37-year-old Corinn O’Brien is currently two months pregnant through in vitro fertilization. However, recent ultrasound results have revealed some potential complications with the fetus. Thus, she wishes to have the option to undergo the process again if necessary.

Kailani Greenwood, a person who has overcome cancer, is expected to have a baby in the upcoming season through IVF. In the future, she hopes to have additional children and currently has four embryos stored.

The Alabama women who belong to two categories that are commonly associated with using IVF in order to start a family, namely women over 35 and those with serious illnesses, are concerned about the availability of these options in the future. O’Brien and Greenwood are just two of the many individuals whose hopes are uncertain as three of the state’s biggest clinics have put a pause on offering IVF services following a ruling by the state Supreme Court that classified frozen embryos as “children outside the womb.”

“It has been difficult,” O’Brien expressed with a cracking voice. “I am uncertain of what the future holds, and that is quite frightening.”

Around 1 in 6 individuals globally experience issues with infertility. In the United States, women are choosing to postpone motherhood despite the fact that fertility declines gradually after the age of 30, with a greater decline after 35. This has increased the demand for treatments such as IVF. According to a 2023 survey by the Pew Research Center, women aged 35 to 44 are more than twice as likely as younger women to report using fertility services.

In addition to the increasing number of elderly patients, physicians also note a smaller yet noteworthy group of women dealing with illnesses like cancer, lupus, and sickle cell disease, who wish to maintain their ability to have children.

Doctors in Alabama state that numerous women are in a state of uncertainty or seeking assistance from other states. Some are advocating for a bill to address the issue, and on Tuesday, committees in both the House and Senate made progress on legislation to protect clinics from legal action. It is the goal of lawmakers to pass these measures to the governor for approval by the end of the week.

However, certain medical professionals and individuals express concern that these efforts may not be sufficient, and that future laws or legal decisions in other states could potentially jeopardize IVF on a larger scale.

Dr. Beth Malizia, the physician for Greenwood at Alabama Fertility, a clinic that temporarily stopped providing services, explained that the current disruption has only added more challenges for women who are facing difficulties.

“Look, nobody wants to be in our clinic. … No one chooses fertility issues. No one chooses cancer. No one chooses recurrent pregnancy loss,” she said. “We’re trying to provide the best care that we can, and this decision has really limited us in our ability to do that. We just want to grow families.”

Realizing the significance of having a sibling to rely on, O’Brien, who sadly lost her mother to pancreatic cancer and lacked other siblings for support, made it a priority for her young daughter. She understood the value of having someone to walk through life with after they are no longer around.

The Birmingham couple attempted to conceive a child for a number of years, but unfortunately the woman experienced a life-threatening ectopic pregnancy. She tried several different fertility methods before proceeding with IVF. In October, ten eggs were collected and three were successfully fertilized and stored. In late January, one of the embryos was placed into her uterus by her doctor and she became pregnant.

However, on the day that the court ruling was announced, an ultrasound revealed complications with the fetal heartbeat.

“She described it as a double blow, with the uncertainty of the treatment’s success and the potential unavailability of IVF.”

For Greenwood, in vitro fertilization (IVF) is the sole method through which she can become a parent.

A 31-year-old woman from Montgomery was diagnosed with Hodgkin’s lymphoma 11 years ago. After undergoing chemotherapy, she went into remission, but the cancer resurfaced when she was 25. The subsequent treatment of radiation, chemotherapy, and a stem cell transplant resulted in infertility. To preserve her fertility, she had her eggs collected and frozen.

“I have always fantasized about being a mother my entire life,” she expressed.

Greenwood became pregnant with her daughter last year via an embryo transfer and is currently in the third trimester of her pregnancy. She expressed her desire to have more than one child, aiming for at least two or possibly more.

She has been holding onto hope that her clinic will resume IVF. However, daily reminders of the court decision affect her work as a physician assistant in surgical breast oncology, where numerous patients aim to maintain their fertility.

According to Dr. Kara Goldman, who serves as the medical head of fertility preservation at Northwestern Medicine in Chicago, older patients and those with severe illnesses encounter unique obstacles.

Cancer patients require prompt cancer treatment, which includes starting medication to prepare for egg retrieval as soon as possible. They have the option to either freeze their eggs or fertilize them and freeze resulting embryos, which have a higher chance of surviving the thawing process in the future.

As individuals age, the possibility of conceiving decreases while the risk of genetic disorders in their children increases. The process of becoming pregnant can also be emotionally taxing.

According to Goldman, 41, the months that pass without getting pregnant when you’re trying to have a child can feel like a form of sorrow. She herself gave birth to her 9-month-old son through IVF.

The medical professionals stated that the chaos in Alabama has heightened the sadness for numerous individuals.

Dr. Mamie McLean, the physician to O’Brien, reported that a woman in her forties who desires a second child underwent an unsuccessful in vitro fertilization (IVF) procedure and is now interested in trying again this month. She is contemplating doing so in the state of Georgia.

“She would much prefer to stay in Alabama,” McLean said. “But she also knows that time isn’t on her side.”

Dr. Jennifer Kawwass, who serves as the medical director of the Emory Reproductive Center in Atlanta, reports an increase in patients from Alabama who are feeling overwhelmed.

She expressed that fertility procedures are already causing significant social and financial strain for patients. However, the sudden and uncertain halt on IVF in Alabama is only adding to this burden.

An IVF cycle can cost anywhere between $15,000 and $25,000 without insurance. Additional expenses for travel and accommodations can amount to thousands of dollars, especially considering that the cycle requires six to 10 visits over a span of two weeks.

As individuals in Alabama contemplate their opportunities and advocate for resolutions, they, along with their healthcare providers, are hopeful that the challenges to IVF will not extend to other states.

“I believe it is important for our nation to come together and recognize that these treatments are intended to assist individuals in creating families and bringing new life into the world,” stated Kawwass. “It is rather ironic and unfortunate that these treatments are causing harm to those who are trying to start or expand their families.”

___

This report was contributed by Kim Chandler, a reporter based in Montgomery, Alabama.

___

The Science and Educational Media Group of the Howard Hughes Medical Institute provides support to the Associated Press Health and Science Department. The AP is solely accountable for all of the material.