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SALT LAKE CITY — Utah fertility doctors say they are receiving numerous questions from patients worried about the potential impact on in vitro fertilization access after the U.S. Supreme Court overturned Roe v. Wade, setting in motion the state's trigger law that bans abortions.
"As soon as the Dobbs ruling came out, we had patients reaching out to us via telephone, via social media, email, and everybody has concerns about what this means for their ability to transfer their embryos, store their embryos, do diagnostic testing," said Dr. Kristi Maas, with Reproductive Care Center in Sandy and Clearfield.
She said patients also expressed concern about how the ruling could impact their treatment and their obstetric care "after we graduate them from our practice into the real world."
The answer?
IVF providers remain unencumbered under the state's trigger law, SB174. But concerns remain over the future of reproductive care.
Utah trigger law
The Utah Legislature passed the trigger law in 2020 to go into effect should the U.S. Supreme Court ever overturn Roe V. Wade. When that happened in June, Planned Parenthood filed a lawsuit against the law. A Utah judge granted a more extensive ban on Utah's abortion trigger law Monday while Planned Parenthood's lawsuit moves through the courts.
National reports point out that in some states, language in abortion laws does not specify when life begins. That leaves questions about the status of embryos created through IVF, which can undergo testing, be stored in deep freeze or sometimes get discarded when unused. But in Utah, the trigger law prohibits abortion after the "implantation of a fertilized ovum," except in cases such as rape, incest or a mother's life being threatened due to the pregnancy.
Unlike when a fetus has formed in the womb, Utah law does not consider embryos created and stored during in vitro fertilization the start of life. And legislative leaders said they haven't heard about any plans to change that.
"We are not aware of anyone specifically working on IVF legislation, so don't have any information to offer at this time," said Aundrea Peterson, spokeswoman for the Utah Senate, referring to both the House and Senate.
Peterson declined on behalf of legislative leaders to speak to KSL.com about the issue.
Dr. Shawn Gurtcheff, medical director of the Utah Fertility Center, also noted that those at her practice aren't concerned about IVF treatment being impacted by the trigger law.
"We have had independent legal counsel review Utah's trigger statute and have been reassured that it does not affect the ability to practice IVF or embryo disposition or patient care from a fertility standpoint," she said.
Utah Fertility Center does not intend to change its practice in any way, Gurtcheff said.
I would hope that legislators are not interested in affecting people's abilities to build their families (through in vitro fertilization).
–Dr. Shawn Gurtcheff, medical director of Utah Fertility Center
Like Maas, she said she's spoken to many patients who were worried after the state's trigger law went into effect.
"And initially, when it all happened, we didn't really know what to tell them," according to Gurtcheff.
When asked if she fears Utah could pass legislation that affects IVF in the future, she said it's concerning anytime laws pass that come between doctor and patient relationships.
But Gurtcheff said she is "reassured" that Utah tends to be a family-friendly place.
"And I would hope that legislators are not interested in affecting people's abilities to build their families this way," Gurtcheff said.
For some, IVF is the only option to build their families. Regulation around embryo creation and distribution would affect that process, Gurtcheff noted, explaining that she hopes that families can maintain their ability to make decisions about embryo use.
According to a 2018 report compiled by doctors for the Utah Legislature, the state's estimated prevalence of infertility among couples in their reproductive years is between 10-20%.
The report states that Utah had a "higher level of overall use" of fertility treatments than any other state with that population-based data as of 2018. About 5% of births in Utah result from medical fertility treatment, including about 1% of births from IVF, doctors noted.
Questions over when life begins
Maas takes a less optimistic outlook on the issue.
As some states consider life to include an embryo "in a petri dish," providers are becoming limited in their ability to test and screen embryos for diseases, she noted.
"The entire society within the reproductive medicine field is shook. We're all fearful for the future of where things will be and understanding that even if someone such as myself, sitting in the state of Utah, we are somewhat insulated, it could change tomorrow, and that could be the end of the field," Maas said.
She said she fears that short of reproductive care ending, it could get to the point that only those with high socioeconomic status could afford it. That's because legislation could limit doctors' ability to create embryos.
Maas described assisted reproduction as a "numbers game," as doctors need to gather as many eggs and sperm as they can to have success. If doctors go through the process one embryo at a time — "that's what nature does" — it would limit their ability. Patients without the "bandwidth" to get more time with work and access child care won't be able to access the services, Maas said.
She added that patients who are having their frozen embryos stored have reached out to her clinic with worries about what could happen if they don't use them all in the future, as freezing embryos can be costly.
"We have embryos in the freezer, and they're worried that they're going to be on the hook for these embryos for the rest of life," she said.
Contributing: Lindsay Aerts
