Fertility Frontiers: A North Dakota Practitioner’s Personal and Professional Journey

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Tara Harding, a nurse practitioner, has been assisting North Dakota women in getting pregnant for the past five years. Harding will, however, travel to Colorado for her fertility treatment.

The 38-year-old operates a women’s health clinic in Bismarck that specializes in reproductive therapy. In June, she intends to have surgery to address one of her health concerns: endometriosis, a uterine ailment that makes it difficult to conceive. If she is unable to conceive naturally after that, she will consider in vitro fertilization—but not in her native state.

“I’m not going to take any risk with [my embryos] locally and be worried about not being able to move forward with the treatment.” the woman stated.

The reason for Harding’s site change is not a change in North Dakota legislation, but a state Supreme Court judgment in Alabama that declared frozen embryos had the same rights as children, temporarily halting IVF procedures in the state.

No other state has made a comparable decision—and Alabama has subsequently implemented legislation to protect patients and providers from legal ramifications—but reproductive specialists in conservative states told The Daily Beast that some of their patients are still taking aggressive steps.

Dr. Nicole Ulrich is an IVF provider at Audubon Fertility in New Orleans, which outlawed abortion after Roe v Wade was overturned in 2022. She claimed it prompted a surge of patients to her office with queries. Now it is occurring again.

Ulrich stated that two individuals had requested an expedited fertility treatment. One was considering IVF and opted to begin sooner than expected in case the ability to do so was legislated away. The other had a child from IVF and multiple embryos stashed out of state. She opted to begin the process of having a second child earlier than expected for identical reasons.

“I’m excited for them that they’re taking the next step in their journey but it also makes me so sad that they feel like they have to change their plan or speed up their plan because of what’s happening politically,” Ulrich said in a statement. As a physician, she said, “you’re making decisions based on not exactly what’s the best medical decision for the patient, but on external factors.”

Ulrich’s facility already stores patients’ embryos outside of the state; is Louisiana the only state? With a law prohibiting the destruction of extrauterine embryos, many providers store them in another jurisdiction. However, Ulrich said that since the Alabama judgment, at least five patients have wanted to transfer their embryos from the clinic’s long-term storage facility in Texas, fearing a similar outcome.

Other sufferers have asked her for advice on what to do.

“I often tell them I wish I had a crystal ball,” she told me. “I don’t think it will happen here, I just have to hope that cooler heads will prevail.”

The ruling in Alabama, in a case filed by two families who lost frozen embryos in a storage facility accident, sparked outrage around the country—and across political lines. Even former President Donald Trump stated that he “strongly” backed IVF access and urged Alabama lawmakers to protect it, which they accomplished by adopting a measure last week that shields doctors and patients from liability. However, Republicans in the United States Senate failed to do so on a national level, opposing legislation that would have established a legal right to treatment.

According to NPR, no other state has a similar court case pending, but at least 14 are pursuing legislation that would award “personhood” to fetuses. Two states are exploring proposals that would define personhood as beginning with fertilization in homicide and wrongful death cases, while six are considering measures that would allow mothers to seek child support for fetuses.

In Florida, lawmakers postponed debate on a plan that would allow parents to sue for the wrongful death of a fetus due to “questions and concerns” raised by the Alabama decision. However, Dr. Preston Parry, who practices in Mississippi but stores his patients’ embryos in Florida, reported that two patients in the previous week requested that their embryos be moved out of the Sunshine State.

According to Dr. Samuel Brown, a Florida practitioner, hundreds of patients have requested that their IVF procedure be moved up in response to the Alabama verdict.

“We have patients that weren’t quite ready to add to their family and it is expediting them, it’s making them say, ‘Let’s go ahead and transfer these embryos now so we don’t have to deal with this atrocity later,'” he added.

This week, Republicans in Iowa’s state House passed a law making it a felony to cause the death of an “unborn person,” with no exceptions for IVF. The measure must still be enacted by the Senate and signed by the governor, but IVF providers in the state say they’ve already received calls from concerned patients.

Dr. Abigail Mancuso, a fertility doctor at the University of Iowa hospital system, said that since the measure passed the House, people have called all three locations to inquire about moving their embryos out of state. Dr. Amy Sparks, head of the hospital system’s IVF labs, reported that in recent weeks, more patients than usual requested to discontinue storage—in other words, to dispose of their embryos.

Sparks said she wasn’t sure if the hospital system would be able to continue giving IVF treatment if the Iowa bill passed.

“This is a stressful job, to begin with, and we do our absolute best,” she was quoted as saying. “But if we can’t have that trust with our patients and people are at risk of being charged with a felony, why would you want to continue offering services in the state?”

She also expressed surprise that the law was moving forward in light of the national outrage at Alabama’s decision.”You just wonder, ‘Geez, did they turn off the news or are they that blind?'” she went on to say.

Even women in jurisdictions without fetal personhood legislation are thinking about transferring their embryos abroad. Amanda Zurawski is suing Texas over its abortion ban, alleging she was unable to terminate a risky pregnancy despite the law’s exception for medical circumstances.

She revealed shortly after the Alabama judgment that she would relocate her embryos, telling NBC News that she “[does not] want them in a state where a similar ruling could very likely take place.”

North Dakota is also not considering a fetal personhood measure, but Harding stated that she does not want to begin the IVF process there only for it to enact something similar while she is still in the process. She and her boyfriend have previously budgeted for the additional expenses and inconvenience of traveling out of state for each visit.

Nonetheless, she sees a silver lining in the entire event.

“I think the one thing this did was bring the infertility community together,” she went on to say. “Since I’ve been involved in over six years, it’s the loudest and most productive, quick change that we’ve seen happen.”

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