What are the potential ripple effects of the Alabama IVF ruling?

On Wednesday, Alabama’s state House held a hearing on a bill designed to shield doctors who perform in vitro fertilization from legal prosecution. At the federal level, Senate Democrats are working on a measure that would ensure protections for IVF nationwide.

It's part of the continued fallout from an Alabama Supreme Court ruling that declared frozen embryos are people. The state court’s Feb. 16 ruling said embryos in a lab are protected under the state’s Wrongful Death of a Minor Act.

The decision threw fertility treatment in Alabama into a tailspin. Some clinics, including at the University of Alabama at Birmingham, have paused treatments.

The situation has also stirred up a political fracas, with many Republicans declaring their support for assisted reproductive medicine, while Democrats are crying foul, and arguing the Alabama ruling is in line with the conservative-backed personhood movement and the dismantling of Roe v. Wade.

"There are hundreds of thousands of embryos in cryostorage around the country," said UW Medicine reproductive endocrinologist and infertility specialist Ginny Ryan. "The reason basically is that reproduction is inefficient. In general, fewer than 20% of all eggs will eventually make it to a pregnancy."

Ryan describes watching what's happening in Alabama as "chilling."

"That could have a devastating effect on access to care," she said, "because nobody's gonna want to support these clinics in the potential litigation."

Seattle University Professor Sital Kalantry agreed, saying this legal battle takes things to the extreme.

"This is going to become very difficult for people in Alabama who are infertile and need IVF to conceive," Kalantry said.

Kalantry is associate dean for Seattle University's School of Law, and an expert in reproductive law.

Axios health-care policy reporter Victoria Knight said the news, and ongoing debates on IVF, could be a good messaging tool for Democrats heading into the November elections.

Unless Republicans can quell attention, the legality and limitations on IVF will remain in the spotlight in 2024, Knight said.

"It's a topic that families care a lot about, and so think is going to dominate the conversation," she said.

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