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Can you put a person in a freezer?

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Written with contributions from Mercedes Randhahn, Natasha Matta, and Dr. Carol Lynn Curchoe, PhD, HCLD

The Supreme Court of the United States issued the landmark Dobbs v Jackson decision, imminently affecting more than half of the country’s population. Dobbs officially overturned the 1973 Roe v. Wade decision, thereby abandoning the principle of stare decisis, or former legal precedent. Roe v. Wade was formative in establishing the right to privacy, and granting pregnant persons the Constitutionally protected right to exercise autonomy in seeking an abortion. The decision paved the way for feminists across the world to rally for further rights, including; contraception accessibility, same-sex marriage, equal pay rights, and basic protection from discrimination on the basis of sex. 

Right now, many people have been left dumbfounded and horrified as to what overturning Roe means for the future of essential rights to privacy. As of June 30, 2022, 6 states have banned abortion, 5 states have heavily restricted abortion, and 11 more states have pending legislation to severely limit abortion access. Such legislation that aims to hinder abortion availability falls under the category of “personhood laws”, which define personhood as beginning at the moment of fertilization. Now that stare decisis has been formally abandoned, other rulings like those that legalized same-sex marriage, birth control and gay marriage are without a doubt, also in danger. Abortion is healthcare. Will other reproductive medical procedures become illegal or highly restricted? There have already been reports of pharmacists refusing to fulfill orders for needed medications and physicians refusing to place IUDs. 

One of the biggest risks of equating a fertilized egg to having the same rights as a living, breathing child concerns assisted reproductive technology (ART). ART is most frequently used to assist infertile people in their journey toward reproduction. The most well known facet of ART is in vitro fertilization (IVF). In vitro fertilization consists of removing eggs from a consenting person’s ovaries, fertilizing the eggs with sperm from a partner or donor, and freezing the resulting embryos or gametes for later use. Although the process is scientifically sound, personhood laws threaten to disrupt IVF by criminalizing the act of making, freezing, or discarding embryos. 

In fact, prominent fertility physicians have been raising alarms about the threat of this court to ART since at least Amy Coney Barrett’s Supreme Court nomination. During her confirmation hearing, Barrett evaded questions about her views on IVF and whether she would overturn Roe v. Wade. When asked whether criminalizing IVF would be constitutional, she replied that she couldn’t “answer questions in the abstract.” She has previously been associated with extremist anti abortion, “life begins at fertilization” groups who have been openly hostile toward IVF. 

One area of concern is the legal status of a fertilized embryo. If legislation uses language like “life begins at conception” or “any stage of human development,” would eggs fertilized in vitro be considered alive? Human? Some states might consider them property while others might confer them the legal rights of an adult citizen. Will egg and sperm donation continue to be legal? What if those tissues are being donated to a single person or LGBTQ family? (or anyone else that activist politicians and judges don’t agree with the lifestyle of?).

What will happen to frozen embryos? People choose to have their embryos frozen for many different reasons. Some freeze embryos to maintain their integrity while taking a biopsy and testing them for genetically inherited diseases or an abnormal number of chromosomes. Many undergoing IVF freeze unused embryos for future cycles if an embryo does not implant successfully or to have more children down the line. Additionally, some people choose to freeze their embryos before undergoing intense medical treatments like chemotherapy, which can cause temporary or permanent infertility.

If embryos are awarded legal rights, would people be allowed to have their embryos frozen or would that be considered abuse? Would destroying unused embryos be considered manslaughter? If it is considered murder to place a 5 year old child in a freezer, is it also illegal to do the same to an embryo? Can the two be rationally considered identical in terms of biological characteristics and rights? 

Overturning Roe v. Wade may have unwittingly (or worse, perhaps knowingly…) impeded people’s ability to choose what is done with eggs, sperm, and embryos in assisted reproduction. Oftentimes during the IVF process, embryos can be discarded under standard of care due to the potential risk of miscarriage or development of chromosomal abnormalities that could pose extreme risk to the mother and child.

Additionally, the legality of other procedures like selective reduction (terminating some fetuses to decrease the risk for the birthing person and their baby). For instance, this process is utilized if a mother is found to have three viable embryos, or triplets, but would likely not be able to carry all three babies to term without risking developmental setbacks or medical risks. A few of the embryos would then be terminated if needed. This is most often only performed when the risk of carrying multiple fetuses outweighs the additional risks that the reduction procedure brings to the pregnancy.  

