Wasted Meds And Dreams On Hold: 5 Alabama IVF Patients On The Horrible In-Between
After the Alabama Supreme Court ruled on Feb. 16 that embryos are considered “children” with personhood, and that individuals could be held liable for their destruction, IVF treatment centers across the state quickly paused all operations. This left the women they treated–some in the midst of fertility treatments, others awaiting an imminent embryo transfer, or simply hoping to begin their IVF journey–completely adrift, without answers.
After a national uproar, the Alabama House and Senate both passed bills on Feb. 29 intended to protect in vitro fertilization, and on March 6, Alabama Governor Kay Ivey signed a bill into law to protect in vitro fertilization patients and providers from legal liability, per CNN. The new law does not address the issue of fetal personhood.
Two weeks after the original ruling came down, Women’s Health spoke to five women in Alabama who shared how they have been affected by the decision. Several are patients at the University of Alabama at Birmingham (UAB), the largest health care system in the state, which halted IVF treatments on Feb. 21. Their stories of loss and heartbreak, yet hope and determination, capture a moment in time in which their lives and dreams of building their family have been upended.
Latorya Beasley, 37, Birmingham, AL
Latorya and her husband were in the middle of a transfer when the ruling halted the process. She was holding out hope that new legislation could make it possible for the transfer to continue. She has one daughter from a prior IVF transfer.
I had an embryo transfer date on Monday, March 4, and it was canceled last Thursday. My IVF coordinator gave me a call, and to be honest, I can’t tell you what she said. It just sounded like: “womp womp womp womp womp.” It was just a gut punch. I immediately started crying. I called my husband, and I don’t think he knew exactly what I was saying, he could just hear sounds and asked what was going on. We were shocked.
The day before, I had gone to a doctor’s appointment for my mid-cycle lab work, and when I came in, I could tell by the look on the doctor’s face that something wasn’t right–that she was upset about something. She told me, ‘Today, we’re going to move forward and we’re trying to get you to that point [of transfer] on Monday. But as of right now, we don’t know what tomorrow may look like.’ I thought: ‘Surely, this can’t happen to us. I’ve already started medicine, there’s no way they’re just going to stop our transfer.’
On Friday, my progesterone shots were delivered. I battled with whether I should accept the medication. I left it by the door and that’s where it’s been sitting since. I continued taking my other medication [to prep for the transfer], and when I told my doctor this, she said that was okay, but to manage my expectations because it was still a possibility that I might not transfer [the embryo] on Monday.
I could have stopped the process, but I wanted to fight for it. In the IVF world, if you are dealing with infertility, every month feels like an eternity. I play this mind game where I say, “Oh, what if I don’t purchase enough sanitary napkins and tampons just in case…” And then I get that negative pregnancy test and I have to go purchase more.
Honestly, today [Wednesday] will be my cutoff, because today is the day I should start those progesterone shots. You typically need five days of shots for a transfer to work. I have a daughter from a previous IVF transfer, and I have three other embryos. I’ve prepared myself for the worst, but I am hopeful. And if I have to wait for a couple of months, I’ve waited for a long time before.
Did I think there was a possibility that something like this could happen after Roe v. Wade? Absolutely. But I didn’t think that I would personally be affected.
I cringe a little every time someone asks if we would leave Alabama. That is just so unrealistic for the average American. This is home for us. This is where my family is. This is where I work. This is home. We’ve already poured so much into this process, so I’m just going to continue to fight, and speak out, and do whatever I can. I’m an American. I should have access to health care in my state.
If you don’t agree with something, you have the opportunity to speak out. Always advocate, because we know what’s best for our bodies.
Kendall Diebold, 32, Hanceville, AL
Kendall, a nurse practitioner in Alabama, and her husband have been trying to start a family for two years. They were planning to start IVF in March when the Alabama Supreme Court ruling came down, halting IVF at UAB, where they are patients.
I heard about the Alabama Supreme Court Ruling when a colleague came into our office and said, “Hey, did you all realize that UAB is pausing their IVF program?” I didn’t stick around to see what she said next. I walked out of the office and found my best friend, who was working [at the same office] that day. “We have to go because you have to take care of me right now,” I told her. We left our floor and went out to the stairwell and we sat and cried. She has frozen eggs at UAB. And my husband and I were planning to start the IVF process there in early March or late April.
We started trying to have children in the early summer of 2022. After a lot of testing and lab work at UAB, we were diagnosed with unexplained infertility. We started our first round of oral medications in October of 2023. We were incredibly lucky and became pregnant. In the middle of November, I had an early miscarriage, and it was one of the hardest things we have gone through together, as people, until the Alabama Supreme Court ruling came down.
