Alabama Supreme Court rules frozen embryos can be considered children

Earlier this month, the Alabama Supreme Court issued a controversial ruling that resulted in several fertility clinics pausing in-vitro fertilization services in that state.

The justices ruled anyone who destroys frozen embryos, even accidentally, can be sued for wrongful death, deeming that embryos are children. 

There's a lot of concern this ruling will have a wider impact, especially in other conservative states. 

Dr. David Prokai, a reproductive endocrinologist and fertility specialist with Aspire Fertility Austin, joined FOX 7 Austin's Rebecca Thomas to discuss.

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Rebecca Thomas: Doctor, last weekend, Governor Abbott told CNN he wants it to be easier for families to have children, including through IVF, not harder. But he wouldn't say if he would consider a state law that would protect access to IVF. And this week, Senate Republicans blocked federal protections for IVF. How concerned are you about what happened in Alabama, potentially happening in Texas? 

Dr. David Prokai: It is a very real concern. I've had patients call me quite frequently this week with the same questions that you pose right now. What does the future hold for us? What does it look like for me in my embryos that I've created? Patients who are about to go through the IVF process, what does that look like? And so I am concerned that there could be a potential similar law enacted here in Texas that would severely limit my ability to care for my patients. 

Rebecca Thomas: If the Alabama ruling is upheld, if other states hop on board. What does that mean to the fertility industry and for doctors and for patients? 

Dr. David Prokai: Oh, it just injects a huge amount of uncertainty regarding this whole process. And if anybody, you know, whether personally, yourself or a friend and colleague, you know that the infertility process is full of ups and downs, uncertainty and just that this is just another element that patients have to consider. And certainly, the way we practice medicine currently, from the first IVF child born in England in 1978 to now 2024. You know, the effectiveness and the safety of the treatments we do now have increased exponentially so much that IVF is no longer a last resort for some couples. It actually can be the most optimal and safest way to achieve pregnancy, both now and in the future. And so the laws that limit the creation of embryos, and some of the practices that we do currently would have huge negative impacts on those chances in terms of overall success and then safety too, which is hugely important. And then additionally would make it more expensive and less accessible for people, which are huge concerns for myself as a fertility doctor.

Rebecca Thomas: For those who don't know what IVF is. Well, you give us a brief rundown of the process and how it helps people build families.

Dr. David Prokai: Yeah. Of course. So, in its very core, IVF is typically about growing more and more eggs from the ovary than typically occurs in a normal cycle and a normal menstrual cycle. One egg is released and that one egg has a chance of fertilizing. But then that's the sort of issue, is that you only have that one chance. And so with IVF, through stimulating ovaries, multiple eggs are grown and extracted from the ovary. And then, typically, multiple eggs are fertilized because we know whether somebody is 20, 30, 40, regardless of age, and not every single egg is going to lead to a healthy implantable embryo. And furthermore, not every single embryo is going to implant and lead to an ongoing pregnancy. So one of my most powerful tools in order to help couples is to have them grow more eggs and assist the fertilization if there are any male factor issues present, and then potentially even test the embryos to make sure only genetically healthy, viable embryos into the uterus. And by that process, we can overcome a number of fertility challenges.

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Rebecca Thomas: And you just touched on that. So not all embryos are viable or without genetic defects. What happens if you can't use discretion, obviously with the consent of the parents in these cases? How big of a concern is that? 

Dr. David Prokai: It's a huge concern because, you know, with the Alabama statute suggesting that all, you know, frozen embryos are essentially unborn children, that introduces a huge element of uncertainty that the clinics in Alabama have responded to, as you alluded to earlier, is the, you know, the embryo that if it doesn't implant or something happens to it, is that an unlawful or an endangering act to a child? I mean, that that's a huge implication that fundamentally is incorrect on a scientific level, because we know that each month that a person is trying to get pregnant, potentially an embryo does form and enter the uterus, but doesn't implant and essentially fades away. So nature itself discards embryos, not just, you know, the fertility industry per se, but nature does this and furthermore, kind of obscuring the fact. Even more, an embryo that forms and doesn't implant in the uterus like an ectopic pregnancy. Is that considered like an unborn child that's just in the fallopian tube? When we know that is a medical emergency, we can. So we all agree that that's an unviable pregnancy that needs potentially urgent care and medical intervention. 

Rebecca Thomas: All right. We are out of time, doctor. Thank you so much for sharing your time and your expertise with us tonight.