‘We did it to cattle’: Alabama Republicans’ botched response to IVF patients

OOn Wednesday morning, approximately 200 in vitro fertilization (IVF) patients, doctors and attorneys in Alabama descended on the Alabama Statehouse. They wore orange and pink infertility awareness shirts and carried a variety of handmade signs: “You cannot hug an embryo.” “I just want to be a mother.”

For these people and thousands of others across the state, the past two weeks have been tumultuous.

Following the Alabama Supreme Court’s recent ruling that frozen embryos are considered “children,” IVF clinics in the state have halted their services, leaving people undergoing treatment in the dark. Embryo shipping companies have also stopped providing services to the state, meaning patients who want to transfer their frozen embryos out of Alabama cannot do so.

The meeting concluded with some direct conversations between advocates and lawmakers. In one such interaction, Republican state Rep. Ben Harrison told families that a “solution” would be to freeze the sperm and egg separately, rather than freezing embryos, comparing the first procedure to a process used at cows is used.

“My personal opinion is that we keep them apart and bring them together only for what you need and what you are willing to implant,” Harrison said. “We’ve done it in cattle all the time.”

The interaction highlighted the disconnect between families undergoing the IVF process, doctors providing IVF services and lawmakers who may not understand the intricacies and science behind IVF, but who can ultimately decide whether or not it remains legal.

Dr. Mamie McLean of Alabama Fertility in Birmingham has become one of the most outspoken opponents of the Supreme Court ruling. Flanked by other doctors and IVF patients, she spoke to the meeting participants before they entered the State House.

“As an infertility doctor, I’m used to difficult conversations, but the past two weeks have been absolutely heartbreaking,” she said. “Due to the uncertainty brought about by the Supreme Court ruling, we have had to cancel embryo transfers for patients who desire and pray for a child. We call on the state of Alabama to provide immediate, full and permanent access to IVF care to the women and families of Alabama.”

Resolve, the national infertility group that helped organized the meeting, provided pamphlets and advised attendees on how to talk to lawmakers. “What happens here today in these offices will be watched by the rest of the country,” said Barbara Collura, the group’s president and CEO. “This could potentially be a roadmap for other states to restrict access to IVF, or a roadmap for protecting access to IVF and family formation. Please use your voice.”

Collura said some desperate families were leaving the state for treatment.

“You take these drugs for weeks and they cost a lot of money. For most of these people, it is not covered by insurance,” she said of the medications used during IVF treatment. “You can’t just stop and start again next week, and we don’t know when this will be resolved.”

‘It could end my journey’

Elizabeth Goldman, who assisted McLean and other advocates at the meeting, was diagnosed with Mayer-Rokitansky-Küster-Hauser syndrome when she was 14. The rare condition means she was born without a uterus; doctors told her she would never be able to carry her own child. When the University of Alabama launched a uterus transplant program in 2020, Goldman applied and moved with her husband from Mobile to Birmingham (near the school campus) in hopes of having a child. After undergoing the uterus transplant and several IVF treatments and transfers, Goldman was able to become pregnant. Her daughter, who was with her at the rally, was born in October 2023.

Transplant patients may only keep the uterus for one or two deliveries, due to the volatility of a foreign organ, Goldman said. She estimates that she has taken about 20,000 pills since her transplant 22 months ago to prevent her body from rejecting the uterus.

Her medical team cleared her to carry a second child and planned to go ahead with her transfer in March. But the Supreme Court ruling has put a stop to that. Goldman was on her way to a transfer appointment when she found out through a notification that her clinic was closed.

“With all the transplant medications I take, it can cause kidney damage and other health problems,” she said. “It is not a life-saving transplant, but a life-giving transplant. So basically I’m healthy now. My kidneys are good. But if it continues, it could end my trip.

Jamie Heard and Deidra Smith drove from Birmingham to the meeting in hopes of speaking to lawmakers in person. Heard used IVF to give birth to her now two-year-old son. She had already started her cycle for a second child when news of the Supreme Court decision broke. Her clinic canceled her appointments in the middle of treatment.

“It was heartbreaking,” Heard said. “The emotions of the last few days – I feel like I have saddened a loved one, that’s how heavy my emotions have been.”

Brittany Pettaway and her husband Byron of Montgomery currently have eight frozen embryos. She said this was their only chance to become parents. They attended the meeting hoping that lawmakers would ensure that things “literally go back to the way they were two weeks ago.”

“We’re just trying to protect that right, and what should be a natural, God-given ability to do that,” she said. “It’s surreal, I feel like I’m waiting for someone to say it was a joke, a really horrible emotional nightmare.”

‘I don’t know what the answer is’

After the meeting ended, attorneys lined up outside to enter the statehouse to speak directly to lawmakers. The floors of offices for senators and representatives were filled with people dressed in orange and pink.

Outside an office, a group of families spoke with Alabama State Auditor Andrew Sorrell about their problems. As auditor, Sorrell reports the state’s receipts, claims and payments, taxes and revenues to the governor.

“I don’t know exactly what the answer is, but we have to find a way to protect the IVF industry while maintaining our pro-life stance,” he said.

Sorrell suggested that women create only as many embryos as they want to use. The proponents explained “the numbers game,” where a family may produce dozens of eggs but end up with only one or two viable, healthy embryos. Sorrell also suggested that the state pay to make it easier for people to adopt frozen embryos.

After the almost immediate reaction to the court ruling, Republicans across the country were initially silent on the issue. But when clinics across Alabama began closing, they turned around and spoke out in support of IVF. Alabama’s attorney general vowed not to prosecute IVF clinics or patients, while former President Trump also supported the procedure. On Wednesday, multiple accounts that would allow IVF to move forward in the Alabama legislature. One bill, which will be sent to the Alabama Senate on a 94-6 vote on Thursday, would shield clinics from lawsuits.

But there is no comprehensive solution for preserving IVF in the state and in the meantime, patients and families, even those in the middle of treatment, have to wait.