The elephant in the womb: Why personhood policy is scientifically wrong

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After my third miscarriage, I turned to In vitro fertilization (IVF) with preimplantation genetic testing in order to conceive. I am a reproductive endocrinologist and infertility specialist and went through multiple rounds of fertility treatments.

Preimplantation genetic screening is new technology that allows an embryo to be chromosomally tested before being placed in the uterus. Genetic testing increases the success of IVF, decreases the risk of miscarriage and decreases the risk of a child being born with a chromosome abnormality such as Down syndrome.

In my case, the majority of my embryos has chromosome abnormalities and would never have resulted in a healthy baby. 

{mosads}In the 38 years since Louise Brown made news as the first live birth from in-vitro fertilization, more than one million babies each year are born as the result of IVF. Success rates have increased, multiple pregnancy rates have decreased and the procedures have become safer. 

Most people view fertility treatments as the opposite end of the reproductive spectrum from abortion. These couples are desperate to build their families. 

Congressional Republicans recently introduced HR 586, The Sanctity of Human Life Act, commonly referred to as a Personhood Bill.

This seeks to define human life as beginning with fertilization of the egg “at which time every human has all the legal and constitutional attributes and privileges of personhood.”

Days later at the March For Life rally in Washington, D.C., thousands gathered to hear Vice President Mike Pence declare that, “Life is winning.”

Without question, the purpose of these bills is to circumvent Roe vs. Wade in order to make abortion illegal. The timing of the introduction of HR 586 was coincident with the 43 anniversary of Roe vs. Wade, an irony not lost on proponents for reproductive choice.  

By classifying an embryo — and subsequently a fetus — as human life, the intent of this bill is to supersede the language used in the Roe decision that protects the potentiality of human life. 

The central holding of the Roe ruling is that a woman has a right to an abortion until fetal viability which is defined as “potentially able to live outside of the mother’s womb, albeit with artificial aid.” 

HR 586 introduces the concept of embryo as human life and not simply the potential to become human life. This is scientifically unfounded; historically, these bills have been repeatedly introduced and have failed to pass. In addition to the intended consequence of banning abortion, the unintended consequences are severe restrictions on in-vitro fertilization.

To be sure, an embryo has the potential to become human life but should not be given the same moral status as viable human life. 

As women age, the likelihood of chromosome abnormalities in the eggs increases. Chromosomally abnormal embryos either fail to implant and establish a pregnancy or do not progress beyond the first trimester. 

As the average age of women pursuing IVF in the USA is 38, the majority of embryos created in this country will not result in an ongoing pregnancy.  In the very best of circumstances, when a chromosomally normal embryo is transferred to a woman’s uterus, there is only a 50 percent chance that embryo will implant and there remains a 10 percent chance of miscarriage. 

A patient must overcome many hurdles in order to progress from embryo to live birth.    

Personhood legislation would restrict the ability to perform several key components of IVF procedures. Specifically, anything that would put the embryo’s viability at risk would be a criminal violation.  

Embryo freezing, or cryopreservation, has played a critical role in advancing the success and safety of IVF. When embryos are frozen and later warmed, survival rates are as high as 95 percent. One could argue that because survival rates are not 100 percent, that freezing embryos puts viability at risk. 

Embryo cryopreservation and successful preimplantation genetic testing have been transformative. Pre-implantation genetic testing and selective transfer of an unaffected embryo is morally less complex than the decision of whether or not to terminate a pregnancy.

Genetic tests can be done either for chromosomes or for fatal and serious single gene disorders including spinal muscular atrophy, cystic fibrosis and muscular dystrophy. Couples who carry genetic diseases can use this technology to prevent gene transmission and to avoid causing unnecessary suffering to their future child.

Personhood legislation would hinder the ability to use this technology.  If abortion also becomes illegal, couples who carry genetic diseases would face even greater challenges, heartache and suffering in the quest to have a healthy baby.   

IVF technology does far more good than harm.

Personally, it allowed me the ability to have healthy children and to avoid further reproductive risk. I am by no means alone as 1.5 percent of all babies today are born as a result of IVF. The long term economic benefit to our country from these IVF babies is significant.     

On a fundamental level, the suppositions made by personhood bills are scientifically incorrect. Embryos have the potential to become life, but IVF is an inefficient process. Multiple embryos are often required to achieve a single live birth due to human biology and ovarian aging. In order to best help women and couples have children, the science – and not the politics – must be prioritized. 

Eve C. Feinberg, MD is an Assistant Professor of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine and founder of the Kevin J. Lederer Life Foundation. She is an NU Public Voices Fellow through The OpEd Project. 

The views of contributors are their own and are not the views of The Hill.

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