Oops, they did it again…
“Real” versus “Ethical” IVF
Everybody loves things that are ethical, right?
It has a feelgood factor of doing things that are fair and principled. Sadly, however, that’s not the case when it comes to what the Right have dubbed as “Ethical IVF.” This term has been flying around far-right conservative circles for over a year and while they have yet to exactly define what it means, it follows the line of a “pro-life” view of fertility treatments.
Speaker of the United States House of Representatives Mike Johnson, for example, said last year that while he supported IVF, “it needs to be handled in an ethical manner.” His office also, according to NBC News, stated – in relation to provisions for military families having easier access to IVF— that House and Senate negotiators couldn’t agree on "sufficient pro-life protections.” They added that, “the Speaker remains pro-IVF and has encouraged states to take up the issue responsibly and ethically.”
This foreshadows something of grave concern.
What exactly does the Right mean by “Ethical IVF”? Well, it likely means no genetic testing on embryos (we will be doing something soon on why genetic testing is so very integral) and only allowing for fresh embryo transfers. “Ethical IVF” may allow for the freezing of embryos but only for the likely amount of children a couple wish to have. (You want four kids; you get to have four embryos). If there are any leftovers that won’t be used, it might be mandated that the embryos will have to be donated, which, for example, is the law in places like Poland. Or if they decide to take a hardline like Italy, it would become a crime to freeze or destroy embryos. For those who have gone through IVF, alarm bells are sounding because you know the implications of these restrictions. Not to mention the governmental overreach and intrusion on your right to have a family.
If you have ever had to undergo IVF treatment, you know that it’s all a numbers game. The more eggs you get means the more embryos that might result from that retrieval. The more embryos you make, the better the chances are that some might make it to a five day blastocyst. And that means the more likely a chance for a pregnancy, which will lead, hopefully, to a live birth, with those chances increasing drastically with genetically tested embryos.
Any political roadblocks in the way are not only heartbreaking and more costly, but also, in our opinion, unethical. To make people who have gone through such a harrowing experience already to then have to jump over even more hurdles for their longed-for child is simply depraved, not to mention this is the opposite of making IVF more affordable as the White House Executive Order (EO) claimed it set forth to do.
Republicans, of course, are treading on thin ice with how they define IVF, because statistically 70% of Americans—on both sides of the aisle—are pro-family building through fertility treatments, including IVF. So to create ways of making IVF less accessible, dressed up as pro-family, is something that could seriously backfire.
We at State Strong have started referring to IVF as “Real IVF” to differentiate from what conservatives have begun spinning as “Ethical IVF.”
We first came across the term in a Boston Globe editorial by Dr. Antonio Gargiulo, a former Harvard University associate professor of obstetrics, gynecology and reproductive biology. He described “Real IVF” as IVF with no limitations on eggs inseminated, embryos frozen or genetic testing. We also have added that it’s a fertility treatment that is supported by evidence-based medicine. That we have to now differentiate IVF is silly but we think it’s going to unfortunately become integral over the next several weeks when the Trump administration trots out findings from the EO.
From our calculations based on the mention of a 90 day due date in the February EO, on or around May 20th there will be an event where the White House’s “Ethical IVF” policy proposal will be presented, which will also potentially include references to “restorative reproductive medicine” (RRM). If you read our newsletter last week, we pointed out that RRM is not recognized by leading medical authorities and lacks scientific validation. We fully support patients doing what it best for them but RRM is unregulated and unproven and should not be promoted as an alternative to IVF.
RRM also does not acknowledge male-factor infertility nor the fact that many people have to expand their families through the IVF route because of underlying medical conditions. (Much more on this in next week’s newsletter!) The EO findings will likely be focused on presenting “Ethical IVF” as the way forward—for heterosexual married couples. LGBTQ couples, minorities, single people and unmarried couples will all be conspicuously absent from the conversation.
However, “Real IVF”, which used to be called just plain old IVF, is for everyone who needs fertility treatments to grow or expand their families. The real way to make “Real IVF” more accessible is by making it more affordable, requiring insurance companies to cover IVF as a treatment for the American Society of Reproductive Medicine’s definition of infertility.
For more reading on “ethical IVF” check out this piece on Fox as well as these stories in Business Insider, New Yorker, CBS News and NPR.
Fertility Challenges for Black Women
We wanted to share this important new fact sheet from our allies over at the National Women’s Law Center on the how Black women experience disproportionately high rates of infertility:
In the United States, non-Hispanic Black women are almost twice as likely as either Hispanic or non-Hispanic white women to experience infertility. Black women have higher incidences of medical conditions that can cause infertility, such as uterine fibroids, a condition that can increase infertility risk and contribute to adverse pregnancy outcomes. Black women also experience higher rates of tubal factor infertility than white women. Tubal factor infertility can be caused by a range of conditions, including pelvic inflammatory disease and endometriosis.
Pelvic inflammatory disease is more prevalent in Black women, and endometriosis in Black women is commonly misdiagnosed as pelvic inflammatory disease and inadequately treated, likely due to implicit and explicit racial and gender bias in health care. Black women are also more likely to be exposed to environmental toxins that harm fertility, such as industrial pollutants and water contaminated with lead or endocrine-disrupting chemicals.
No matter who seeks fertility care, or their reasons behind it, every person deserves to access this necessary care without cost being a barrier. Comprehensive fertility care insurance coverage reduces financial barriers to care, thereby improving access for Black women and other under-resourced communities.
The solution is simple, require insurance coverage for IVF
State IVF bills!
While we don’t have new bills to update for you this week, we did come across this piece What ‘fertilization president’ Trump can learn from state efforts to expand IVF access from CBS News/KFF Health News. We found it a fascinating read to see what states are doing to tackle these issues around insurance mandates. An excerpt from the story:
“Whether the administration's efforts will change policy remains unknown, but state-level attempts to mandate fertility coverage reveal the gauntlet of budgetary and political hurdles that such initiatives face — obstacles that have led to millions of people being left out.
Twenty-two states have passed legislation requiring insurers to cover at least some fertility care, and 15 of those require coverage for IVF. The laws vary widely, though, when it comes to who and what gets covered, largely because of debates over cost. Fertility services can range from diagnostic testing and ovulation-enhancing drugs to IVF, widely considered the most effective but also the most expensive treatment, during which one or more lab-fertilized eggs are transferred to a uterus.
IVF advocates… cite data from a decade ago showing that fertility care in states with mandates has accounted for less than 1%of total premium costs, a figure similar to estimates for newer mandates. And advocates often argue that building a family is a human right, though fertility care is disproportionately used by wealthy, white women. Covering IVF for the Medicaid population, which includes more than 70 million Americans, rarely works its way into legislative proposals.”
Want to share bad bills we need to be tracking?
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