The impact of the Dobbs decision on in-vitro fertilization and fertility care.

Abstract

The 2022 Supreme Court ruling in Dobbs vs Jackson marks a frightening new reality in America. Physicians and patients have been left confused and concerned regarding the broader implications of this ruling. Now that the constitutional right to an abortion has been overturned and the power has been relinquished to individual states, there is justifiable concern regarding the impact on in-vitro fertilization (IVF). This review explores the ways IVF and fertility care are at risk in the context of our new reality. The decision to overturn the right to an abortion without specifying a viability standard opens the door to interpretation of when 'life' begins. Laws that do not specifically exempt IVF, or that include language suggesting that 'life begins at fertilization' pose a real threat to IVF. The potential for personhood laws poses a threat to embryo freezing and disposition, preimplantation genetic testing and culpability among other concerns. Limitations to IVF may become an unintended consequence to the Dobbs decision, making IVF less efficient, more costly and unsafe, and inevitably limiting access to care. It is therefore crucial that public health legislation be rooted in science and not dictated by religion or politics. Physicians must act alongside legislators to protect reproductive freedom and access to care.