“I just feel like I don’t even want to ever come back to Alabama,” Gabrielle Goidel said Thursday.
Yesterday, Goidel was days away from having her eggs retrieved at an Alabama fertility clinic, after three miscarriages and more than a $20,000 investment in a grueling in vitro fertilization journey. Now, she and her husband are packing for a flight to Texas tonight, in hopes of salvaging their shot at a successful pregnancy.
After the Alabama Supreme Court ruled last week that frozen embryos are considered human beings and those who destroy them can be held liable for wrongful death, fertility clinics throughout the state began pausing IVF treatments out of fear of legal prosecution.
Goidel said her provider, Alabama Fertility Specialists, called her Thursday morning and told her because she is so far along in the IVF process, the clinic was still willing to retrieve her eggs – but could not make any guarantees about whether they would be able to use them to make embryos, store or ship them.
Goidel and her husband pursued IVF after losing three pregnancies within the span of nine months. That phone call filled her with a very similar feeling, she said.
“It was absolutely my worst fear,” Goidel said. “I don’t think I’ve ever been this stressed in my life, this worried.”
After frantically calling other fertility providers, Goidel and her husband found one in Texas willing to provide IVF treatment.
The top court’s decision sent Alabama’s fertility industry into a state of fear and chaos. Providers fear they could face legal repercussions every time an embryo does not turn into a successful pregnancy. Parents are facing the possibility of lifelong storage fees for unwanted or unviable embryos they won’t be allowed to discard. Experts are warning that liability costs could increase already-astronomical fertility treatment prices.
The Goidels’ doctors told them they have a higher-than-normal likelihood of having a pregnancy with genetic abnormalities and suggested they pursue IVF, which would allow them to do pre-genetic testing. When they moved from Texas to Alabama in 2023, they immediately started looking for IVF clinics. There weren’t many options, Goidel said, but they finally landed on Alabama Fertility Specialists in Birmingham.
Now, Alabama Fertility along with the Center for Reproductive Medicine at Mobile Infirmary and the state’s largest health care system, the University of Alabama at Birmingham, have paused or plan to pause IVF treatments.
Experts expect more providers to follow suit. As the American Society for Reproductive Medicine put it, “No healthcare provider will be willing to provide treatments if those treatments may lead to civil or criminal charges.”
Alabama Fertility said Thursday it is working to find solutions for impacted patients after making the “impossibly difficult decision to hold new IVF treatments due to the legal risk to our clinic and our embryologists.”
“We are saddened that this will impact our patients’ attempt to have a baby through IVF, but we must evaluate the potential that our patients and our physicians could be prosecuted criminally or face punitive damages for following the standard of care for IVF treatments,” Hannah Echols, a University of Alabama spokesperson told CNN in a statement.
What will happen to frozen embryos?
Goidel said the state court’s decision left her eggs at risk.
Had she chosen to stay in Alabama, she would be faced with the questions many patients in the state are now facing.
“What happens to my embryos after we retrieve them? Do I have to keep those frozen forever? Do I get to let the ones that are genetically abnormal pass naturally? Is my doctor going to be in any sort of danger by doing this procedure to me? There are so many questions in the air right now,” Goidel said.
Providers don’t have the answers, and a spokesperson for the state attorney general’s office didn’t immediately respond to specific questions about whether Alabama would charge people who destroy embryos with a crime.
“We’re just literally in cryogenic limbo,” Dr. Andrew Harper, medical director for Huntsville Reproductive Medicine, told CNN Monday. Harper has refused to stop providing IVF treatments, although he has paused the disposal of embryos.
“If some DA or attorney general wants to come after me, bring it on,” Harper said. “You better believe we’re not going down without a fight.”
It’s unclear whether a policy will be implemented that requires embryos, even those that are genetically nonviable, to be kept frozen. The cost of storing embryos indefinitely or shipping them out of state to be destroyed would add to the tens of thousands of dollars that parents regularly spend on the IVF process.
Goidel said her wish is to let her non-genetically viable embryos pass.
“I’ve had to detach myself from those embryos emotionally, because I know I’m going to lose them,” Goidel said. “I view them as this world of possibility for me and my husband, but I can’t view them as physical children.”
“To have to keep those somewhere as just a reminder of all the pain is really emotionally hurtful,” she added.
Experts fear providers and patients will be driven out of state
“We will probably be going into debt with the flights going back and forth,” said Goidel.
She and her husband intend to travel between Alabama and Texas, where they have family and can access the reproductive care they need – for now. They fear what could happen if Texas adopts similar policies to Alabama.
“We love the South,” said Goidel. “We love living here. We’re huge SEC Football fans. We moved from Texas A&M to Auburn. We love it here, but it definitely has made us think about whether or not we’ll stay here long term.”
The National Women’s Law Center said this decision could have a chilling effect on access to health care in the state.
“Physicians at the start of their careers will choose not to come to the state for training or to begin their practices. Existing clinics will be forced to choose between risking criminal prosecution, providing substandard care, or shutting their doors,” Katie O’Connor, the law center’s Director of Federal Abortion Policy, told CNN.
O’Connor warned if the court’s decision is taken to its extreme, the people of Alabama risk losing access to other fertility treatments or methods of contraception.
Progyny, a company providing 6.7 million members nationwide with fertility benefits, told CNN that the ruling will result in higher costs, with patients considering leaving the state to get care and providers recommending high-cost alternatives.
“If doctors are now fearful about the penalties associated with offering IVF to their patients, they will instead recommend intrauterine insemination (IUI) treatments, which is a higher risk option that is less likely to result in a pregnancy – so that’s an added cost on the front end for patients,” Progyny Chief Medical Officer Dr. Janet Choi told CNN via email.
“It’s a pretty large state that’s already very limited access and it’s an expensive process,” Goidel said. “Anything that makes this less successful and more expensive is crazy to me.”
Another concern is that providers may skip genetic testing for gene disorders that might affect whether an embryo transfer is effective, instead choosing to place more embryos into a patient, which could result in more multiple births or failed transfers, Choi said.
“If patients are now forced to transfer abnormal embryos that we know will result in a failed pregnancy or miscarriage – the emotional and financial burden will be detrimental to many,” Choi added.
Experts say the impact of the court’s decision could extend beyond Alabama.
Liberty Counsel, a non-profit that says it works to advance “religious freedom, the sanctity of human life and the family,” is considering using the Alabama ruling as precedent to target abortion rights in Florida.
“I’ve kind of gone through the social media rabbit hole of starting to look up what people are saying about this, and to see that people are advocating for banning IVF – or that IVF isn’t moral – I fear what this means long-term for women who are looking for care and trying to get access,” Goidel said.
The Medical Association of Alabama has called on the state Supreme Court to stay or reverse its ruling, arguing the decision will likely lead to “fewer babies – children, grandchildren, nieces, nephews, and cousins – as fertility options become limited for those who want to have a family.”
“All we want is to just have the American dream and have a family,” Goidel said. “I never thought that this would be something that would be seen as immoral.”
CNN’s Maxime Tamsett, Christina Maxouris and Meg Tirrell contributed to this report.