After two more rounds of failed oral fertility medication, we tried IUI in January. We wore these special little socks [to the first procedure] that said, “Stick Baby Stick,” and we were super hopeful. It didn’t work. We did our second IUI procedure and we wore the socks again. We found out it didn't work the same day UAB paused its IVF program. At this point, we’d already been talking with our physician about IVF, asking how quickly we could start it. Timing is a bit more crucial now, because a hip replacement I got last March is failing. We were really hoping to start IVF in late March or early April, and then the ruling came down. And that shook up everything.
Now, we’re worrying and wondering what comes next. We talk about it every single day. When we found out about the ruling, my husband asked, “Should we move? What do we do now? Do we get care out of state?” (Neither of us are from Alabama originally, but this is home.) There’s so much uncertainty. What’s to say that other states won’t do this? And based on how you interpret this law, is it possible to criminalize miscarriages?
Working in health care, I worry about my patients. I work in hematology oncology and trying to preserve fertility in young patients is a huge part of what we do. I worry about what that looks like now. I worry that we may potentially lose our physicians, and not just our incredible reproductive endocrinologists, but even our ob-gyns, who provide so many preventative health care services like mammograms and cervical cancer screenings. [Fertility doctors] are more than just your doctor, they are your friends. They’re the people who get you through the hardest moments. We don’t want to leave UAB because we love our physician. We credit her with getting us through our miscarriage.
I never really planned on being someone who told the entire world what we were going through. Infertility is such a sensitive topic and we had decided to keep things private. But the reason I’m sharing our story is because I want people to realize that this is happening, and it’s happening to people that they know. It’s affecting real people with real lives. We’re all scared and sad and overwhelmed, but it’s reassuring to see everybody within the fertility clinic [world] come forward and stand up and say, “Hey, this is not okay. This isn’t right. And this can’t stay.”
Elizabeth Goldman, 32, Birmingham, AL
Elizabeth, a uterus transplant patient, has an infant daughter via IVF. She and her husband hoped to transfer another embryo in the coming months.
I was born without a uterus. I was diagnosed at 14, and I thought I would never be able to create my own babies. I knew I wanted a family from a young age so it was really heartbreaking and devastating for me. So, I’ve been dealing with infertility for 18 years.
In 2020, UAB launched a uterus transplant program (the fourth in the country behind Cleveland Clinic, Baylor, and then Penn). We lived in Mobile, a 3.5 hour drive south, but I told my husband we had to go for it. It was a huge dream of mine to be able to have our own babies and I wanted to experience pregnancy. ‘We have to apply,’ I told him. I was accepted into the program on April 6, 2021, and we left everything behind. We sold our house that we recently bought, we left our jobs that we loved, family and friends–everything– to move to a whole new city and restart our lives from scratch to chase the dream of having our own baby.
We did three rounds of IVF back to back to create embryos and I got listed for transplant. I got the call on April 12, 2022, and had my uterus transplant three days later. It was a nine hour surgery. And I was the 36th woman in the United States to have that surgery.
Seven months later, we did our first embryo transfer, and I had a positive pregnancy test. That was pretty mind blowing because even still, I replay the day I got that diagnosis at 14. It just never goes away–even after I got the uterus, even now that I have my daughter. I took probably 50 pregnancy tests because I couldn’t wrap my head around it [the fact I was pregnant].
I had an early miscarriage 10 days after that first transfer. I went through a really tough season of life and had to pick myself up, brush myself off, and keep going. We did a second transfer in February of 2023, and I delivered my daughter on October 4, 2023, at almost 37 weeks.
My uterus transplant allows me to have up to two babies, as long as everything goes well with the first pregnancy and I’m healthy. I’m the first woman at UAB to keep that uterus for baby No. 2, and the seventh in the United States. But that also means I’m on immunosuppressant medication to keep my body from rejecting the uterus. Last summer, I got all the pill bottles, and I counted over 15,000 pills [that I’ve taken since the transplant]. At this point, I’m well over 20,000 pills. It can take a toll on your body. If my kidneys start to decline [or any other health problems occur] they will do a hysterectomy. The goal was to do another embryo transfer around six months after the first birth, and my daughter will be five months next week. I’m on a timeline, and right now, we’re just basically at a standstill. We’re working against the [immunosuppressant] meds at this point. My kidneys are just as good as they were pre-transplant, but will it be like that in two months?
I have 13 normal embryos and four abnormal embryos at UAB right now. It’s hard, because you want to say that an embryo is a baby, and I think my view has shifted even a little bit from just being on my journey. But just because you have an embryo and do a transfer, it doesn’t guarantee that you’re going to have a baby. An embryo is a chance at a baby.
