In vitro fertilization (IVF), once a groundbreaking medical advancement, now faces political and legal challenges that threaten access to fertility care. 

For months, Martha Baker and Karen Terhaar sat together flipping through catalog after catalog, each page filled with profiles of sperm donors. Some were brief, only a few sentences describing family history and medical background, while others were detailed, complete with photos and stories. It was a tedious, yet intimate process, one that carried the weight of their hopes for a family.  

After much deliberation, they finally agreed: a donor who was 6 feet 5 inches, with blond hair and blue eyes, was the perfect sperm for the two children they anticipated. He was an anonymous donor with just a brief medical history and a few short sentences about his background. Yet, in that moment, it was everything they had been searching for. 

But the path to parenthood was far from straightforward. Martha and Karen met in 1997, when same-sex marriage was still illegal, later becoming legal in their home state of Massachusetts in 2004. Despite the legal and social challenges of the late 1990s, the couple decided just three years into their partnership that they wanted to start a family.  

They determined that in vitro fertilization (IVF) was the best option for them – a process in which an egg is fertilized outside the body and then implanted in the uterus. But this decision raised another hurdle: finding a doctor willing to perform the procedure for a same-sex couple. The search was far from simple as many fertility clinics lacked experience with LGBTQ+ couples or were reluctant to provide services due to personal or institutional biases. After months of research, phone calls and consultations, in 2000 they finally found a doctor in Buffalo, New York, who was both knowledgeable and receptive to their needs. 

The process was quite easy for Karen, and it only took a couple of treatment rounds until she was carrying their first child, Emma Baker-Terhaar, who was born in 2001. 

A couple of years later, once Emma could nearly walk on her own two feet, Martha and Karen decided it was time to start trying for their second child. In 2003, Martha gave birth to Max, using the same tall, blond-haired, blue-eyed sperm donor they had chosen years earlier. Unlike Emma, Max was not baptized. 

While the emotional and physical journey of IVF was taxing for the Baker-Terhaars, the financial burden added yet another layer. The couple invested $10,000 in sperm for both Emma and Max, and though some doctor’s visits were covered by insurance, many other costs weren’t. They spent an additional $4,500 in adoption fees for each child, so that each woman was legally the parent of both children, but it was worth every penny. 

The Baker-Terhaars on a beach vacation. Pictured top left, Karen; bottom left, Emma; top right, Martha; bottom right, Max. Photo courtesy of Emma Baker-Terhaar.

“I’m definitely super grateful that they were able to do this, especially at a time before gay marriage was even legal,” Emma Baker-Terhaar says. “Everyone should be able to have more babies. And I hope it’s not just straight couples. I hope they allow single women and LGBTQ queer people the same access to things like funding.” 

Today, over 500,000 IVF deliveries take place each year worldwide. Families like the Baker-Terhaars turn to IVF to achieve the parenthood they couldn’t otherwise have — because for them, it’s not just an option, it’s a necessity. 

What is IVF? 

IVF was developed by Dr. Patrick Steptoe and Dr. Robert Edwards, leading to the birth of the first IVF baby in 1978. This groundbreaking procedure, which involves fertilizing an egg outside the body and implanting it into the uterus, revolutionized fertility treatment and offered new possibilities for those struggling to conceive. A full cycle of IVF can involve multiple procedures, each with their own costs, with a single cycle ranging between $15,000 and $20,000. The average number of cycles before a viable pregnancy is around 2.5, according to the U.S. Department of Health and Human Services. 

The practice of IVF has rapidly evolved, with over 10 million babies worldwide born through the procedure. Today, IVF accounts for 1-3% of all births annually in the United States and Europe. According to infertility advocacy group Resolve, only 15 states currently offer some form of IVF insurance coverage. 

Infertility affects about 17.5% of adults, or roughly one in six people, emphasizing the need for better access to affordable, high-quality fertility care. This includes support for families struggling with infertility, single mothers, same-sex couples and cancer patients. IVF has expanded beyond these groups, offering solutions for individuals facing challenges like recurrent miscarriages, male factor infertility, failed treatments and surrogacy. As a result, IVF has become a cornerstone of modern reproductive medicine, providing hope and a pathway to parenthood. 

Timeline 

This timeline follows the history of IVF from 1978 to the present day.

Alabama Ruling 

This remarkable scientific technology may now be at risk following its trail of political attention earlier last year. On February 16, 2024, the Alabama state Supreme Court issued a first-of-its-kind decision that overruled a lower court’s dismissal. It upheld that stored embryos are afforded the same legal protection as children under the state’s Wrongful Death of a Minor Act of 1872. This marked the first time the definition of a minor or child under the statute had been applied to an embryo that exists in a lab — a move rooted in the same legal arguments used to restrict abortion. 

