The Rapidly Changing IVF Landscape

By: Agbo Ikor, Policy and Advocacy Director & Rachel Utz, If/When/How RJ Fellow

What is IVF? 

There are many types of assisted reproductive technologies that can help a person get pregnant. Some of the most common forms are: Intrauterine insemination, where healthy sperm is collected and inserted directly into a uterus when a person is ovulating; cryopreservation, freezing of eggs, sperm, or embryos; egg or embryo donation; and gestational carriers, aka surrogacy.

IVF is a term that has been used quite frequently in the past month. In vitro fertilization, IVF, helps with fertilization, embryo development, and implantation so a person can get pregnant. It is one of the more widely known and used types of assisted reproductive technology (ART). IVF uses a combination of medicines and surgical procedures to help sperm fertilize an egg and then help the fertilized egg implant in the uterus. A person going through IVF treatment will begin by taking medication that makes several eggs mature and ready for fertilization. Next, a doctor takes the eggs from the body and mixes them with sperm in a lab to help fertilize the eggs. Finally, they implant the fertilized eggs into a person’s uterus in hopes that the egg attaches and implants to the uterus, which results in pregnancy. 

A major concern of IVF and lack of access to fertility treatments, is the great financial burden. A report from 2015 estimated the median cost for a round of IVF treatment was over $19,000. One round of IVF includes the medicines, procedures, anesthesia, ultrasounds, blood tests, lab work, and embryo storage. 

There are significant racial and socioeconomic disparities among fertility patients accessing care. In a recent analysis it was found that there are no differences in infertility rates by race/ethnicity, education, income, US citizenship, insurance or location of healthcare but that there is difference between who is accessing fertility care. The majority of individuals accessing services were white, highly educated, and had income levels > $100,000. Additionally, Black and Hispanic birthing people attempted to conceive longer before seeking treatment and reported more difficulty getting appointments, taking time off work, and affording fertility treatment. In a recent analysis it was found that there are no differences in infertility rates by race/ethnicity, education, income, US citizenship, insurance or location of healthcare but that there is difference between who is accessing fertility care. 

While cost alone is a major barrier for people seeking fertility care, there are significant inequalities for the LGBTQIA+ communities seeking care. While health insurances may help cover the cost of fertility treatments, they may exclude couples that are not “having heterosexual sex”. Only 14 states provide coverage on private insurance plans for fertility health care, but only three of those 14 states have fertility insurance laws that inclusively cover LGBTQ people.  Further, some insurances will require a person to be diagnosed with ‘infertility’ in order to qualify for coverage of fertility treatment. They will consider a person being infertile after failing to become pregnant after attempting for at least 12 months of intrauterine insemination – paid out of pocket- before insurance would kick in to pay.

Lawmakers Roles in IVF  

Lawmakers and legislators have the most say in reproductive rights. It is no surprise that many legislators are working overtime to ensure abortion and other reproductive care ceases to exist, by any means necessary. In the last few years, the concept of fetal personhood has been pushed and has become law in many states. Fetal personhood statutes give fetuses, and sometimes embryos, the same legal rights as people. More than a third of US states have these types of laws. Fetal personhood laws can be used to prosecute pregnant persons for miscarrying or potentially undergoing necessary medical procedures. Many insurance companies will also use extremely gendered terms, this language can exclude hopeful trans and gender expansive  parents. 

A recent court ruling has pushed IVF to the forefront in the past few weeks. The court ruling came from the Supreme Court of Alabama and recognized embryos as “extrauterine children” after an IVF treatment center was sued by expectant parents. The case came forward after the parents of the embryo tried to collect damages under the Wrongful Death of a Minor Act, leading the courts to identify whether an embryo is a child. In coming to their conclusion, the Justices used a lot of religious rhetoric including a line, “We believe that each human, being from the moment of conception, is made in the image of God, created by Him to reflect His likeness. It is as if the People of Alabama took what was spoken of the prophet Jeremiah, and applied it to every unborn person in the state.” The court largely used theology to back up their decision rather than outlined legal precedent. 

Many questions arose after this opinion was released. Patients and providers were concerned about liability and possible criminal implications if they discarded embryos that were not viable or if they had a genetic defect. In Louisiana, the disposal of embryos is prohibited, they must be stored indefinitely or donated to a married couple.

