Fertility at risk: What ACB confirmation means to reproductive rights

While it was no surprise, the Senate judiciary committee advanced Amy Coney Barrett’s nomination to a full Senate vote. Among the biggest concerns if she is to be confirmed and seated to the Supreme Court is the impact it would have on reproductive rights. 

Barrett is a known conservative who signed her name to a 2006 advertisement that called for abortion rights to be overturned, and more recently, refused to answer whether Roe v. Wade was correctly decided during the Senate confirmation hearings. Contraception coverage through the Affordable Care Act is also at risk with the upcoming Supreme Court case, California v. Texas.  

Earlier this month, Fertility and Sterility, the flagship journal of the American Society for Reproductive Medicine, published an editorial “For the Supreme Court: Choose Another,” warning that the seating of Barrett on the Supreme Court could also severely limit access to in-vitro fertilization (IVF) based on her stance that life begins at the moment of fertilization. 

The social media response to her nomination and pending confirmation has been strong. Many are sharing on Twitter their #ThanksIVF stories to highlight the families they would not have if not for IVF. 

This is no surprise as infertility affects about 12 percent of reproductive-age women. More than 8 million babies have been born through IVF since its inception in 1978. And approximately 2 percent of all babies born in the U.S. each year are conceived using IVF. 

In addition to those actively struggling with infertility, IVF is critical for the increasing number of women choosing to freeze their eggs and delay childbearing to focus on educational or career demands. 

IVF also opens doors for family building for cancer survivors who preserve fertility by freezing eggs or sperm prior to receiving life-saving, but gonadotoxic treatments. As of August 2020, 19 states have passed fertility insurance coverage laws —13 include mandates for IVF coverage and 10 include fertility preservation coverage for iatrogenic infertility caused by medical treatment. 

IVF is also critical to a family building for LGBTQ couples as it facilitates the use of donor eggs/sperm or gestational carriers. According to the LGBTQ Family Building Survey conducted by the Family Equality Council, nearly half of LGBTQ people ages 18-35 are actively planning to grow their families with many considering biological pathways to parenthood that would include IVF. 

As a clinical psychologist working with transgender adolescents and young adults, I routinely provide fertility counseling. This includes a discussion of options for fertility preservation, as part of my standard practice when working with youth who are seeking gender-affirming medical or surgical interventions that have the potential to impact long-term fertility. 

While biological parenthood is certainly not something all, or even most, transgender AYA desire, having biological children is something that a sizable minority wants. For instance, over a third of transgender teens ages 14-17 surveyed expressed interest in having biological children in the future.  

To be sure, biological parenthood is just one pathway to parenting and some may argue that adoption is an equally viable option for those who want to be parents. But reproductive justice means that each person gets to choose for themselves whether and how to be become a parent. 

Not everyone’s pathway to parenthood is linear. Restricting IVF as a family-building option is another step toward limiting our reproductive rights. 

Diane Chen, Ph.D., is a pediatric psychologist at Ann & Robert H. Lurie Children’s Hospital of Chicago, Associate Professor in the Departments of Psychiatry and Behavioral Sciences, and Pediatrics, at Northwestern University Feinberg School of Medicine, and a Public Voices fellow through The OpEd Project. Follow her on Twitter @DrDianeChen.