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Fertility Medicine in the Crosshairs: by Cort Casady

Fertility Medicine in the Cross Hairs by Cort Casady For much of our lives, single and married, my wife, Barbara, and I feared getting pregnant. So, after being married for several years, when we decided to start a family, we thought all we had to do was stop using birth control. It wasn’t so easy. When we wanted to get pregnant, we couldn’t.

Barbara took her temperature every day for two years to determine when she was ovulating. We tried everything; nothing was working. Finally, because science had advanced to the point where it was possible, and because we could, we turned to fertility medicine. As we moved forward, trying various procedures, our fertility doctor reminded us more than once that conception is a process, not a “moment.”

I’ve written about our ups and downs with fertility medicine in my memoir, “Not Your Father’s America.” We had a bumpy, at times harrowing, ride. After trying in vitro fertilization (IVF), Barbara eventually got pregnant following a gamete inter fallopian transfer (GIFT) procedure. Then, 21 weeks later, she went into preterm labor, which couldn’t be stopped, and gave birth to a tiny little girl born too soon. We were heartbroken.

After more attempts, Barbara became pregnant again, this time thanks to a zygote intrafallopian transfer (ZIFT) procedure which combines IVF and GIFT. Eggs are stimulated and collected using IVF methods, then combined with sperm in a Petri dish in a lab. Fertilized eggs, or zygotes, are then placed, via laparoscopy, in the fallopian tubes, where they will be carried into the uterus.

That’s how Barbara became pregnant with triplets. You read that right – triplets. And we were mortified. Having lost a baby, we feared what might happen in a high-risk triplet pregnancy: mortality, morbidity, another total loss. Data published by the U.S. Centers for Disease Control and Prevention indicates that approximately 2 in every 100 children born in the U.S. are conceived through IVF. Now, experts say, the elimination of the right to choose is allowing states to seriously interfere with the practice of fertility medicine.

According to reporting by CNN journalists Jessica Schneider and Tierney Sneed, now that the Supreme Court has overturned Roe v. Wade, fertility medicine is in the crosshairs of anti-abortion forces spread across a disturbing number of states. And doctors who practice in vitro fertilization and other fertility procedures whereby sperm and eggs are collected and sometimes combined outside the body, are threatened, too.

We consulted several perinatologists about whether to “reduce” Barbara’s pregnancy from three to two. People who are pregnant with multiples are sometimes advised to reduce, an especially vital option for anyone who’s pregnant with quads, quintuplets or more, both to protect the pregnancy and the mother.

After balancing atop what felt like a moral precipice and a medical dilemma for weeks, we decided to leave the pregnancy alone and, hopefully, have three babies who were healthy and whole.

We were blessed with a spectacular outcome.

When an individual or couple elects to use any of these fertility methods, the process begins with weeks of preparation. Hormones are used to stimulate the woman’s ovaries to produce eggs.

Eggs and sperm collected outside the body are combined inside, either separately, or as gametes or zygotes. In a gamete or zygote inter fallopian transfer, the goal is to ultimately transfer one or more healthy embryos to the woman. But first, those embryos must grow to blastocyst stage, which typically occurs between five and seven days after fertilization. Because approximately half of all embryos created this way are chromosomally abnormal, embryologists like to encourage the production of as many embryos as possible. This way, they can choose to transfer the healthy embryos, while discarding the others. Remember: we’re dealing with a process, not a “moment.” However, anti-choice activists are likely to see this essential scientific process as “abortion.”

Moreover, now that the right to choose has been overturned, reducing a pregnancy involving an embryo or nascent fetus could also be considered an abortion — and a crime — even though it’s intended to protect the life of the mother and assure the safe development and delivery of the other fetuses. To be safe, according to the CNN reporters, those already using fertility medicine may want to move their embryos out of states that are hostile to choice and a woman’s right to determine what’s best for her body and her family. Indeed, an array of measures targeting fertility procedures could, and probably will, move forward, threatening not only the fertility medicine industry but also the opportunity for many couples to start a family.


Cort Casady has won two Emmy Awards and three NAACP Image Awards for his work as a television/documentary writer-producer. His memoir, Not Your Father’s America, is available to pre-order now and will be available to purchase Jan. 17, 2023, from Amazon, Barnes & Noble, and independent bookstores nationwide.


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