Sydney Breedlove, co-founder and vice president of DePaul Planned Parenthood Generation Action (PPGA), describes the Alabama ruling as a paradox that creates significant barriers to fertility treatments. While the abortion ban aims to protect all embryos as potential lives, it simultaneously imposes restrictions on the very processes essential for successful fertility care, such as embryo creation, freezing and disposal. This legal contradiction leaves patients and providers in a complex ethical and procedural dilemma, making it very tricky to navigate fertility care in Alabama. 

“IVF is a very selective process. It is not like you’re getting 20 children out of the 20 embryos you use,” Breedlove said. “I think explaining this as a death of a child with an unborn fetus that’s frozen is both absurd, but it’s also going to turn people away from that reproductive care that they might need to start a family, especially in southern states like Alabama, like Florida, where those abortion limits are there.” 

Following the ruling, IVF procedures in Alabama were temporarily halted, as embryos created using the technique were deemed to have the same rights as children. Although a new state law shielding clinics from legal consequences has allowed treatments to resume, clinicians and scientists working with human embryos across the U.S. remain deeply concerned about escalating legal and constitutional challenges. 

“You’re placing this in the hands of courts instead of the hands of medical professionals, and that, to me, is just the most egregious part of all of this,” Breedlove says.  “We in no way should be handing the lives of women, the lives of mothers, into the hands of courts, as opposed to into the hands of the medical professionals who can save them, who can keep them healthy, who can keep them safe.” 

Like the Alabama case, there is a growing concern that similar restrictions could be enacted in other states without federal protections for women, as leaving decisions up to individual states has led to severe restrictions on women’s rights in certain areas. While such policies could potentially spread to other states, Jill Dunlap, a part-time faculty member at DePaul who also works on federal policy issues, believes that the significant backlash against such legislation across both political parties serves as a warning to other states not to follow suit.  

“The greatest protection against seeing that sort of contagion effect happening in other states is the fact that there was such a significant backlash by both Republican women and Democratic women and Republican men who have used IVF with their partners,” Dunlap said.  

Fertility Services as a 2024 Election Topic 

Fertility services have never been so explicitly talked about by candidates as they were in the election this year. Both parties voiced support for IVF, yet the high cost of infertility treatments remained a significant issue for many families. The Alabama ruling has further highlighted the urgency of protecting access to fertility services, prompting many lawmakers to express their support for reproductive healthcare. However, their inaction underscores a harsh reality: promises alone are not enough to make lasting change for families in need. 

Minnesota Governor Tim Walz opened up about his family’s experience with intrauterine insemination (IUI) — another type of fertility treatment — sharing a personal account of the challenges he and his family faced with fertility treatment. Walz spoke candidly about the process, highlighting its emotional toll and the importance of making reproductive healthcare accessible.   

President Donald Trump has made significant promises regarding IVF in the past, reaffirming his commitment to universal access, including for LGBT couples. His campaign even promised to make IVF treatment free for women if he returns to office, with costs covered by the government or insurance companies. Trump also called himself the “father of IVF” during a Fox News Town Hall for women, sharing a story about Alabama Senator Katie Britt explaining IVF to him after the Alabama Supreme Court’s February 2024 ruling that frozen embryos are considered children. In other words, the “father of IVF” only learned about IVF a few months earlier. 

Dunlap elaborates how many of Trump’s claims are contradictory. Given his stance to ensure IVF services are covered by government and insurance, he has also made claims to revoke the Affordable Care Act (ACA), which Dunlap explains is the natural outlet that funding for these treatments would come from, given that it is the government’s means of providing financial assistance and mandated benefits for health insurance. 

“If you’re trying to make IVF covered, make it covered through the Affordable Care Act. But if you’re trying to get rid of the Affordable Care Act, how else do you make that happen? So, it’s like, oh, so how serious was he? Or was that just sort of like a campaign promise that they didn’t really have any inclination of following up on?” Dunlap says. 

With these rights left in the hands of the state, there are various potential restrictions on IVF that could impact its accessibility and affordability. One of the major concerns is the possibility of capping the number of embryos that can be created per IVF treatment cycle. Such a measure, along with potential bans on freezing unused embryos rather than discarding them, would significantly reduce the efficiency of IVF treatments. If freezing embryos becomes legally risky, couples may be forced to limit the number of eggs retrieved or inseminated per cycle to avoid creating frozen embryos. This would not only increase the number of IVF cycles needed, but also drive up costs and expose patients to greater health risks from fertility drugs and procedures. As the political landscape shifts, these concerns highlight the growing intersection of healthcare with law and ethics, raising alarms about the future of reproductive treatments. 

The Right to IVF Bill (S.4445) 

In January 2024, Illinois Senator and IVF parent Tammy Duckworth of Illinois introduced the Access to Family Building Act. Duckworth’s bill sought to protect nationwide access to IVF and other reproductive technologies in response to concerns that state-level abortion bans could limit fertility treatments. The Alabama ruling further intensified these concerns by creating legal conflicts for fertility providers. Despite her efforts, the bills failed to gain traction due to Republican opposition. 