Being such a complex patient and part of the uterus transplant program, I can’t just move my embryos to another clinic. My team is at UAB. They know my body. They know the complexity of the transplant. I want to stay there with them. We gave up everything to go on this journey, and this was really the last thing I expected. It never crossed my mind in a million years. There’s a lot of sadness. And a lot of stress. I’m sad for my team almost more than myself because all they want to do is show up for work and do what they’re passionate about, help people build families. It makes me think: When’s the next shoe going to drop?
Julie Cohen, 38, Mountainbrook, AL
Julie works as an infertility nonprofit advocate with the Jewish Fertility Foundation and as a speech language pathologist. She is an IVF patient, and shares three sons with her husband–all conceived with the help of fertility treatments. They hope to transfer one of her remaining frozen embryos at some point.
My husband and I have been going through infertility for many, many years. People always say it’s the worst club with the best members. We have three beautiful boys–our oldest just turned seven and we have four year old twins– all of them are the result of fertility treatments. The twins were a direct result of IVF–but I had to go through six transfers to get those two babies.
The week after Roe v. Wade was overturned in June of 2022, I was pregnant with a baby girl–a tested embryo that was supposed to be genetically normal–but something had gone wrong, and we were given a fatal diagnosis. There was no gray area. We had to terminate the pregnancy and deliver her early. Afterwards, we had to fight with the insurance company because they thought it was illegal in Alabama for me to deliver her early for a fatal condition, and were under impression that it was only legal if the mother’s health was at risk, which is not the case in this state. They didn't understand the Alabama law and they weren't going to cover the medical bills. But I knew it was legal, and I had the connections to get in touch [with my insurance provider] and fix it.
Since this ruling came out, I’ve been livid. I’ve been angry. We still have frozen embryos here in Birmingham at a local fertility clinic–we are not preparing for an embryo transfer right now, but it still feels like such a blow. We don’t feel like our family is complete yet. And now it feels like my embryos are being held hostage. I don’t want to think about having to move them [to another state], and none of the couriers would move frozen embryos right now [anyway] because nobody wants to risk liability. I’ve been with my fertility doctor for eight years. I don’t want to start over with a new doctor. I don’t want to start over with a new clinic. I don’t want to get new embryos.
I wish each embryo was a baby—I would have a lot more kids then. But every embryo does not equal a baby. Each embryo was a chance at a baby. I understand people not wanting to refer to embryos as property because, yes, I think of my embryos very differently than I do my house and my car and my clothes and my things. However, my embryos are also different from my living children. Right now, by stopping IVF, they are literally taking away that chance for women to try to have a baby.
I’m scared for the future of Alabama. I’m scared that IVF will never come back here. I wish I could do more. And I’m really hoping and praying that it comes back.
Eli Palmer, 34, Birmingham, AL
Eli is a pre-school special education teacher who is proactively freezing her eggs after being diagnosed with unexplained diminished ovarian reserve. She hopes to start her own family when she’s ready.
I am a single woman who is not actively trying to get pregnant, so my case is a bit different than most. I froze my eggs earlier this month at UAB because I have unexplained diminished ovarian reserve. I found this out after deciding to make an empowered choice about my future and biological timeline and getting my AMH levels tested. The number came back lower than what a 45-year-old should have. There’s no explanation. I was just stunned. This changed everything. And freezing my eggs went from an empowered choice to an urgent necessity.
My body was only able to produce two eggs for my first retrieval. I didn’t know for a few days [after the ruling] if egg retrieval and freezing would still be available (it is), and that was definitely a fear because I need to be doing this again and again and again–and as soon as possible. My ovaries are shutting down, I’m very much going to be looking at early menopause. I’m not sure that my body is going to have the capability [to carry a child] but I would like to preserve whatever fertility I have left. Access to reproductive health care should be a fundamental human right. The choice of whether or not I want to have a baby should be a basic American freedom.
I’m not actively trying to use my eggs. Right now, [with this ruling] we’re only talking about embryos, but the alarm bells go off: “What’s next?” I can only hope and pray that I will one day have access to my genetic material that I paid for out of pocket.
I keep hearing people say [this is like] The Handmaid’s Tale. The woman sitting next to me at the roundtable with US Secretary Xavier Becerra from the Department of Health and Human Services [Sect. Becerra met with families impacted by the IVF ruling on Tuesday], the sign she took to Montgomery said, “It’s giving Gilead.” I heard someone on NPR say that we think of Alabama as being 50 years behind the rest of the country. But another way of looking at this is: Are we 50 years ahead in these conservative states? It makes me fearful because it seems to be so politicized more than it is personalized.
Being able to harness the emotions and energy after a not-so-successful retrieval into something like this actually makes me feel much more powerful now. If I’m having to go through this really horrible difficult thing, at least I can perhaps be in service to others. Let me share my story of how I got here in the first place, and ask people to wake up to this, to hopefully invite people to just pause for consideration [the fact that] I should have the freedom to make choices about my body, my reproductive health, my future.
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