Ever since Justice Anthony Kennedy’s June announcement that he would retire from the Supreme Court, the spotlight has been on Roe v. Wade, the 1973 decision legalizing abortion. Less than a day after the news broke, The Washington Post was reporting on the “real possibility” of abortion becoming illegal. Anti-abortion activists proclaimed that they were on the threshold of a historic moment: “In the history of the right-to-life movement, there has never been a more important time for us to come together and stand united,” Carol Tobias, the president of National Right to Life, wrote in a July newsletter. Kristan Hawkins, president of the group Students for Life, tweeted: “THIS IS NOT A DRILL.”
Whether Roe is overturned will in all likelihood depend on Donald Trump’s nominee to the Court, Brett Kavanaugh, a staunch social conservative. And if it is struck down in the coming years, what comes next? An emboldened anti-abortion campaign could lead to consequences for women’s health care and reproductive rights that range far beyond abortion restrictions. Contraceptive devices, such as IUDs or even the pill, could cease to be covered by insurance. But there is one procedure, in-vitro fertilization (IVF), that is curiously absent from this debate, though it results in the destruction of embryos.
Anti-abortion leaders are open about why they won’t go near it, revealing insights into the tactics and motivations of their movement. “It’s much more difficult to try to explain what is objectionable about IVF,” says Ann Scheidler, who founded the Pro-Life Action League with her husband in 1980. “You can only do what you can do with the resources you have, and we choose to really focus on the abortion issue.”
IVF poses a puzzling challenge for conservative groups: How do organizations that liken embryos to people reckon with a technology that creates babies for families, but destroys embryos along the way?
The first “test-tube” baby was born in 1978, meaning that not enough cyclical time has passed to comprehensively understand what will happen to most embryos that go unused during the IVF process. Some, for example, are frozen, ostensibly so they can be used at a later date. What’s clear, though, is that millions are rendered unviable. In other words: disposed.
Fertility treatments like IVF involve laboratory processes that combine extracted egg and sperm, then transfer the newly created embryos back to the uterus. If the embryo implants, the patient becomes pregnant. IVF in the United States has a live birth rate of 41-43 percent for women under 35, though that rate decreases with age.
But these successful pregnancies aren’t born of a single, perfect egg combining with a single, perfect sperm. One pregnancy results from the creation of multiple embryos, the amount depending on age and health of the patient, as well as sheer chance. Some cycles produce three embryos. Others produce 25. Dr. Nicole Noyes of the NYU Fertility Center estimates that 70 percent of all combinations she attempts manage to fertilize. Of these cases, she estimates 40 percent have viable, unused embryos after implantation, most of which are frozen. Other estimates are higher, and some say that almost half of viable embryos are eventually disposed of after being frozen.
Viable, unused embryos can be dealt with in a variety of ways. Freezing. Donation to research. Donation to another family. “Thawing” (a euphemism for disposal). The New York Times estimated in 2015 that as many as a million embryos could be frozen across the country. But many of those embryos remain just that—frozen, preserved—while outside the laboratory the families who created them raise children and go on with their lives.
Storage costs for frozen embryos can reach $1,000 per year, a cost that would seem prohibitive if it weren’t for the economic status of IVF’s typical clientele. An IVF cycle’s cost altogether adds up to around $20,000, and a 2011 study found that college-educated and higher-income patients were disproportionately using IVF treatments, thus achieving higher rates of pregnancy.
Even when families can afford to store their embryos, technology could still fail them. In the same week in March, the storage facilities of two fertility clinics—one in Cleveland, the other in San Francisco—malfunctioned, losing thousands of fertilized embryos. Lawsuits ensued, but on shaky ground. The losses, after all, were embryos the size of sesame seeds, most of which had undecided futures anyway.
But those same embryos—a varying amount of weeks further along, but unborn and largely undeveloped all the same—are also being extracted in abortion clinics. “There’s a disconnect between how public policy treats women who undergo IVF and women who have abortions,” says Margo Kaplan, a Rutgers law professor. When Kaplan herself underwent the IVF process, she says she was trusted with every decision regarding her embryos. She and her husband chose to donate theirs to medical research, an option for which Planned Parenthood has come under fire, but which has also aided essential research into Parkinson’s and other diseases.
Women who undergo IVF and choose to donate embryos do not have to read any mandated material or sit out a waiting period, both of which are required of women in many states who choose to get an abortion. “Nobody ever questioned my ability to make my own decision. And we don’t assume that women have the same ability to do that when they have an abortion,” Kaplan says.
Why the discrepancy? For one, the anti-abortion movement isn’t pushing the issue. “We’re making very great strides with regard to the abortion issue itself,” Scheidler says, while acknowledging that she doesn’t like that embryos are destroyed during the IVF process. “Why jeopardize that by adding something that’s going to be too emotional to be able to get people to pay attention and join us at it?”
But in being so cavalier about the fate of embryos that nominally bolster the ideology of their movement, anti-abortion activists reveal that the abortion question is really composed of a galaxy of issues that go beyond simply protecting the unborn. Kaplan thinks the reluctance to address IVF is related to a set of values the anti-abortion right holds close. “IVF doesn’t question the woman’s role as a mother,” Kaplan says. “Abortion tends to have to do with women who have had sex but don’t want to become mothers.”
That the stigma surrounding abortion is based on old-fashioned patriarchal values—ones that would deprive women of the freedom to make choices about their bodies and break from traditional conceptions of both family and sexuality—is apparent in the demographic data. Both men and the over-55 age group skew anti-abortion, while women and the 18-34 age group skew pro-choice, a 2014 Gallup poll shows.
Fertility treatments stand alone as a reproductive right that still reinforces conventional norms. Birth control leads to freer sexuality, to more career-focused women, and to further opportunities for disadvantaged women. IVF, on the other hand, favors women who are older, who have been married, who have graduated from college, who have a high income, and who are non-Hispanic white, according to a 1995 study.
So when the anti-abortion movement comes for reproductive rights, claiming to safeguard the right to life, IVF will likely be quietly ignored. The rise of fertility treatments is a positive development—lacking in equitable access, yes, but admirable all the same—yet this glaring gap reveals what Kaplan calls a “greater truth about the movement.” IVF is a treatment cloaked in privilege—both socioeconomic and normative—and if it thrives, it will be because of this.