In defense of in vitro fertilization: time to get involved in state-level advocacy!

We share experiences in advocating to defend in vitro fertilization (IVF) in Virginia, Missouri, and Mississippi; provide historical context on the "Personhood" anti-IVF movement; and discuss why "embryo donation" is a more accurate term than "embryo adoption." Some individuals and communities have a deeply held belief that a fertilized oocyte is a very early human life, and we will likely never change their minds. In the fertility community, most providers consider embryos to be an important part of the continuum between gametes (sperm and eggs) to live birth. Embryos are neither life nor property but rather a special class of "potential life" deserving of particular respect. The premise of the "Personhood" movement is that each fertilized oocyte is already an individual living being, subject to child custody and similar legal protections. Both in nature and in the laboratory, however, only a minority of fertilized eggs result in live birth. Not all IVF embryos are of adequate quality for transfer, and most transferred embryos result in negative pregnancy test results or miscarriages and, rarely, ectopic pregnancies. "Personhood" bills would also criminalize the life-saving, appropriate standard-of-care management of ectopic pregnancies, the most common cause of first-trimester maternal mortality. Efforts to apply a religious and moral lens to regulate and interfere with the practice of IVF on the basis of a mistaken perception that all fertilized eggs are early human beings, would make standard-of-care IVF practice impossible. By equating all fertilized eggs with live-born children, the broadly worded measures in "Personhood" bills would consign fertility patients to less effective treatments. As a practical matter, "Personhood" bills simply cannot coexist with legislation to protect the practice of IVF, without inordinate risks to physicians, their practices, and their patients. In response to recent events, the investigators encourage all readers to consider participating in state-level advocacy. Sharing IVF experiences and clinical expertise with state legislators (and other officials) can help protect patients, their providers, and the families that they strive to create. Efforts to inappropriately regulate and restrict IVF will decrease access to care to essential family-building treatments and services.