Following  this ruling, three of Alabama’s major IVF providers paused services. After this court ruling, there were major concerns regarding anti-abortion rhetoric and issues that could arise in a post-Roe landscape. It raised the question about the thousands of fertilized eggs across the country and whether they would need to be preserved indefinitely. IVF clinics routinely discard unviable and leftover embryos, a practice which could have led to charges of involuntary manslaughter or homicide under the new legal precedent. This ruling, coupled with the fetal personhood laws, has many reproductive rights advocates concerned that halting and getting rid of IVF may be the next target. 

In the aftermath of this ruling, many states have taken steps to protect and enshrine IVF and other fertility care treatments into their state constitutions. In early March, Alabama lawmakers were successful in passing IVF protections. Alabama State Legislature passed a bill granting civil and criminal immunity for in vitro fertilization service providers and receivers. Alabama governor, Kay Ivey, signed the bill into legislation an hour after she received it. This specific bill moved really quickly, essentially as a stop-gap measure to allow fertility treatments to resume. The bill was originally intended to define personhood but the language was removed to ensure it would move smoothly. 

What Happens When IVF is no longer available

Fertility care and other assisted reproductive technologies are extremely important and necessary for creating families. Without IVF and other fertility treatments, many families will not be able to have a child. 

Like many other issues plaguing this country, inaccessible fertility care can disproportionately affect already marginalized communities. IVF is widely used by queer couples because they have fewer options than straight people and depend greatly on access to fertility care to start a family. Many queer people already face barriers because of the language used in health insurance to determine whether they will cover fertility treatments. Alabama, for example, also makes it more difficult for LGBTQIA+ couples to foster or adopt, leaving very few options for starting a family. The Affordable Care Act prohibits discrimination in the healthcare sector based on sex, but the Trump Administration eliminated these protections through regulatory changes and without the explicit protections, LGBTQIA+ patients may be denied healthcare, including fertility care, under religious freedom laws.

Additionally, if states begin banning IVF, lower income couples will likely be unable to travel outside of the state to access the fertility care that they need in order to start their families. IVF is also used to test embryos for genetic abnormalities that increase the risk of miscarriage and stillbirth, if IVF care is no longer available then this testing may not be either. People are growing hesitant to harvest and store their eggs because of the uncertainty surrounding storing this genetic material. Single parents also often struggle to access fertility treatments because of the language used to define infertility. 

There are major contradictions with fetal personhood and IVF treatments in the laws. It is confusing for legislators to fight really hard to protect IVF but on the back end they are promoting fetal personhood. Many anti-abortion ‘advocates’ are in favor of protecting IVF. This is contradictory  in the fact that a fertilized egg is considered a child for abortion purposes but they want to allow IVF to continue. This logic is extremely disingenuous, legislators should not pick and choose when they want their rules to apply, especially rules based on theology rather than law. Even if Georgia legislators work to protect IVF, Georgians will still face problems when trying to access IVF and other fertility treatments. Protecting IVF is only part of the battle, albeit the most pressing at the moment.  

IVF in Georgia

Georgia is not immune from fetal personhood statues and has many legislators working to ban abortion altogether. In Georgia, a law was passed in 2019 called the Living Infants Fairness and Equality Act. It defines a ‘fetus’ as a person at around 6 weeks gestation, when cardiac activity can be detected. This aligns with Georgia’s 6 week abortion ban. Georgia also allows other fetal “protections”, under a new law Georgia residents can choose to claim a fetus as a dependent on their taxes. Anyone who claims an “unborn dependent” on their taxes is eligible to reduce their taxable income by $3,000 per fetus. This is another way for the state to extend fetal personhood. 

Many states have been trying to get ahead of the impending IVF restrictions. In Georgia, legislators are working across the aisle to protect IVF access. Georgia Sen. Elena Parent is the lead sponsor on a bill that was introduced on February 29th. This bill relates to general provisions of health, “so as to provide that a human egg or human embryo is not considered an unborn child, a minor child, or a person for any purpose under the law.” Even with this, more clarification is needed because of how this may interact with Georgia’s law relating to fetal personhood. Sen. Parent said, “Our code is riddled with all kinds of places where there are question marks, and therefore, we need this strong, very clear, very simple statement that embryos outside of the uterus are not children.” Democrats from both chambers held a press conference to encourage the majority party to act on just bills that would protect access to IVF and contraception, including condoms, birth control pills, and IUDs. There is pushback from some legislators, saying that the issue is in Alabama and does not exist in Georgia. 

