus, many women embark on their IVF journeys without knowing the physical and psychological risks to themselves and their preborn children, as well as what may happen to any additional embryos that are not implanted during IVF cycles. Many women are unaware of the implications of freezing their additional embryos. The IVF process halts the development of a preborn child at the embryonic stage, where they may be left frozen indefinitely or destroyed if not transferred. It is estimated that there are over a million of frozen embryos in U.S. laboratories, many of which are “surplus” embryos that do not have a chance at being born.
Some women have even been pressured to “selectively reduce” their pregnancy because their provider implanted multiple embryos and all or most survived, which may lead to a higher risk pregnancy. This is a heartbreaking situation for any woman because “selective reduction” results in the intentional destruction of a preborn child and can be recommended for various elective reasons that do not have do with the mother’s life being at risk. Fertility specialists are also failing to discuss alternatives to ART such as restorative reproductive medicine options, which are far less expensive and often more efficacious. This lack of informed consent has left many women with regret.
However, Jamie Skipper was an exception to the rule. For the Skipper family, it was important to engage in IVF in a way that honored their religious convictions, including their belief that embryos deserve the same human dignity as born children. While there are nuanced approaches that can uphold this dignity, the first IVF provider Jamie consulted tried to convince her that she was incorrect and uneducated to hold these beliefs. No woman should ever have to face that kind of prejudicial treatment from a medical professional. She left feeling disrespected, violated, and unsure where to turn next. Jamie thankfully found another provider that respected the family’s beliefs and ensured they were given all the information necessary to make an informed decision that aligned with their personal convictions. Unfortunately, the judgment by their first IVF provider is the story more commonly told by women and families struggling with infertility.
As the Trump administration considers ART-related policies under its executive order, these policies must 1) ensure women receive proper education and counseling throughout the entire process, and 2) respect the human dignity of embryonic children. To accomplish these objectives, the Trump administration can include comprehensive informed consent requirements in all ART-related policies, cap the number of embryos implanted to no more than two per IVF cycle, and limit the number of embryos conceived in efforts to avoid “surplus” embryos being left frozen indefinitely or destroyed. The administration can also promote the use of restorative reproductive medicine, which focuses on the root of infertility and attempts to treat its underlying cause—a more effective option than ART and far less expensive for families to undertake.
In line with these policy suggestions, Americans United for Life (AUL) has authored the Assisted Reproductive Technologies Disclosure (ART) and Risk Reduction Act and Policy Guide which lays out a more ethical approach to IVF. AUL celebrates the precious lives of all babies and advocates for the equal protection of children from the moment they’re conceived, which is why AUL believes that IVF should be properly regulated to promote the health and safety of the families and preborn children involved.
Ultimately, all women deserve to be given the information necessary to make an informed decision when it comes to their personal health and the health of their children and families. It is time for women like Jamie to be the rule, not the exception.
