Two weeks ago, I was one of a lucky few standing in the Houses of Parliament listening to 78-year-old Grace MacDonald, mother of the world’s first IVF boy, Alastair MacDonald. Forty-five years earlier, Grace happened to flick through New Scientist magazine and read a feature on an upcoming trial spearheaded by three British scientists – Robert Edwards, Patrick Steptoe and Jean Purdy – who would eventually become the pioneers of in vitro fertilisation. Despite being told she was likely infertile due to blocked fallopian tubes, she was determined to become a mother, and wrote a letter to Edwards pleading to be a part of the trial that paved the way for IVF as we now know it. “We knew we were involved in something very special,” she tells me, “and that taking part was about more than just us.”
There wasn’t a dry eye in Westminster that night.
But what Grace didn’t know when delivering her speech was that, the very next day, Alabama’s Supreme Court would rule that frozen embryos should be considered children under state law. The decision created widespread confusion and fear for both fertility clinics and patients, not just in the United States, but globally.
So how did we get here? In December 2020, a patient at a clinic in Alabama allegedly walked into an embryo storage unit, lifted a cryogenic vessel, and immediately dropped it when it burnt their hand, subsequently destroying the embryos inside. Fast forward four years – after multiple filings of wrongful death suits relating to this incident, as well as the overturning of Roe v Wade – and the Alabama Supreme Court ruled that frozen embryos can be considered children (previously, they were considered property) under state law.
What does this mean for patients going through IVF? In the short term, multiple cycles have been paused or cancelled entirely across Alabama – a devastating and financially crippling outcome for so many.
But for patients and clinics alike, the concern and confusion goes even further. If embryos are considered children, it may be mandatory that they’re kept in storage indefinitely, even if they are not wanted or able to be used. This would drive up the cost of IVF, making it even more inaccessible than it currently is. There would also be less incentive to fertilise lots of eggs, thereby driving down IVF’s success rate and increasing the number of cycles needed to create a family.
“We’ve been trying to make IVF more accessible,” says Barb Collura, president of Resolve.org, “and this ruling will now have the opposite effect. Clinics have been forced to make an impossible decision: pause IVF procedures, or put their doctors at risk of prosecution.” And as Dr Catherine Hill, head of policy and public affairs for The Fertility Network UK, points out, “What kind of reproductive choice does it leave patients with?”
The accessibility of IVF has already been a key talking point for decades now. For a technology just shy of 50 years old, it remains expensive, restrictive and full of unknowns, with no guarantee of a successful outcome. But it’s also a beacon of hope for so many, including myself. As someone who has gone through multiple rounds of IVF and embryo losses, it gave me my son – and for that, I am forever thankful.
It also gave me reason to become part of a growing collective making access to better fertility treatment, services and products easier – after all, it should be a right, not a privilege. Frustrated with the lack of good quality egg health supplements at an accessible price point to support my own IVF journey, I co-founded OVA, a clinically backed fertility supplement brand. At OVA, we want to bring the TTC (trying to conceive) community the tools to take charge of their reproductive health and be better nutritionally prepared to navigate their fertility journey – whatever that route may look like.
And while fertility providers in Alabama and across the US are also trying to make things better, their fight is not just in the lab, but now continues in the courtroom. How we move forward is far from clear.
“Fertility treatment is healthcare – and should be accessible to all, regardless of zip code,” explains Dr Roohi Jeelani, chief medical officer and reproductive endocrinologist at KindBody. “Every person should have the agency and ability to access fertility care and advanced reproductive technologies if they want or need them. Everyone has the right to build the family of their dreams.”
As for the “children” I’ve lost, and the two frozen embryos that I have yet to meet (when and if that time comes), I hope the world will have landed at a place where IVF is celebrated for what it does best, giving us hope in place of heartache.
Danielle, is the co-founder and Chief Egg Officer of OVA (sign up for the pre-launch waitlist theovaco.com).