Many Georgia lawmakers have been speaking about IVF protections following the Alabama court ruling. However, with Georgia’s own fetal personhood law in effect, lawmakers must contend with their own dissonance and–perhaps unintended–outcomes of that policy. When states grant personhood to embryos, when they codify that “life begins at conception” this is the result. And while we’ll continue to call on legislators to take away the barriers to abortion and support the bodily autonomy and dignity of all Georgians, we hope that any IVF protections that pass will also remedy its current inaccessibility in Georgia. As of now, Georgia does not have IVF protections or measures to support IVF access such as mandated insurance coverage for IVF and other fertility treatments. We hope that legislators who wish to protect IVF also wish to make it more attainable for our communities. 

At SPARK, we are working on a campaign to increase IVF access. Our ‘Fertility Access Campaign’ was created to guarantee equitable and non-discriminatory access to fertility care for all residents of Georgia. Be on the lookout for more information on this campaign and ways to be involved! 

CLICK HERE FOR FULL STATEMENT WITH RESOURCES

A Message From SPARK RJ NOW! – GA HB 481 | Sister Song v. State of GA Ruling

This morning, we learned that the Georgia Supreme Court released their ruling on case Sister Song v. State of Georgia, and have decided to allow the six week abortion ban to remain in effect, forcing birth upon Georgia residents. You can read a summary of the opinion HERE. We are frustrated, we are sad, but we remain determined and unwavering. 

Georgia’s House Bill (H.B.) 481 took effect shortly after the U.S. Supreme Court overturned Roe v. Wade abortion protections last year. Following its enactment, this forced birth bill has been involved in litigation with this opinion being the latest in what has been a lengthy battle. This is a dangerous law and will continue to cause harm to communities already marginalized. As Georgia has one of the highest maternal mortality rates in the country, a rate even higher for Black birthing folks, the state’s concern should be toward making sure pregnant folks have all the resources they need, including abortion access.  

Although these arguments did not prevail, this case will continue through the courts. It has been sent back to the trial court of Fulton County to determine whether this law violates the Georgia State Constitution. We will follow with updates as this continues, hopefully with safer and healthier outcomes. 

To be clear, this ruling does not change the current law, it just allows it to stay in effect. A person seeking abortion care within the state can do so prior to six weeks, but that is often well before a person even knows they are pregnant. It is illegal to access abortion care at around six weeks OR when electrical activity is detected by ultrasound in the uterus. This forces many Georgians to seek care outside of the state, a trying and sometimes impossible task. 

SPARK remains dedicated to expanded abortion access and abortion justice for all Georgians and will continue to fight. 

We know that this abortion ban and all other barriers to abortion services are the most harmful for our marginalized kin, especially those of us who are Black, brown, Indigenous, im/migrants, disabled, low-income, queer, and trans/gender-diverse.

If you have questions about your legal rights surrounding abortion, check out the If/When/How Repro Legal Helpline

When the government fails to protect us, we protect each other. 

In solidarity,

SPARK Reproductive Justice NOW!

Summary of opinion

A Message from SPARK Reproductive Justice NOW! —UPDATE ON SB 435

This week the Senate Education and Youth Committee voted in favor of SB 435, a bill that would prevent trans and gender expansive children and young adults from participating in school sports on teams that correspond with their gender identity. If passed into law, this bill would harm all young people – cis, trans, intersex, and gender expansive alike – with particularly troubling implications for Black girls and young women. For more detailed information on how this bill would negatively impact students in Georgia schools, please see our detailed statement

We unapologetically oppose this transphobic and misogynistic piece of legislation. We are deeply disappointed, although not particularly surprised, that the committee voted in its favor. However, this committee is only one set of decision makers that the bill needs to go through before it becomes a binding law. We invite all of our base to join us in continuing to fight it as it goes through the next steps in the legislative process, whether that be through contacting your legislators, giving committee testimony, or educating others in community about the bill. 

To gain advocacy skills and have opportunities to speak directly to your legislators, please register to attend our Legislate This! advocacy day on March 3, 2022. 

