IVF Care Now Carries Legal Risk Beyond the Clinic
The post-Dobbs fertility experience has changed in a way few patients anticipated. For people pursuing IVF, the medical questions that once centered on stimulation cycles, embryo quality, and implantation timing now collide with legal uncertainty over whether an embryo can be treated as a legal person. In states that have adopted fetal personhood language, even routine steps in reproductive medicine can feel precarious: freezing embryos, discarding abnormal embryos, transporting stored embryos across state lines, or deciding what to do after a failed cycle.
Allison Mertzman’s case captures that shift with painful clarity. After breast cancer delayed her plans to implant stored embryos, she and her wife decided not to continue pursuing IVF once the legal climate changed. Nine embryos were being stored in Michigan while the family lived in California, and the possibility of damage during transfer raised a question no fertility patient used to have to ask so directly: if an embryo is harmed, who could be held responsible? For Mertzman, the answer was enough to stop treatment altogether.
The fear is not abstract. At least 24 states have placed some form of fetal personhood language into abortion restrictions or broader civil or criminal statutes, and several states have some of the most sweeping versions. Louisiana now prohibits intentionally destroying IVF embryos. Alabama provides broader civil and criminal immunity to clinicians involved in IVF care, but many physicians still view the legal environment as unstable rather than settled.
Routine Embryology Steps Can Trigger Liability Fears
The most unsettling part of these laws is how they intersect with ordinary fertility practice. Embryology labs routinely handle embryos that do not develop normally. Clinics also manage cryopreservation, thawing, genetic testing, and the discarding of embryos that are not viable. In a legal framework that treats an embryo as a person rather than tissue or property, those actions can be recast from standard medical practice into possible grounds for wrongful death claims, felony charges, or other penalties.
Benjamin McMichael, a health law professor at the University of Alabama, framed the issue starkly: the legal move from embryos as property to embryos as people can alter the damage calculations at the center of tort law. Once a frozen embryo is treated as a legally recognized life, clinics have to think differently about storage failures, mechanical errors during flash-freezing, and standard laboratory decisions that have long been part of IVF care.
One sentence explains the practical effect: clinicians are now being forced to consult lawyers before doing what used to be routine fertility work.
Those consultations are expensive, and the costs do not stop there. Clinics in restrictive states may face higher insurance premiums, additional compliance burdens, and more time spent documenting decisions in case they later need to defend them. Fertility doctors worry that malpractice policies may not protect them if prosecutors or civil plaintiffs argue that embryo handling falls outside conventional medical negligence and into criminal or wrongful death territory.
Patients Are Changing IVF Decisions to Reduce Exposure
Patients are responding to that uncertainty by changing how they think about treatment itself. Karenne Fru, who leads Muna Fertility in Georgia, said patients increasingly ask whether they can limit the number of eggs retrieved and fertilized so they reduce possible liability. They want to know whether they are exposed if an embryo does not survive freezing, whether preimplantation genetic testing could damage embryos, whether they should transfer multiple embryos at once, and how miscarriage or ectopic pregnancy would be handled under the law.
Those are not theoretical concerns. Fru said some patients decide against IVF after getting answers, and she sometimes modifies stimulation protocols to reduce the number of mature eggs produced by about 30% by stopping treatment a day or two earlier than usual. She described the goal as optimizing outcome while limiting risk. In other words, the legal environment is not only changing patient counseling; it is shaping clinical decision-making at the cycle level.
The emotional toll is visible in more than one state. In Louisiana, Nicole Ulrich said she is careful about even discussing embryo destruction with patients because the state forbids intentionally destroying leftover IVF embryos. She tells patients early that the clinic is not set up for long-term storage and that once embryos leave the state, the transfer company may need to handle next steps. Even with new legal protections in place, she said the fear of criminal charges still lingers.
In Texas, Damla Karsan said the law makes abortion provision nearly impossible, yet she still helps patients find care out of state. That kind of legal navigation has become part of reproductive medicine for patients facing ectopic pregnancy, fetal anomaly, or miscarriage management. For some, the delay itself becomes its own harm.
Delays, Distress, and the Medical Consequences of Confusion
The legal uncertainty does not stop at embryo storage. It can also delay treatment when insurers, hospitals, or clinicians misread what the law allows. Julie Cohen experienced that after she learned at eight weeks of pregnancy that her fetus had lethal anomalies. Her insurer initially refused to cover the hospital procedure, leaving her facing an estimated $20,000 bill because staff believed the state abortion ban might prohibit the care, even though the procedure was legally allowed in that situation. The denial was later reversed, but the waiting period was described as agonizing.
Lauren Hock’s experience in Alabama showed how fast a pregnancy complication can become a legal emergency. During one pregnancy, she began hemorrhaging at 14 weeks. Her doctor told her that if the situation became life-threatening, the hospital would need approval to end the pregnancy under the state abortion ban. When she hemorrhaged again weeks later, the fetus had died, removing the need for that approval. The medical risk had not changed; the legal calculus had.
One line from Hock captures the bedside reality better than any policy argument: “I would have done anything to save my baby at that point, but I also could have lost my life with my baby’s life.”
Psychological strain is spreading across the fertility setting as well. Lauren Berman, a clinical psychologist in Atlanta, said more patients are arriving scared and need help deciding whether to move, get pregnant, or have children at all. For LGBTQ+ families, the legal uncertainty can widen further because parentage through assisted reproduction already varies by state, and nontraditional families face uneven legal recognition.
Mertzman and her wife ultimately chose to have their embryos destroyed. The decision carried grief, but it also reflected a hard calculation about liability, family security, and the way post-Dobbs laws can shape reproductive choices before a pregnancy even begins. For fertility medicine, the central issue is no longer only whether IVF can create embryos. It is whether clinicians and patients can continue using the technology without criminal law intruding into the laboratory, the exam room, and the delivery hospital.