Under personhood laws, it would be criminal to dispose of an embryo just as it would be deemed manslaughter to do the same to a child. Preimplantation genetic testing, or biopsy of a few cells from an embryo to diagnose inherited genetic diseases or mutations, for example, that cause conditions like breast cancer or Huntington’s disease) could change. But as a society, how can we expect all women to deliver babies with known abnormalities into a country with minimal resources to support people with such disabilities? Without the protections of Roe v. Wade, pregnant people will be forced to carry high-risk pregnancies that compromise themselves and their babies. 

The fall of Roe v. Wade signals that IVF along with any other medical procedure that politicians disagree with, could become illegal or severely restricted, leading to higher costs, less accessibility, and lower chances of successful, safe pregnancies. ART recognizes each person’s individual choice to pursue reproduction and intends to support those people with fertility disadvantages that may obstruct the likelihood of conception and safe delivery. On that same note, we recognize that not each person wants to reproduce and we support all people in their right to discern which reproductive journey is right for them. Therefore, our industry is a target for this activist Court. 

The government must take steps to mitigate this heinous decision, and codify into law  the right to choose what people do with their own bodies.    

ART Compass shares the concerns of the infertility community in the USA as the shocking overturn of 50 years of reproductive healthcare certainty leaves more questions than answers. The infertility community already faces many barriers to family building. This vital healthcare is inaccessible, unaffordable, under-diagnosed, under-treated and impacted by complex social and psychological factors like fear, shame, misinformation, stigma, and trauma.

Undoubtedly, IVF accessibility, safety, and success are now in peril in many states. Over the years, there have been 100+ “personhood” bills proposed in the United States to give full personhood status rights to fertilized eggs.

With fertilized eggs considered full humans under the law, anything putting those cells at risk could be a criminal violation for fertility doctors, embryologists, and families. This is an enormous and concerning problem for IVF patients.

Can you perform surgery (biopsy and genetic testing) on a person so without their consent? Will IVF clinics be able to make more than one embryo at a time? What happens to aneuploid embryos? Will we be forced to transfer every embryo or pay to keep them frozen forever? Will unused embryos have to be adopted rather than discarded? Will freezing embryos even be legal? Can you freeze a person? Will PGT testing itself be outlawed in certain states, as it is used to avoid the transfer of unviable embryos?

Already roughly 18 million women lack fertility care in the USA, and insurance coverage is inadequate, preventing families from being able to obtain life-changing IVF care to treat their medical conditions.

Our top priority remains our clients and providing best-in-class fertility support to their patients through our artificial intelligence IVF products.

At ART Compass we pledge to:

Denounce the decision of Dobbs V Jackson Women’s Health Organization. This decision will cause patient harm, and further marginalization, stigma, and inaccessibility in the infertility community.

Support family building journeys for all people.

Develop technologies that advance infertility and IVF healthcare, and reduce the risk of transferring unhealthy embryos. We deliver world class artificial intelligence based embryo selection (noninvasive biopsy) technology to support elective single embryo transfer to the ASRM standard of care, to all clinics regardless of location, and to democratize and expand access to the highest standards of infertility care.

Support medical institutions, like the American Society for Reproductive Medicine – ASRM and the American College of Obstetricians and Gynecologists (ACOG) positions on abortion as essential healthcare.

Lead innovations in the infertility and IVF health space, with a passionate team, and be an outstanding partner to IVF companies doing critical work.

Advocate and support infertility and IVF health innovators and researchers who have already faced a lack of resources, funding and attention. Progress and research in infertility will be negatively impacted by these changes.

Reject and denounce any policy decisions that increase existing inequalities when it comes to accessing reproductive medicine, or restrictions that make accessing IVF more expensive, limit the number of embryos made or implanted, lead to lower chances of successful pregnancy, more IVF cycles, and greater costs.

    

References & Resources to Learn More 

https://reproductiverights.org/maps/what-if-roe-fell/

https://www.plannedparenthoodaction.org/issues/abortion/roe-v-wade

https://www.pbs.org/newshour/health/how-overturning-roe-v-wade-could-affect-ivf

https://www.npr.org/2022/05/05/1096732347/roe-v-wade-implications-beyond-abortion

https://www.plannedparenthoodaction.org/blog/the-womens-health-protection-act-critical-to-help-keep-abortion-legal-throughout-the-u-s