For fertility specialists across the country trying to help those who want to start families, Abortion is prohibited in many states after, after Raw vs. Wade It was overturned and raised new questions and concerns about the practice of in vitro fertilization.
Perhaps the most important concern, according to experts, is the possibility of state laws that specify that life begins at the moment of fertilization, and what that might mean for embryos, including whether they can be frozen for future use, and whether they can be discarded, and whether patients can ultimately choose to do what they want with their fetuses.
Currently, there are tens of thousands of fetuses in cryopreservation across the country, according to Jenny Ryan, a reproductive endocrinologist and fertility specialist at UW Medicine in Seattle, MedPage today.
For patients undergoing IVF, confusion over what new state laws could mean for their fetuses is an added stress, and not the only reason that has arisen. At the end of the RoRyan noted that one patient recently told her, “I don’t even feel like I want to be pregnant in this current climate.”
Challenges to standard practice?
The idea that life begins at fertilization worries IVF providers because of the way the process works intrinsically.
Once the eggs are extracted from the patient, Ryan explained, they are fertilized, and all the embryos are cultured in a dish and monitored in an incubator. After 5 to 6 days, those that have not progressed to a normal state are usually eliminated. Biopsies on remaining embryos are often done to detect chromosomal abnormalities, especially for women in their late 30s or older. After genetic testing is complete, there may be additional embryos that are either discarded or donated for research.
In IVF, a large number of eggs are collected, many of which are genetically abnormal, said Jennifer Makarov, an obstetrician-gynecologist and endocrinologist and fertility specialist at New Hope Fertility Center in New York City. Providers can determine which fertilized eggs are likely to continue a pregnancy and which ones are not. However, if the new laws provide for the protection of embryos from the time of fertilization, this could lead to a huge problem for patients.
The possibility of such laws in general, Makarov said, shows a lack of understanding of how biology works MedPage today. For example, consider a female patient in her 30s who had 10 eggs collected during an IVF cycle. “We are fortunate if we finally have one that shows the possibility of growing into a pregnancy,” she said.
If you have to treat all the other abnormal eggs, and you’re not able to get rid of them when you know they don’t have the ability to develop in pregnancy, that’s a real problem when it comes to the doctors doing their jobs, she said.
Makarov added that there are also concerns about the ability to screen embryos for certain diseases and the possibility of having to use one fetus, as well as concerns about the possibility of targeting embryologists and doctors to do their jobs and make decisions with patients. .
She noted that fertilizing one egg at a time and implanting it in the uterus would add a huge amount of expense and travel for treatment, and put women at risk of multiple miscarriages and the inability to receive proper care for those abortions.
“everything is mysterious”
Makarov said that she and her colleagues answered many questions from patients wondering about the end Ro Means of their treatment, as well as their current and future fetuses.
“Right now, we feel very protected here in New York about being able to practice medicine and make decisions with our patients,” she said. However, “we don’t know what will happen in some of these trigger law states.”
Makarov noted that morale in health care has generally declined. Many healthcare professionals have left the field due to the effects of the COVID-19 pandemic, and now, it has flipped Ro “An additional blow to our independence and ability to practice medicine.”
Ryan said she hopes the end of abortion protections will encourage people who are passionate about access to care to pursue a career in health care, although she is concerned about whether institutions will become less willing to support practices financially and legally in such a way. The uncertain climate, and what it means to support holistic practice and the next generation of providers.
“Everything is vague and unclear at this point,” Makarov said. “It’s always the fear of the legal repercussions that could be, or that could change.”
Legal experts weigh in
Molly O’Brien, JD, partner at International Fertility Law Group in Los Angeles, said she and her colleagues also sent in a large number of inquiries from domestic and international clients wanting to know the end of Ro It means IVF-related services, primarily from those who are currently undergoing operations or treatments, but also from agencies that connect egg donors with parents, as well as doctors.
She noted that one particular concern is when embryos are not stored in the same condition as the provider’s office. Some people may not want to risk transferring embryos, while others may feel uncomfortable retaining embryos if new abortion laws are enacted or seek to follow.
O’Brien said there is a constitutional right to travel to another country or region for any reason, particularly to seek medical care. As long as this constitutional right is not affected, people can technically transfer their embryos if they need to.
Lisa Ikimoto, a professor at the University of California Davis School of Law, said: MedPage today It is already common practice for people to travel for reproductive health services, which may limit access to these services.
Furthermore, new laws could affect private equity investing in fertility clinics, including large systems that practice in multiple states, she said.
Ikimoto also noted that biomedical research being done with the goal of improving IVF – some of which uses embryos – could be affected, as new laws could make it more dangerous for researchers to conduct these types of studies, creating a catch-22 that The laws would undermine efforts to improve the pregnancy success rate.
In the end, Ryan said it’s important to remember that fertility care is not just a specialized, charming practice, but one designed to help a wide range of patients achieve their goal of starting a family.
“We don’t just see your standard infertility patient,” she said of her practice. This affects people who have cancer or who have other reasons to want to preserve their fertility in the future.
It can also affect same-sex couples, transgender patients, and patients with a wide range of health challenges, such as uterine abnormalities and recurrent pregnancy loss.
“We are concerned about being able to provide quality care,” she said.