Cardinal & Pine by Michael McElroy

In the wake of an Alabama court ruling that threatens fertility treatments, a group of North Carolina mothers and doctors warn that any restrictions on the process would mean fewer moms having babies in North Carolina.

The Alabama Supreme Court ruled last month that discarding an unused embryo during fertility treatments, a vital part of the process, was no different than murdering a child. The court’s decision raised fears that the Republican lawmakers who passed abortion bans in North Carolina and other states would now use the ruling to target in vitro fertilization as well. 

Any lawmaker considering such a move should perhaps talk to Hannah Johnson.

Johnson and her husband always wanted children, but they knew they’d never have them naturally. So they considered their options, prayed about it, and like millions of couples across the country, decided to pursue in vitro fertilization (IVF).

The science behind IVF is exemplary, doctors say, with success rates as high as 65%, depending on the woman’s age. 

But it is not easy.

By design, IVF produces multiple embryos in each round to increase the chances that one of them will eventually become viable. Often one does, often none do. Sometimes the news is worse.

Over the course of her IVF treatments, Johnson had several successful embryo transfers, and several miscarriages. 

Two years ago, she gave birth to stillborn twins.

Then, last August, “I got to hold my miracle baby,” she said.

“His name is Ellis.”

Johnson laid out these details at a press conference last week alongside state Attorney General Josh Stein and two other women who’d had children through IVF. The group urged the Republican-controlled legislature to protect IVF treatments in North Carolina.

One in five couples face infertility issues in the United States, and IVF has helped millions of them have babies they likely would have been unable to have on their own. But since multiple embryos are produced in the process, the extras are either frozen for future use, donated, or if the couple doesn’t want any more children, destroyed. Restrictions would have a devastating effect on IVF overall, the women said. 

The Alabama court’s ruling, they said, threatened to deny women across the country the chance to hold their own miracle babies.

‘The threats on reproductive healthcare keep coming’

“Right now in North Carolina, IVF is legal and we are so grateful for that and these incredibly brave women are a testament to why that’s a wise reality,” Stein, who is also the Democratic nominee for governor, said. 

But, he added, “We thought that a woman’s right to an abortion was settled law, [too].”

The US Supreme Court’s 2022 Dobbs decision striking down Roe v. Wade, he said, “turned the table upside down.”

Soon after, Republican lawmakers turned the table over in North Carolina as well, passing a 12-week abortion ban last year that also added extra barriers to actually seeking care.

“Things that we thought were … impossibilities turn out to be very real,” Stein said. “The threats on reproductive healthcare keep coming.” 

Alabama’s Republican lawmakers moved fast after the court ruling to protect IVF patients and doctors from criminal liability, but they did not address the underlying issue of whether embryos were children. 

North Carolina’s GOP leaders so far seem in no rush to do anything at all. 

The Republican nominee for governor and Stein’s opponent in November, Mark Robinson, has been silent on the issue, refusing to say whether he supports IVF protections.

And legislators don’t return until late April, but House Speaker Tim Moore told reporters last week that he did not foresee any new laws on IVF.

Stein and the other speakers, including US Rep. Deborah Ross, urged Republican leaders to reconsider. 

“We want to assure the women of North Carolina that we will fight with everything we’ve got to continue to protect their right to make decisions about shaping their own families,” Stein said. 

Ross said urgent action was needed.

“If we do not take action soon, the devastating consequences of this decision will continue to ripple across the country,” Ross said.

Congressional Republicans say they support IV treatments, but, Ross pointed out, Senate Republicans recently blocked a bill that would have enshrined IVF protections into law. And more than 125 House Republicans co-sponsored a bill last year classifying embryos as children. Five NC Republicans were among them, including Rep. Dan Bishop, who is running for NC Attorney General.

‘No clear pathway forward.’

Dr. Meaghan Bowling, the IVF Medical Director at Carolina Conceptions in Raleigh, where Johnson and the other women got their treatments, said at the press conference that doctors across the country were troubled by the Alabama ruling. 

“The Alabama decision has weighed heavily on both infertility patients and physicians over the last few weeks,” Bowling said. The case raised significant legal issues for medical providers, she said, but the court’s ruling “was not grounded in medicine.”

“Every part of IVF from freezing embryos to genetic testing of embryos to discarding of embryos could all be seen as harmful to the embryo and therefore result in criminal liability for both doctors and patients,” Bowling said.

“Would patients be forced to use every single embryo they had, with no right to decide for themselves how many children they wish to have?” she asked.

Doctors, she said, would have “no clear pathway forward on how to handle the legal questions that arose, other than to stop IVF completely.”

‘Beacon of hope’

Lauren Garrett, a nurse at Carolina Conceptions, has Polycystic Ovary Syndrome, a hormone imbalance that affects ovulation and is one of the most common causes of infertility in women. Her husband, Jake, had male factor infertility, which affects sperm production, and is the cause of fertility issues in more than half of all couples who have trouble conceiving.

IVF, Garrett said, was their “beacon of hope.”

It took two years, but multiple embryo transfers brought them two daughters, first Tenley, now 4, and Teegan, 2. 

IVF “granted us the gift of parenthood,” Garrett said, but it also “elevates each moment with our children,” because she knows what it took for them to get here.

Without an IVF process that allows for multiple embryos, Tenley and Teegan wouldn’t be, she said.

“Our hearts overflow with appreciation for the remarkable advancements in science, the unwavering support of physicians and healthcare providers, and the profound privilege of choosing to embrace the journey of parenthood through IVF, free from governmental interference,” she said.

‘A little less daunting’

IVF patient Ashlee Beal had premature ovarian failure, she said at the press conference, and she and her husband pursued treatment using a donor egg. 

Her daughter, Greeleigh is now 5. Her son, Meyer, is a year old. 

The women shared their stories, Beal said, to show other women facing similar issues that they are not alone.

“I made the decision not to stay quiet about what we were going through and what it looked like,” Beal said. “I spoke openly with others about how we were planning to grow our family and how they could pray for us during this exciting but formidable journey. This allowed me to connect with other women who were going through similar circumstances.”

She added: “The sense of community made our struggle a little less daunting.”

Restricting IVF access would deny other families from joining that community, Bowling, the IVF doctor, said. 

“Should something like this happen in the state of North Carolina, it would leave patients stranded and without the fertility care that they need to have a child that they want so desperately,” Bowling said. 

“Without IVF, there would undoubtedly be less babies born in North Carolina.”