Why in vitro fertilization is at risk in Ohio

Human life needs conception to occur, even when using technologies such as in vitro fertilization (IVF). But conception is not the same as personhood. You can’t reduce a very nuanced matter to a voting points game. When you politicize medical issues, Ohio families get hurt.

My children are my world. As difficult as parenting can be, not a single day goes by that I’m not grateful that access to in vitro fertilization allowed us to build our family. So when the Ohio legislature introduced House Bill 704, a “personhood” bill that would effectively ban access to IVF in Ohio, I was floored and quite offended. I couldn’t believe my own government would outlaw the fertility treatment that is so integral to so many Ohio families. Whether intentional or not, this bill is irredeemably harmful. As the anti-choice movement continues to strike its peril across the nation, it is important to understand the potential impacts on the practice of IVF and other Assisted Reproductive Technologies (ARTs).

Our family’s story is similar to many others. Throughout our four year pursuit to create a family, we tried everything and suffered greatly. Before we tried IVF, our family endured five miscarriages, including a life-saving medical abortion for twins that were not viable. Pursuing IVF is not a decision we took lightly, and it was not an easy process, though well worth the end goal. We had to see a number of doctors, including several psychologists throughout the process. We spent thousands of dollars, even going into debt, just to create a family (most insurance providers do not cover ARTs). We even had to fly to a different state in order to receive the care we ended up needing.

My marriage has been tested, and my body was pushed to its limit over and over again. My heart goes out to all families struggling to conceive, and the fears they must be feeling in light of this bill. House Bill 704 requires Ohio to recognize “all unborn human individuals from the moment of conception.”

“Conception” is not defined in the bill, but colloquially means when the sperm and the egg meet to create an embryo. Our embryos, like all conceived through IVF, were created in a petri dish, when sperm was injected into the eggs by a specialized doctor called a Reproductive Endocrinologist. These embryos were in no way viable prior to being inserted and incubated inside a carrying body. After the embryos were created, some died off immediately, while any potentially viable embryos were frozen at 5 days old and stored. By giving these petri dish embryos the rights of living humans, the entire IVF process would be made illegal.

When we were ready, the two embryos we implanted had to first survive the thawing process. Once they thawed and survived, they were tested again and then implanted into my body. After that, there was only around a 30% chance, give or take, that this process would result in a live birth of one baby, let alone two. Every newborn child, facilitated through IVF or otherwise, is a miracle.

We celebrate a person’s birthday, not ‘the moment the sperm got into the egg’ day. Embryos are a promise towards life, but they are not fully alive without gestation and ultimately, birth. Without the connected lifelines (both placentas and umbilical cords) supplied by my own body, neither of my children would have come to be a full human being in the world. I had to birth them for their lives to truly begin.

Simply put, an embryo will not become a fetus on its own, and will certainly never survive without a gestational carrier and a live birth. Creating life this way is a delicate dance between science and nature, and a lot of variables have to go right. Extending life at conception to personhood presumes that there are no other ways to get pregnant other than by a penis being inserted into a vagina directly. It creates ambiguity around who controls an embryo before it’s even implanted or grows into a viable born baby.

Redefining when legal life begins is not just subversive and cruel, it’s a huge blow to an otherwise capable adult’s decision-making processes. If states give rights to an embryo, it not only muddies the legality of IVF, it abandons rights for the gestational carrier, and opens the door for even more subversive arguments, like the argument that life could begin even before conception, or that the government should treat those who don’t use all of their embryos as criminals.

This bill and ideology creates completely unnecessary risks and burdens, including forcing hopeful parents to leave the state in order to pursue a family. It encourages doctors and patients to consider implanting more than one embryo, resulting in more high risk pregnancies. Already invasive procedures will undoubtedly get more challenging, and already at-capacity doctors in states without onerous abortion bans will get overwhelmed. In short, Ohioans will not be able to create the family they dream of if this bill stays.

A person’s desire to create a family is not a politician’s business. Medical treatments are not something to be decided in a non-medical setting. Politicizing IVF raises an entire subset of consequences, and of course it impacts struggling families most. I don’t want my home state to become known for pushing even more families out, and that’s exactly what this bill will do.

As the prevalence of IVF, surrogacy, and other ARTs grows among LGBTQ+ populations, the introduction of HB 704 should not be ignored as a queer issue. 30% of LGBTQ+ adults are currently raising families in Ohio, many of them via ARTs including IVF. But this doesn’t just impact LGBTQ+ families. Infertility is a national public health concern, as roughly 9% of women and 11% of men are diagnosed with infertility.

The Centers for Disease Control and Prevention (CDC) reports around 4 million live births—about 1 to 2 percent of all US births—are via IVF each year.

IVF is timely, invasive and costly (can we talk about how expensive it is?) Medical protocols can involve injections that have a variety of side effects several times a day. Some people successfully retrieve one embryo in a cycle, some get 12 or more. Eggs are retrieved, fertilized in a petri dish, and given time to grow before implanting into a uterus. After that the gestational carrier goes through a personalized cocktail of medications and injections to hold the pregnancy. Each IVF cycle can cost anywhere from $3,000-9,000 and has success rates around only 40%. The average patient gets pregnant in 3-6 cycles, or maybe not at all. My wife and I spent over $40,000 in total, we wanted children so badly.

HB 704 creates big problems for ART medical providers and patients. If personhood is defined at the moment of conception, do petri dish embryos have rights? In 2019, the Ohio 8th District Court of Appeals ruled that embryos are not entitled to personhood, stemming from a case where an embryo storage unit overheated from tank failure, causing over 4,000 embryos to be destroyed. While this was devastating for each and every family, and while my heart aches for the prospective families over those losses, it was a sound decision from the court.

What about frozen embryos?  Some patients who’ve created their family through IVF may or may not want to destroy remaining embryos. There are an estimated 1 million embryos currently frozen in US cryobanks. What happens to them? Do they have rights? Are the creators of these embryos criminals if they do not use them or give them up for adoption? Are they criminals for freezing them altogether? What consequences do the donors now face if they want to dismantle the embryos when they are done making their family? Do tax benefits granted to families with children apply to those with embryos? Does child support apply if the parents split before the embryos are implanted? Do potential parents have the right to claim WIC or food stamps if they go into debt before their embryos are implanted? How far will we go?

If criminal charges arise from pursuing these technologies, it will not only cost taxpayers unnecessary dollars (though it will do that too). The Right to Privacy will evaporate as the defendant’s medical decisions get aired out in a public space. The difficult decisions like the ones my wife and I made won’t just continue to be weaponized in a political arena for voting points, they will also be aired out in criminal court.

It’s all emotionally difficult enough to go through, and very personal. Most importantly, it is none of these politicians’ business. I would not go to a hairstylist to get my car oil changed, and I will not rely on a politician to make my medical decisions. That’s between families and their medical team.

Conservative lawmakers are once again making a private family decision into a political issue for quick voting points. It’s particularly disappointing to see self-described disciples of “small government” making laws that confine our choices about our own bodies and families. Body autonomy is a human right. It was my family’s right to create a family via IVF, and it’s now our responsibility to raise the children born from it—not Ohio lawmakers.

Every day when I see my beautiful children, I am grateful that I had the choice to bring them into the world. I only hope future generations have the same opportunity.