Battle Lines Sharpen Over Future Fertility Research
WHY YOU SHOULD CARE
Because ironically, passing a “pro-life bill” could mean infertile couples will never get to conceive a baby.
By Molly Fosco
The day Lesley and John Brown first became parents, they traveled to the hospital under cover of darkness to avoid tipping off the media. They didn’t want anyone to know they were about to welcome a baby conceived through in vitro fertilization (IVF). The press eventually found out and dubbed little Louise Brown the world’s first “test tube baby.” An estimated 5 million babies worldwide have since been born through IVF, but now, fertility science faces fresh challenges and a fight for the future.
It’s a battle that is pitting some doctors, scientists and infertility advocates, worried about a growing pushback against fertility science, against critics who appear to have growing political support, including from the Trump administration. Sure, fertility science has encountered pushback from the very start. Brown’s birth in 1978 upset religious groups that didn’t like the idea of science involved in procreation. But the latest threats could directly impact the advancement of fertility treatment.
In October, the Department of Health and Human Services (HHS) released a draft of its strategic plan, which defined life as “beginning at conception.” The Republican tax plan revealed in November included a stipulation that parents could create a tax-advantaged college savings account for their unborn child. And bills seeking to give human rights to embryos, known as “personhood bills,” continue to be proposed at the state and federal level each year.
It’s very problematic when you have a government organization putting a fundamentally unscientific statement into their manifesto.
Dr. Richard Paulson, fertility specialist
To try and blunt this onslaught, fertility specialists like Dr. Richard Paulson, the immediate past president of the American Society for Reproductive Medicine (ASRM), are lobbying Congress against personhood bills every time they’re proposed. Paulson has done this for years, but the Trump administration’s moves — like the HHS memo — have heightened his concerns. ASRM also partners with RESOLVE: The National Infertility Association to educate legislators and the general public about how personhood bills threaten fertility research and treatment. RESOLVE tracks every state bill that impacts infertility, whether “pro- or anti-family,” to ensure access remains open to family-building resources. The Union of Concerned Scientists (UCS), a nonprofit, provides online training and toolkits for anyone to fight threats against science. It advocates for fertility research, like the debate over Planned Parenthood’s fetal tissue study, and plans to arm citizens with resources to take on future threats.
The heightened debate coincides with a pivotal moment in the evolution of fertility science. In 2017, CRISPR gene editing was used to correct a mutation linked to a heart disorder in a human embryo, fetal lambs lived for several weeks inside an artificial womb, and a new in vitro process advanced using DNA from three parents instead of two. But scientists are concerned these milestones could nudge the Trump administration to impose restrictions on their research, similar to the way President George W. Bush imposed restrictions on federal funding for stem-cell research in 2001.
“It’s a religious concept,” says Paulson, referring to the HHS memo. “It’s very problematic when you have a government organization putting a fundamentally unscientific statement into their manifesto.”
While the Trump administration has yet to take steps like Bush did, its moves so far have “created a culture of fear in the scientific community,” says Gretchen Goldman, research director for UCS. Last year, Trump sought to roll back an Obama-era rule requiring employers to provide birth control coverage in health insurance plans. “They were citing concerns over the safety and efficacy of birth control,” Goldman says, which weren’t based on scientific evidence. So, Goldman and her team authored multiple articles and reports on their website detailing how the administration was using fake science to justify restriction on contraceptives.
Paulson says that’s also the trouble with personhood bills. In 2017 alone, there were personhood bills introduced in 11 states, as well as three bills proposed at the federal level. If one of these bills passed, it would mean that embryos in a laboratory setting would be considered human beings. “What happens if you unfreeze the embryos and one doesn’t survive the thaw? Is that murder?” Paulson asks. “If the answer is yes, I don’t think there are many of us willing to take that kind of chance.” Paulson and the ASRM plan to fight life at conception definitions by writing to legislators and filing amicus briefs in litigation that threatens fertility science.
Barbara Collura, the CEO of RESOLVE, is also trying to prevent government regulation from influencing IVF by fighting anti-abortion bills at the state and federal levels. Her focus is on educating legislators. “Most of the time, legislators don’t know how personhood would impact the practice of IVF,” Collura says. But some legislation targets IVF directly. After a bill passed in 2016 covering IVF treatment for U.S. veterans, a similar bill was proposed, making clear no embryos could be destroyed where the government is paying for IVF. It didn’t pass, but “an amendment like that could show up anywhere,” says Collura. “The political climate is ripe and we have to be vigilant,” she says.
Not everyone working in fertility is concerned. The Order of St. Francis (OSF) Institute for Women’s Health and Fertility advises couples struggling to conceive in natural family planning methods in line with Catholic ideology. “I can help women with infertility achieve a pregnancy up to about a 40 percent success rate using the Creighton model,” says Paul Kortz, a fertility care clinical educator at OSF. The Creighton model helps women track their menstrual cycle so they know when they’re ovulating, and they can achieve pregnancy through “the natural act of intercourse,” Kortz says. While they don’t take an active stance against IVF, they don’t encourage it either. “Why would we [advise IVF] when we have something better?” asks Kortz.
But while IVF has a success rate of less than 45 percent, in some cases, it’s often the only option that might help some women conceive. “In vitro fertilization has made family building possible for millions of people around the world,” says Paulson.
Whether future fertility research can help millions more bring babies into the world could hinge on the sharpening debate in the U.S. And neither side is backing off.