For 13 years it has been an honor and a privilege to practice as a fertility doctor in the state of Alabama. As a reproductive endocrinologist initially at the University of Alabama and now in private practice at Alabama Fertility, my professional career has been to care for patients who are trying to build their families and to teach younger doctors to do the same.
Following the Alabama State Supreme Court ruling last week that embryos have the same rights as children and that their destruction amounts to wrongful death, my partners and I made the devastating but necessary decision to stop In-vitro fertilization (IVF) procedures. I am accustomed to difficult conversations with patients as we together navigate failed treatments and negative pregnancy tests, miscarriages, and ectopic pregnancies.
The phone calls I have made over the past twenty-four hours to tell my patients that we have to cancel their treatment have been the worst in my career. IVF treatments require weeks if not months of planning and involve medications, injections and procedures. More importantly, a patient’s decision to do IVF requires courage, commitment, and trust in their physician. The abrupt cancellation of IVF in our state has been a tragedy for all. The patients have lost their chance to start or add to their family. Doctors, like me, have been restricted from providing the medical care their patients entrusted them to provide and deserve.
Doctors want and are obliged to provide their patients with safe and effective treatment options. An oncologist would never be expected to treat cancer without chemotherapy or radiation. A surgeon would never be asked to operate without proper surgical equipment. It is unethical to expect a fertility doctor to care for their patients without offering IVF. That is below the standard of our field. No physician would willingly provide care that is substandard. No patient should have to see a doctor that cannot provide them with all of their treatment options.
I wake up this morning full of uncertainty and frankly with fear. Fertility doctors are planners — our nature is to always be one step ahead. Our patients are calling, flooding our office with messages desperately asking how they can proceed with their treatments, how they can move their embryos to another center. It is frustrating beyond belief to not have answers for these patients.
Embryos can be moved but they have their best chance of becoming a baby if they are handled within the lab where they are made. If the decision is made to move an embryo, are the transport companies going to be willing to take that risk? How can I endorse a plan that I know is not what is best for my patients, that is not best for the embryo? I have been touched by the outreach of colleagues in neighboring and far away states offering to help our patients, to pick up their IVF treatments, but have these doctors fully consulted with their lawyers to understand the implications of their involvement? The fertility doctors in the state of Alabama have been providing IVF safely and effectively for decades. The best and only acceptable solution is to make it safe for us to take care of our patients and help them build their families just like we were doing last week.
After 13 years Alabama is my home. At my kids’ sports games and playgrounds I bump into former patients and I love seeing them with their children — children many of them would not have without IVF. Whether you believe my ability to perform IVF is a God-given talent or the product of years of medical training (for what it is worth, I believe it is both) an infertile patient deserves the right to have a child and the liberty to have this treatment where they live.
An IVF patient has decided to use this medical treatment to build their family and they have been counseled about the options regarding fertilization of eggs, freezing of embryos, and embryo disposition — the options for embryos once they have been frozen. I do not believe the intent of the Supreme Court ruling was to create the chaos that has ensued in our state and our nation.
I do not believe the leaders in the state of Alabama, nor the leaders of our nation, accept this affront to the right to have a family and access to medical care. I fear for not only the people of Alabama as this chaos and sadness can only be expected to continue in other states. I will go to work today and do all that I can to take care of my patients but I plead to anyone who believes in the right to have a family, in the right to access safe and effective medical treatment, to help put this right.
Dr. Janet McLaren Bouknight is a reproductive endocrinologist in Alabama.