Alabama governor signs bill into law protecting IVF providers in wake of frozen embryo ruling

Alabama Gov. Kay Ivey signed legislation into law Wednesday shielding in vitro fertilization providers from potential legal liability raised by a court ruling that equated frozen embryos to children. 

The bill, approved by the Republican-controlled state House and Senate Wednesday night, protects providers from lawsuits and criminal prosecution for the "damage or death of an embryo" during IVF services. 

The state's three major IVF providers paused services after the Alabama Supreme Court's ruling last month.

The decision prompted an outcry from groups across the country. Patients in Alabama also shared stories about having upcoming embryo transfers abruptly canceled and their paths to parenthood put in doubt.

"I'm just elated to get these ladies back on schedule," said Republican Sen. Tim Melson, the bill sponsor.

Lawmakers pushed the immunity proposal as a way to address the clinics' immediate concerns and get them open. But they did not take up any legislation that would address the legal status of embryos.  

The court ruled that three couples who had frozen embryos destroyed in an accident at a storage facility could pursue wrongful death lawsuits for their "extrauterine children." The ruling, treating an embryo the same as a child or gestating fetus under the wrongful death statute, raised concerns about civil liabilities for clinics.

The court decision received immediate backlash as groups across the country raised concerns about a ruling recognizing embryos as children.

"The overwhelming support of SB159 from the Alabama Legislature proves what we have been saying: Alabama works to foster a culture of life, and that certainly includes IVF," Ivey, a Republican, said in a statement after the signing. "I am pleased to sign this important, short-term measure into law so that couples in Alabama hoping and praying to be parents can grow their families through IVF."  

Immediate ramifications

Patients in Alabama shared stories of upcoming embryo transfers being abruptly canceled and their paths to parenthood put in doubt.

Beth and Joshua Davis-Dillard watched as the Senate committee voted. The couple had transferred frozen embryos to Alabama after moving from New York.

"We've been working up to getting ready to trying again. We still have embryos from our prior cycle, which we did in New York. We transferred them here. We can't use them. We're on hold," Beth Davis-Dillard said. "I'm 44, so time is limited. We don't have unlimited time to wait. We really want to give it a try and see if we can have another baby."

Beth David-Dillard said she felt "very helpless and very frustrated" and in a "little bit of disbelief." She said that before they transferred the embryos to Alabama, the couple briefly discussed whether the state's strict abortion ban or political climate could be a problem but presumed it would ultimately be fine.

"It just feels like our rights are being restricted," she said.

Following Ivey's signing of the bill, the University of Alabama at Birmingham, which had paused IVF treatments after the court's ruling, said it "appreciates the Alabama Legislature and Governor Kay Ivey for swiftly passing and signing legislation that provides some protections and will therefore allow UAB to restart in vitro fertilization (IVF) treatments. While UAB is moving to promptly resume IVF treatments, we will continue to assess developments and advocate for protections for IVF patients and providers."

And Barbara Collura, president and CEO of RESOLVE: The National Infertility Association, issued a statement saying her organization "is relieved that Alabama clinics can reopen their IVF programs and work with patients to help them fulfill their dreams of becoming parents. While we are grateful for the actions of Alabama legislators, this legislation does not address the underlying issue of the status of embryos as part of the IVF process – threatening the long-term standard of care for IVF patients. There is more work to be done. Patients and providers in Alabama, and across the country, want and deserve the protected right to build families."

Measure's contents   

The bill says that "no action, suit, or criminal prosecution for the damage to or death of an embryo shall be brought or maintained against any individual or entity when providing or receiving services related to in vitro fertilization."

The immunity would be retroactive but would exclude pending litigation. Civil lawsuits could be pursued against manufacturers of IVF-related goods, such as the nutrient-rich solutions used to grow embryos, but damages would be capped and criminal prosecution would be forbidden.

Dr. Michael C. Allemand with Alabama Fertility said the legislative proposal would allow the clinic to resume IVF services by returning "us to a normal state of affairs in terms of what the liability issues are."

He said the past weeks have been difficult on patients and staff as procedures have been postponed.

"There's been some truly heart-wrenching conversations that have taken place," Allemand said.

Some critics still not satisfied   

The American Society for Reproductive Medicine, a group representing IVF providers across the country, said the legislation does not go far enough. Sean Tipton, a spokesperson for the organization, said Monday that the legislation does not correct the fundamental problem, which he said is the court ruling "conflating fertilized eggs with children."

House Democrats proposed legislation that would put in state law or the state Constitution that a human embryo outside a uterus cannot be considered an unborn child or human being under state law. Democrats argued that was the most direct way to deal with the issue. Republicans have not brought the proposals up for a vote.

State Republicans are reckoning with an IVF crisis they partly helped create with anti-abortion language added to the Alabama Constitution in 2018. The amendment, which was approved by 59% of voters, says it is state policy to recognize the "rights of unborn children."

The phrase became the basis of the court's ruling. At the time, supporters said it would allow the state to ban abortion if Roe v. Wade were overturned, but opponents argued it could establish "personhood" for fertilized eggs.

Collins said she doesn't think lawmakers got it wrong with the amendment but that the wording was broad enough that it had ramifications they didn't anticipate.

Collins, who sponsored the state's stringent abortion ban, said she thought any law exempting embryos from legal protections might be found unconstitutional under the 2018 amendment. Changing the constitution, she said, is a longer conversation.

"It's very divisive," she said. "Everybody has very strong opinions on when life begins."

Republicans are also trying to navigate tricky political waters - torn between IVF's widespread popularity and support and conflicts within their own party. Some Republicans have unsuccessfully sought to add Louisiana-style language to ban clinics from destroying unused or unwanted embryos.

At the federal level, Sen. Tammy Duckworth, an Illinois Democrat, took action last week to try to pass legislation that would create federal protections for IVF access nationwide. But Sen. Cindy Hyde-Smith, a Mississippi Republican, blocked the bill, saying in remarks on the Senate floor that the proposal is a "vast overreach that is full of poison pills that go way too far."

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