A Message from SPARK Reproductive Justice NOW! —SB 435

On Monday, February 1st, a group of Senators in the Georgia Legislature introduced SB 435, a bill that denies the existence of trans and gender expansive students in Georgia schools and actively excludes them from full participation in school athletics. 

If passed, SB 435  would require K-12 schools to discriminate against trans and gender expansive student athletes. Hyperbolic and unsupported claims of unfair competition are no justification for systematically excluding children as young as 5 years old from participation in sports. This bill serves no legitimate purpose and is yet another thinly veiled attempt to advance a bigoted, transphobic agenda.

Trans and gender expansive students experience significantly higher rates of depression and anxiety than their cisgender peers. However, when their families and communities accept and reflect back their names, pronouns, and identities, these students have better mental health outcomes across all measures. Requiring schools to discriminate against their trans and gender expansive students will make it impossible for educators to create environments that foster community acceptance and support. We need legislation that will protect the mental wellbeing of all students, not a bill that will exacerbate existing disparities. 

Trans and gender expansive folks, even when they are young, know themselves. They deserve space to explore their identity and self expression without having to sacrifice opportunities to participate on teams that affirm and respect who they are. Trans and gender expansive children and young adults exist and have always existed, and they are valuable members of our communities. We demand that the Georgia Legislature treat them as such. 

Join us for our annual SPARK Organizing Intensive

New to organizing? Want to develop your leadership while building community with other advocates? What does liberation look like to you?

Leading up to our annual Legislate THIS! Advocacy Day. Join SPARK as we discuss the issues that impact our communities the most and learn how we can build the power needed for us to live our most liberated lives. This training is for new and seasoned organizers and advocates who want to learn about the issues facing Georgia today and gain the valuable skills necessary to build power and effect change.

You will gain:

  • Concrete organizing and campaign development skills
  • Tools and tips for organizing & advocacy
  • Useful information about the 2022 legislative session
  • The confidence to speak truth to power
  • The opportunity to build community with fellow RJ leaders

The SPARK Organizing Intensive is a space that centers Black queer, trans, and nonbinary young people. We invite all to register, but we are amplifying the issues that impact those that exist at the margins.

SPARK will provide $25 Uber meal codes to all participants.

Register by visiting: bit.ly/soi-2022

A Message from SPARK Reproductive Justice NOW! —Texas Abortion Ban

September 3, 2021

As a Reproductive Justice organization that fiercely and unapologetically advocates for unrestricted access to abortion for anyone who wants it, SPARK strongly opposes the six-week abortion ban that went into effect in Texas earlier this week. This ban is an unconstitutional affront to reproductive autonomy, and will force many people to carry unwanted pregnancies to term. 

Like all barriers to abortion access, the Texas ban will have a disproportionate impact on People of Color – particularly Black and Indigenous folks – as well as queer and trans people, low income individuals, people with disabilities, and those who experience multiple forms of marginalization due to systemic and interpersonal hierarchies of oppression. Where you live, who you are, or the amount of money you make should never determine whether or not you get to make the significant and life-changing choices about your body and reproductive future. 

The Supreme Court had the opportunity to intervene and block the ban from going into effect, but they chose to blatantly ignore existing constitutional precedent and do nothing. In our overwhelmingly conservative judicial system, we can no longer rely on the rights promised by Roe v. Wade. In Georgia and the entire Southeast, we need to continue to fight tirelessly in our communities and state legislatures to protect and increase abortion access. Although the Texas ban going into effect is a significant step in the wrong direction, we cannot let it lead to discouragement and inaction. Instead, we need to use our anger and solidarity with people in Texas as a tool to strengthen the Reproductive Justice movement. 

SPARK will continue to advocate against all barriers to abortion access that are introduced in Georgia, and create opportunities for our base members to make their voices heard. We urge you to directly support people in your community by donating to your local abortion fund, or to funds in Texas that continue to provide vital resources to people seeking abortion care there. When the government fails to provide the things we need to thrive, we need to take care of each other. 

 

In solidarity, 

SPARK Reproductive Justice NOW!

SPARK Statement on the Atlanta Homeless Union Demands and City Response

July 9, 2021

SPARK stands in solidarity with the Atlanta Homeless Union in their demand for housing, healthcare, water, and a seat at the table. These demands represent central tenets of Reproductive Justice – we all need access to safe places to live, clean water, comprehensive healthcare, and a say in the policies that govern us in order to make liberatory decisions about our bodies, lives, and futures. 

