SALT LAKE CITY — Fertility doctors in Utah say they are receiving many questions from patients worried about the potential impact on access to in vitro fertilization after the U.S. Supreme Court struck down Roe v. Wade, triggering the state’s trigger law that bans abortions.
“As soon as the Dobbs decision came out, patients contacted us by phone, via social media, by email, and everyone was worried about what this meant for their ability to transfer their embryos, to store their embryos, to do diagnostic tests,” said Dr. Kristi Maas, of the Center for Reproductive Care in Sandy and Clearfield.
She said patients also expressed concern about how the decision might impact their treatment and obstetrical care “after we graduate them from our real-world practice.”
IVF providers are not burdened by state trigger law, SB174. But concerns remain about the future of reproductive care.
Utah trigger law
The Utah Legislature passed the trigger law in 2020 to go into effect if the U.S. Supreme Court ever overturns Roe V. Wade. When this happened in June, Planned Parenthood filed a lawsuit against the law. A Utah judge granted a broader ban on Utah’s abortion trigger law on Monday as Planned Parenthood’s lawsuit continues in court.
National reports point out that in some states, the wording of abortion laws does not specify when life begins. This leaves questions about the status of IVF-created embryos, which may undergo testing, be stored in a freezer, or sometimes be discarded when not in use. But in Utah, the trigger law prohibits abortion after “implantation of a fertilized egg,” except in cases such as rape, incest, or a mother’s life threatened because of the pregnancy.
Unlike the formation of a fetus in the womb, Utah law does not consider embryos created and stored during in vitro fertilization to be the beginning of life. And legislative leaders said they haven’t heard of any plans to change that.
“We don’t know of anyone working specifically on IVF legislation, so we have no information to offer at this time,” Utah Senate spokeswoman Aundrea Peterson said, referring to both the House and Senate.
Peterson declined on behalf of legislative leaders to speak to KSL.com about the issue.
Dr. Shawn Gurtcheff, medical director of the Utah Fertility Center, also noted that members of his firm were not concerned that IVF treatment would be affected by the trigger law.
“We have had independent legal counsel review Utah’s trigger law and have been reassured that it does not affect the ability to perform IVF or the disposal of embryos or the care of patients from a fertility standpoint,” she said.
Utah Fertility Center has no plans to change its practice in any way, Gurtcheff said.
Like Maas, she said she spoke to many patients who were concerned after the state’s trigger law went into effect.
“And at the beginning when it all happened, we didn’t really know what to tell them,” according to Gurtcheff.
When asked if she was concerned about Utah passing legislation that would affect IVF in the future, she said it pertained to any time laws intervened between the doctor-patient relationship.
But Gurtcheff said she was “reassured” that Utah tends to be a family-friendly place.
“And I hope lawmakers aren’t interested in affecting people’s ability to start families that way,” Gurtcheff said.
For some, IVF is the only option to start their family. Regulations around the creation and distribution of embryos would affect that process, Gurtcheff noted, explaining that she hopes families can retain their ability to make decisions about the use of embryos.
According to a 2018 report compiled by physicians for the Utah Legislature, the estimated prevalence of infertility among couples of childbearing age is between 10 and 20 percent.
The report says Utah had a “higher level of overall use” of fertility treatments than any other state with this population-based data in 2018. About 5% of births in Utah result from a medical fertility treatment, including about 1% of IVF births, doctors noted.
Questions about when life begins
Maas takes a less optimistic view of the matter.
While some states consider life to include an embryo “in a Petri dish,” providers are increasingly limited in their ability to test and screen for embryo diseases, she noted.
“The whole society in the field of reproductive medicine is shaken. We are all afraid for the future of the situation and understand that even if someone like me, sitting in the State of Utah, we are somewhat isolated, that could change tomorrow, and it could be the end of the peloton,” Maas said.
She said she feared that unless reproductive care ended, it could get to the point where only people with high socio-economic status could afford it. This is because legislation could limit the ability of doctors to create embryos.
Maas described assisted reproduction as a “numbers game”, as doctors need to collect as many eggs and sperm as possible to be successful. If doctors went through the process one embryo at a time – “it’s what nature does” – it would limit their ability. Patients who don’t have the “bandwidth” to spend more time at work and access childcare won’t be able to access services, Maas said.
She added that patients whose frozen embryos are stored have contacted her clinic with concerns about what might happen if they don’t use them all in the future, as freezing embryos can be expensive.
“We have embryos in the freezer, and they fear they will be dependent on those embryos for the rest of their lives,” she said.
Contributor: Lindsay Aerts