In response, The Right to IVF Bill (S.4445), introduced to the Senate on June 3, 2024, sought to reduce barriers to IVF treatment and safeguard its availability across the country. The legislation, co-authored by Senate Democrats Patty Murray of Washington, Tammy Duckworth of Illinois and Cory Booker of New Jersey, aimed to prevent states from imposing restrictions on IVF while also making the procedure more affordable.  

On June 13, however, a motion to proceed with the bill failed to meet the 60-vote threshold required for cloture (or ending the debate), resulting in a narrow 48-47 vote. The bill was reintroduced a few months later, on September 17, but once again failed to secure the supermajority of 60 votes, garnering just 51 votes. While two Republican senators, Alaska’s Lisa Murkowski and Maine’s Susan Collins, voted with Democrats in favor, the rest of the GOP remained opposed. 

Since early 2024, Senate Republicans have blocked four separate Democratic efforts to safeguard and expand access to IVF, including the Access to Family Building Act and Bill S.4445. The claim that the GOP is more progressive on IVF than Democrats stands in stark contrast to these repeated rejections, highlighting the disconnect between rhetoric and action on reproductive health policy. 

Prince Priyanshu, treasurer of DePaul’s Student Government Association (SGA), offers insight into why Senate Republicans may have blocked the Right to IVF Bill (S.4445).  

“The idea of IVF, the idea of science, is supposed to help people that need it. That’s what it is,” Priyanshu says. “But when you make it political, which has happened with a lot of wedge issues, especially abortion, you get in a place where … you start having people feared by science and it becomes a problem.” 

Priyanshu ties this opposition to a broader ideological stance that values children being born through what some lawmakers consider the “natural” process, rejecting assisted reproductive technologies like IVF. This belief shapes much of the GOP’s resistance to legislation that would expand access to fertility treatments, framing the debate around traditional views on family and procreation. 

“You’re taking an egg and you’re taking the sperm, and you are doing it in a hospital setting, you’re playing God. The idea of playing a God also probably doesn’t serve the far right that well in terms of IVF,” Priyanshu says. “The debate itself gets lost in the meaning and the true reason why IVF exists.” 

After failing to secure enough votes for a second time, S.4445 is currently paused, with its future reintroduction still uncertain. Dunlap notes that if the bill were to pass, it would be a win for Trump, aligning with the promises he made during his campaign to support fertility services. Given that he no longer needs to appease the religious right for votes, Dunlap suggests Trump would likely support the bill and sign it into law.  

“It would also fit his narrative that he’s the father of IVF, so I don’t think that it would be something that he would veto. But I think that the players involved in the Senate and the House now just look so different than the first time it was introduced,” Dunlap says. 

IVF is more of a bipartisan issue among the public and electorate than other reproductive matters like abortion. However, its future in Congress remains uncertain. If the bill were to be reintroduced, its passage would depend on several factors, including who chairs the relevant committees in the new Congress. This decision would likely not follow traditional party lines; rather, it would require a close look at each candidate’s stance on IVF to determine what their individual beliefs are. 

“I don’t think it’s their top priority, and even then, I don’t know if they would put it to the Senate to a vote, if they knew they didn’t have the votes to pass it. Like, I just don’t know if it’ll come up again,” Dunlap says. “Like you can’t say, well, now that Republicans are in charge of the House and so they run that committee and it’s not going to move forward because there are some Republicans that are very much in favor of it.” 

What Lies Ahead 

In the broader debate over reproductive rights, IVF has emerged as a flashpoint, sparking concerns over whether reproductive healthcare will remain a medical decision or become a political one. As a bipartisan issue, the struggle to protect access to IVF transcends party lines, yet the stagnation on S.4445 marks a lost opportunity to make meaningful change for American families. 

“All the policy and all the politics aside, women are in the middle, and it breaks my heart for people who need IVF as part of their family planning,” Dunlap says. 

For the Baker-Terhaar siblings, Emma and Max, IVF has connected them to a much larger family than they ever imagined. Now 23 and 21, they’ve discovered 10 half-siblings who share the same sperm donor, using a combination of donor registries and Ancestry DNA to trace their shared origins. 

“I have a lot of siblings who used the same sperm and all of them except for one guy, who was infertile and the wife used an anonymous sperm donor to get pregnant through IVF, were all single mothers who never found a partner or a husband,” Emma Baker-Terhaar says.  

For many individuals relying on IVF or hoping to use it in the future, the current political climate feels discouraging. The high cost of fertility treatments is already out of reach for many, and while President Trump makes promises, government-funded IVF seems distant and out of his control. 

As discussions around IVF access continue, the lack of a clear plan to make this a reality sets up false hope for those who need it most.  But there is no true way to predict what will happen. 

“It’s definitely concerning,” Baker-Terhaar says. “And if this bill is passed, I hope that everything else remains okay, and they don’t restrict this from single moms and same-sex couples, like my moms.” 

Header by Alex Carasquillo