Due to systemic and interpersonal structures of oppression, economic insecurity is correlated along lines of racism, homophobia, transphobia, and misogynoir. Our base members in particular face a heightened risk of experiencing housing insecurity, especially at a time where access to affordable housing has reached the point of crisis in Atlanta. We demand that our city leadership use taxpayer funds to address the tangible outcomes of structural inequality by increasing access to necessary resources – including creating long term housing options. 

We strongly oppose the Atlanta Police Department’s decision to sweep the Atlanta Homeless Union’s encampment and make a series of arrests on Monday. The criminalization of housing insecurity does nothing to address the root of the problem, but is instead an attempt to hide the existence and humanity of unhoused people. Arresting people for the circumstances of housing insecurity does not keep our communities safe. Instead, we need access to resources, safety from police violence, and decreased surveillance in order to thrive. The Union deserves a platform to safely exercise their First Amendment rights without fear of being further victimized by APD and the criminal legal system. 

A Message From SPARK Reproductive Justice NOW! – The Equality Act

The Equality Act
February 25, 2021

Today, Thursday, February 25, 2021, the United States House of Representatives is set to vote on the Equality Act. The Equality Act is a bill that would legally ban discrimination against people based on sexual orientation and gender identity. This bill would be an amendment to the already existing federal civil rights laws to include the aforementioned protections as well as prohibiting such discrimination in public places, on transportation and in government-funded programs.

Although many states have established anti-discrimination legislation, many of these laws have left the queer, Trans and gender diverse communities vulnerable to discrimination. This long overdue legislation is a necessity in the protection of our folks’ basic human services. The Reproductive Justice movement is rooted in the belief that all individuals and communities should have the resources and power to make sustainable and liberatory decisions about their lives. If passed, The Equality Act will bring us one step closer to a reality in which this is possible.

In Georgia we are currently facing HB 276 — “a bill that would make it illegal for Trans girls and women to participate on sports teams with their cisgender peers. This is one of many similar bills filed in state legislatures across the country as part of a coordinated attack on the rights of Trans and gender diverse people in the U.S.” (SPARK HB 276 Statement). The passing of The Equality Act could potentially put a halt to bills such as Georgia’s HB 276, guaranteeing through law that these blatantly Transphobic bills do not have a standing in our society. 

The full text of The Equality Act is available here.

A Message from SPARK Reproductive Justice NOW!, Inc. – Insurrection Response

Insurrection Response
January 8, 2021

It goes without saying that this week’s insurrections were the inevitable culmination of a country that protects the interests of white supremacy. Georgia’s capitol building saw a similar demonstration, and we can’t help but note the stark contrast between the response to this incident and the uprisings this summer. To witness coordinated, armed combatants determined to protect the interests of white supremacy surge around the nation protected by police officers and goaded by the president is an affront to Black people who have been victims of and witnessed state violence perpetrated against them, particularly Black queer and Trans folks who have been murdered by the state. This insurrection is a response to the perceived threat to white supremacy and its interests. As we inch towards liberation, it is clear that the goals of Reproductive Justice and Queer and Trans liberation go against those of the harmful, oppressive systems in which we currently live. 

This incident and the COVID-19 pandemic have laid bare the fact that the current capitalist white supremacist system that we live in is untenable. Despite the impending change in administration, demonstrations of this nature will not stop. The oppressive systems that we live within continue to exist. It is a system that is harmful to all of us and pervades most if not all facets of our lives. At this moment, rage is acceptable, despair is acceptable, fatigue is acceptable; complacency is not. This is a moment where we must center the needs and safety of Black queer and trans folks particularly as they are disproportionately murdered by the state. SPARK will continue to center these voices and work to abolish these systems and affirm Reproductive Justice and Queer Liberation. We recognize that true power lies within the people and communities organizing and strategizing against harmful policies and systems. Now more than ever is a time to find your community, organize, and care for one another.

SPARK Reproductive Justice NOW!, Inc is a grassroots organization that builds community and fights for the liberation of all Black, brown, and indigenous people of color. We uplift and honor those working for justice across the nation and will continue to advocate for our communities. To learn more about SPARK, organizing, and legislative advocacy, you can attend SPARK’s Organizing Intensive on January 30.