Families in Tennessee are grappling with difficult questions regarding the future of in vitro fertilization (IVF) in light of recent legal developments. In February, the Alabama Supreme Court granted embryos legal personhood, a decision that has already disrupted many fertility clinics in the state. While Alabama implemented temporary legislation to allow some clinics to resume operations, the impact of this ruling has raised alarms across state lines. In March, a Tennessee bill aimed at safeguarding IVF, sponsored by Rep. Harold Love Jr. (D-Nashville) and Sen. Raumesh Akbari (D-Memphis), failed to advance in a House subcommittee. Similarly, a previous attempt in 2021 to mandate insurance coverage for infertility treatments, led by Rep. Sabi Kumar (R-Springfield) and Sen. Becky Massey (R-Knoxville), also stalled.
As Tennessee enforces a total abortion ban, many families are increasingly concerned that their fertility journeys could be compromised. If rulings like Alabama’s proliferate, families with surplus embryos may find themselves without agency over their genetic material. While this scenario has not yet come to pass in Tennessee, the state’s Republican supermajority raises the possibility of such legislative changes.
To understand the real-life implications of these laws, the Banner spoke with four families currently navigating the IVF process, which involves fertilizing eggs with sperm outside the body to assist conception. Hannah*, 32, and her partner, 33, shared their experience with Nashville Fertility Center, where they initially pursued medications and intrauterine insemination (IUI) before transitioning to IVF. After their egg retrieval in June, they learned of their pregnancy just days before their interview with the Banner in September.
In typical IVF protocols, all retrieved eggs are fertilized, leading to the creation of multiple embryos, some of which may not be used immediately. Families often choose to store these surplus embryos, either in-state or out of state, with the option to implant them in future cycles or decide their fate post-pregnancy—whether to discard them or donate them for research. Hannah and her partner opted to store their extra embryos out of state, prioritizing their safety amidst the evolving legal landscape in Tennessee.
“With everything uncertain, I felt more comfortable having them stored in a liberal state. It felt safer,” Hannah said, expressing disappointment over the lack of legislative support for IVF protections. She also voiced concern over what they would do if IVF became inaccessible in Tennessee, noting that traveling out of state for treatment was a privilege not all families could afford.
Hannah also highlighted worries about managing a missed miscarriage. In Tennessee, if she encounters complications during her pregnancy and requires medication for treatment, she fears she may not have access to necessary care due to existing laws. Misoprostol and mifepristone, medications used to treat missed miscarriages, are also classified as abortion methods, thus making them illegal in the state. The risk of severe complications, such as sepsis, adds to her anxiety, particularly given reports of tragic outcomes in similar circumstances.
Another family, Vanessa*, 32, and her husband Harrison*, 40, cherish their family life and social gatherings, yet face their own fertility challenges. After a year of unsuccessful attempts to conceive, they sought treatment at the Vanderbilt Fertility Clinic, transitioning to IVF after IUI failed. They initially stored their embryos in Tennessee but plan to move them out of state to reduce costs, also expressing concern about the implications of fetal personhood legislation.
“If I knew there were restrictions on discarding embryos, I’d immediately move them elsewhere,” Vanessa stated, reflecting on the emotional burden of decisions around embryo disposition. She shared how her sister-in-law still pays for storage despite knowing she won’t have more children, illustrating the tough choices families face in these situations.
Kayla*, 37, and her partner Rob*, 37, have been on their IVF journey amid significant medical challenges, including Kayla’s Asherman’s syndrome, which complicates pregnancy. After undergoing two rounds of IVF, they opted for surrogacy due to the risks associated with carrying another pregnancy. Kayla noted that the current legal environment adds an unnecessary layer of complexity to their experience. Her doctor advised some patients to store embryos out of state, underscoring the palpable anxiety surrounding their future.
The couple is also mindful of potential complications during their surrogacy journey, particularly in relation to legal restrictions on abortion in Tennessee. If an abortion becomes necessary due to health concerns, they would need to arrange travel to a state where it is permitted.
Thomas*, 47, and his husband Jay*, 33, who celebrated their two-year wedding anniversary, shared their own IVF experiences. After an unsuccessful transfer with their first surrogate, the emotional toll of the process was evident. They expressed relief that their remaining embryos are stored safely for now but acknowledged they would have to move them out of state if legal challenges intensified.
The emotional weight of infertility and surrogacy is profound, compounded by the constant monitoring of legislative actions that could impact their choices. Each family interviewed by the Banner expressed a deep concern over fetal personhood laws and the lack of protective measures for IVF in Tennessee, ultimately leading them to consider relocating their genetic material. The possibility of government intervention in personal family decisions is a burden they find difficult to bear.
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