US Supreme Court's reversal of Roe v Wade abortion law would endanger IVF
Progress Educational Trust25 June 2022
Changes to US abortion law could have wide-ranging impacts on fertility treatment including IVF and preimplantation genetic diagnosis (PGD).
The 1973 'Roe v Wade' case established abortion as a constitutional right, however, the current Supreme Court has been discussing overturning this decision, which would allow individual states to restrict or ban abortion. Several states have 'trigger laws' in place that would come into effect immediately if Roe v Wade is overturned, and some of these confer rights or personhood onto embryos or fetuses.
'If Roe v. Wade is overturned, trigger laws can go into effect immediately that recognise an embryo as a person – [and] if a fertilised egg is considered a person, anti-abortion laws could make it illegal to discard embryos,' Dr Lucky Sekhon, a New York-based infertility specialist told Forbes.
Standard IVF protocol involves collecting and fertilising as many egg as possible, to maximise the number of healthy embryos. These can then be transferred to the uterus ideally one at a time, and the others are frozen for use in future transfers or for subsequent pregnancies.
If embryos are granted legal rights, there may be opposition to allowing any fertilised eggs to be stored or discarded, meaning that eggs will have to be frozen and then fertilised in small batches, which is likely to be less efficient and more expensive for patients.
Preimplantation genetic testing may also be affected if discarding the aneuploid embryos or those carrying harmful mutations is prevented. This could leave families who need PGT-M to avoid passing on serious genetic conditions with few options.
Finally, embryo freezing could also be affected. Some states may try to ban any process deemed 'harmful' to the embryo once it is created – including freezing as a small proportion (less than five percent) of embryos do not survive freezing and thawing.
'This can lead to transferring all of the embryos created at the same time, which increases the chance of having multiples (twins, triplets, quadruplets or more), which are high-risk pregnancies,' obstetrician gynaecologist Dr Heather Irobunda told Forbes.
The result is likely to be more patients travelling to states without these laws for fertility treatment and facing increased costs and inconvenience as a result.
Sources and References
23 May 2022. Politico
How abortion bans might affect IVF
3 May 2022. BBC
Roe v Wade: What is US Supreme Court ruling on abortion?
12 May 2022. The Guardian
IVF treatment faces ‘clear and present danger’ from US anti-abortion effort
9 May 2022. WIRED
The ramifications of Roe v. Wade's fall won't stop at abortion bans
13 June 2022. Forbes
Will a Roe v. Wade overturn impact fertility treatments? Here's what experts say
Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.