Four years after the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization eliminated the constitutional right to abortion, legal experts and medical providers are grappling with an unexpected consequence: a growing tension between state embryo-protection laws and access to in vitro fertilization, one of the most commonly used fertility treatments in America.
The ruling's reach extended far beyond abortion access. By declaring that states could preserve "prenatal life at all stages of development," Dobbs opened the door for legal challenges to practices central to IVF, which helps an estimated 3 percent of babies born each year enter the world through laboratory fertilization before transfer to the uterus.
The conflict centers on how excess embryos are created and handled during fertility treatment. A typical IVF cycle costs between $15,000 and $20,000 and involves fertilizing multiple eggs to increase chances of success, resulting in surplus frozen embryos. There are currently estimated to be more than 1 million frozen embryos stored across the United States.
The Trump administration has sought to navigate this tension with competing approaches. During his campaign, then-candidate Donald Trump declared he would mandate payment for all costs associated with IVF treatment and fertilization for women. In May, while referring to himself as the "father of IVF," the president unveiled an administration rule designed to make it easier for employers to cover fertility care.
What the Right Is Saying
Conservative groups and some state legislatures maintain that protecting embryos is a moral imperative rooted in the belief that life begins at conception. The Southern Baptist Convention issued a statement two years ago declaring that human embryos are people and urging constituents to "only utilize infertility treatments in ways consistent with the dignity of the human embryo."
The Texas Republican Party is currently debating whether IVF should be banned to protect prenatal life, reflecting ongoing tension within conservative circles about how strictly to apply embryo-protection principles. The Alabama Supreme Court ruled in a 2024 case that cryopreserved embryos qualify as persons for wrongful death claims, a decision that temporarily shut down IVF services until the state legislature passed a law providing legal immunity to fertility providers.
In May, the Trump administration issued guidance on "embryo adoption," describing frozen embryos as "children who already exist and are in need of a family" while simultaneously working to expand access to IVF treatments.
What the Left Is Saying
Abortion rights advocates and reproductive health organizations argue that both abortion and IVF represent fundamental aspects of reproductive autonomy and should remain accessible without legal restriction. The American Society for Reproductive Medicine classifies both as essential reproductive healthcare, a position echoed by groups including Planned Parenthood and the Center for Reproductive Rights.
"The ability to pursue either is fundamental to reproductive justice," wrote Sonia Suter, a professor of law at George Washington University Law School who studies health policy. "Reproductive justice focuses on the right to have or not have children, and the right to raise children with dignity."
Suter and other progressive advocates point out that states that banned abortion post-Dobbs undermined reproductive rights especially for disadvantaged populations. According to data cited by supporters of abortion access, pregnancy-associated mortality and infant mortality have increased in abortion-ban states since 2022.
What the Numbers Show
IVF cycles typically cost between $15,000 and $20,000 per attempt, with success rates varying significantly by age and health factors. The procedure involves creating multiple embryos to maximize the chances of a successful pregnancy.
An estimated 1 million or more frozen embryos are currently stored across fertility clinics in the United States. Approximately 3 percent of all infants born annually in the country are conceived through IVF.
Italy implemented strict embryo-protection laws in 2004, limiting fertilization to three eggs and banning embryo freezing. In the five years those restrictions were in effect, Italian IVF success rates declined while rates of multiple births increased, carrying heightened health risks for mothers and children.
Abortion rates have actually risen since Dobbs, according to data from organizations tracking reproductive healthcare access. Meanwhile, pregnancy-associated mortality and infant mortality rates have increased in states that enacted abortion bans following the Supreme Court decision.
The Bottom Line
The legal landscape around IVF remains in flux as courts and state legislatures attempt to reconcile growing public support for fertility treatments with embryo-protection principles embedded in post-Dobbs abortion restrictions. The Trump administration's efforts to simultaneously promote IVF access while adopting language about "embryo adoption" reflect the broader political challenge of addressing both issues without alienating key constituencies.
What happens next will likely depend on how courts interpret existing state laws and whether Congress takes action on fertility treatment coverage, an area where bipartisan support has emerged. For now, patients seeking IVF in states with strict abortion bans face a patchwork of regulations that may continue to evolve as legal challenges work through the court system.