Republicans face thorny path ahead on fertility policy

Former Vice President Mike Pence’s recent support for fertility treatments like IVF as well as a national abortion ban has surfaced in what could become a dilemma for 2024 Republican hopefuls running platforms on reproductive health.

The big picture: Republicans have largely insisted that fertility treatments are not at risk because of the spread of new state abortion restrictions. But anti-abortion groups remain deeply concerned about the use of embryos in IVF and tighter regulations on providers.

• The divisions could create a thorny path for 2024 hopefuls intent on bolstering their anti-abortion bona fides while still hoping to distinguish themselves from the rest of the field.

Manage the news: “I fully support fertility treatments and I think they deserve the protection of the law,” Pence said recently on CBS’s Face the Nation, referring to his and his wife Karen’s struggles with infertility. She has undergone IVF several times, he said.

• At the same time, the likely presidential contender in 2024 was unequivocal on abortion, saying he would support Sen. Lindsey Graham would support the 15-week federal ban if he were in Congress “as a start” — adding that he would continue to work to “restore the sanctity of life to the center of American law in all 50 states .”

Game Condition: Legal experts say that the language of red-state “trigger laws” banning abortion can be interpreted in some cases to also apply to IVF, since embryos are fertilized before they are stored.

• There hasn’t been a widespread push to interpret the laws that way—in fact, some Republican attorneys general have issued guidance saying that they not applies to embryos made outside a woman’s body.
• But the pro-life movement, like the GOP, is still finding its footing in the post-Roe world, and IVF and other assisted reproductive technologies are still opposed by some groups, according to their websites.
• In audio obtained by ProPublica of a meeting between the anti-abortion group Susan B. Anthony Pro-Life America and Tennessee lawmakers, the group suggests that lawmakers could discuss regulating IVF “in a more ethical way” after focused on abortion bans.
• That could put positions like Pence’s in conflict with some of Republicans’ most trusted allies, at least if they don’t include specific guardrails designed to protect embryos.

Between the lines: Some Republican politicians have quietly expressed openness to stricter IVF regulations.

• In an audio clip provided to the Atlanta Journal-Constitution, Georgia Gov. Brian Kemp (R) answered “yes” when asked if he liked the idea of ​​a bill to dispose of excess IVF – to prohibit embryos considered unsuitable for implantation.
• Republican Don Buldoc, who lost the New Hampshire Senate race this month, said at an October campaign event that the disposal of embryos for IVF was “a disgusting practice” and indicated he would be willing to ban it , according to a survey obtained by Vanity Fair. “I don’t like that exercise at all … and we have to do something about it,” Bolduc said.

Be smart: During IVF, a health care provider collects and fertilizes a patient’s egg outside the body, and then those deemed most suitable are implanted into the patient’s uterus. Those that are not implanted can be frozen and stored (usually requiring a recurring storage fee), donated, or discarded.

What we watch: Infertility and health experts are concerned about possible legislation granting legal rights to embryos without banning IVF itself, which they say could still leave the procedure at the mercy of regulators or courts.

• “If you’re regulating embryos, you’re not able to do IVF at the standard of care available today,” says Barb Collura, president and CEO of Resolve: The National Infertility Association.
• “You can’t do IVF if you can’t freeze an embryo, if you have to transfer every embryo created. It’s just not going to work,” Collura added.
• If embryos can’t be discarded, it will likely lead to increased costs and, consequently, reduced use of IVF, says Loren Colson, a family doctor in Idaho who is currently going through IVF with his partner.

Zoom in: The United States Conference of Catholic Bishops opposes IVF, saying that “reproductive technologies like IVF put the lives of women and children at risk.”

• “A moral dilemma is being ignored as an under-regulated industry plays with the building blocks of life,” Kristan Hawkins, president of Students for Life of America, wrote in a statement to Axios. “Our nation avoids hard conversations about how creating disposable children harms the children we ‘allow’ to live by teaching them that they are expendable.”
• Several state right-to-life branches — including those in Texas, Illinois and Louisiana — oppose or express deep concern about the procedure.

The other side: “Not a single state legislature or Congress is debating making fertility treatments illegal. We are focused on stopping the intentional killing of unborn human life,” Susan B. Anthony Pro-Life America said in a statement provided to Axios is.

What they say: Fertility treatments are “just not something I see a whole lot of conversation about, at least in the context of legislative proposals,” said Melanie Israel, a policy analyst at The Heritage Foundation.

• “The Dobbs decision was an earthquake politically, legally, culturally, and I think people are still navigating it,” she added.

Go deeper: IVF centers lobby for protection in post-Roe landscape