Joining her was Dr. Dee Fenner, chair of the Department of Obstetrics and Gynecology at the University of Michigan. Slotkin noted Fenner had been published in the Journal of the American Medical Association on her research into restrictions on reproductive care and how they extend beyond abortion. That April 2023 paper anticipated the current debate, noting the likely “collateral consequences” from the 2022 Dobbs decision by the U.S. Supreme Court that overturned Roe vs. Wade, including that “in vitro fertilization practices are vulnerable to future restrictions on embryo management.”

“So we’re really lucky to have her to speak specifically on the IVF topic,” said Slotkin, who began with a rundown of how the issue came about and where it currently stands, starting with the Dobbs ruling. 

“From the ‘70s until 2022, we had a federal right to an abortion. And even though different states implemented it in different and slightly different ways, it meant that every woman in America should have access, regardless of which state she was in to abortion care,” she said. “When that was overturned, it created a domino effect, and we’re now seeing across the country, other rollbacks happening at the state level for reproductive rights on IVF, etc., etc.”

Slotkin noted Michigan’s response was to pass Proposal 3, enshrining not only abortion rights in the state constitution, but also access to IVF. However, she said the Alabama decision made clear that securing those rights at the state level was not enough, as the ruling provided constitutional rights to an embryo. 

“Of course, a ruling like that could always in theory go to the U.S. Supreme Court, but it impacts way more than just IVF, the concept of personhood or a fertilized egg or an embryo,” she said. “It has major implications for things like the morning after pill for contraception, like IUDs, and even for birth control pills, which is why I wanted to make sure people understood the implications.”

Slotkin said it was why she co-sponsored the Access to Family Building Act, which protects the right to use treatments like IVF without undue restrictions and burdens. Senate Democrats tried moving their version of the bill forward last week, but it was blocked by Republicans.

“There are no Republicans in the House or the Senate on any of these bills,” she said. “There are bills that try to attack IVF at the federal level and do the same thing that the Alabama Supreme Court ruling would do. Right now, 124 of my House colleagues have co-sponsored the Life at Contraception Act, which declares the right to life vested in each human being at all stages of life, starting with a fertilized egg. I think the attacks on IVF are coming from state law, from federal law, and from potentially the federal courts.”

Maggie Abboud, spokeswoman for the National Republican Senatorial Committee, responded to that assertion.  

“Every Republican Senate candidate in the entire country has said they support IVF,” Abboud told the Michigan Advance. “Elissa Slotkin is trying to make this an issue because she cannot defend her support for Joe Biden’s disastrous policies that have led to high crime, open borders, and soaring prices.” 

‘Republicans have put the rights of a fertilized egg over the rights of the woman’

GOP candidates seeking the nomination for the Senate race are: former U.S. Rep. Mike Rogers (R-White Lake), former U.S. Rep. Peter Meijer (R-Grand Rapids), former U.S. Rep. Justin Amash (R-Grand Rapids), Board of Education member Nikki Snyder; Businessman Sandy Pensler, Alexandria Taylor, an attorney who has previously represented former Michigan GOP Chair Kristina Karamo; Sherry O’Donnell, a former 2022 congressional candidate and Michigan state chair for U.S. Term Limits; conservative businessman J.D. Wilson; Sharon Savage, an educator who worked for the Warren Consolidated School District for 42 years, Ottawa County Commissioner Rebekah Curran; and Michael Hoover, who previously worked for Dow Chemical Co.

Slotkin, meanwhile, is facing off against actor Hill Harper of Detroit and businessman Nasser Beydoun for the Democratic nomination.

Fenner described the reaction among health care providers to the Alabama ruling as being “shock, awe and fear” and that to most obstetrician gynecologists such as herself, the implication was not just about IVF, but also extended to many areas of reproductive health. 

Fenner said one out of eight couples suffer from infertility and many turn to IVF in order to have a family.

“The idea that [IVF] could go away is really unfathomable for physicians and patients who rely on this technology to be able to have children besides infertility,” she said. “We sometimes harvest eggs and sperm for patients undergoing cancer treatment. So that opportunity would be gone for them. Newer medications for autoimmune diseases can also impact fertility. So our ability to harvest eggs and sperm and to store embryos for later use for those patients would be gone as well.”

She said because the treatment is expensive, with a cycle costing anywhere from $10,000 to $30,000, patients undergoing the procedure are induced to “super ovulate” so that numerous eggs can be harvested and fertilized, with additional eggs being frozen for later cycles if necessary. However, Fenner noted that embryos are very fragile and that it’s not uncommon to have one not survive the process.

“So the fear of that for our physicians, our lab technicians, our embryologists, the many technicians and the team that work in IVF of having being prosecuted or all of the things that we’re seeing in Alabama has really, I say, shocked the entire field of reproductive endocrinology and OB-GYN. We certainly are grateful that in the state of Michigan that we have Prop 3 and that Gov. [Gretchen] Whitmer signed that into legislation and that is part of our constitution such that we know that this not just protects the right for reproductive freedoms for abortion, but also includes infertility treatment.”

The first question from attendees to the online town hall was why Democrats had depended on Roe v. Wade since it was decided in 1973 and hadn’t turned it into federal law over the decades.  

Slotkin said while it’s clear now that should have happened, the nature of the topic itself prevented concerted action to make it a political reality.

“I will say, talking to my peers who had been here a long time, the issue of abortion and even family planning was something that was pretty taboo and pretty difficult to talk about. We talk about it now, but the truth is, I think generations of lawmakers just said, ‘it’s too sensitive, it’s too political, it’s too dividing of an issue to raise.’ And so frankly, generations before us did not move forward and kind of put some scaffolding in and passed federal legislation,” she said, adding that oversight is being addressed with current legislation, but remains stymied by Republicans.

Another question sought specifics on how the Alabama ruling could have an impact in other states like Michigan. 

Slotkin said while federal legislation that would do the same exact thing as the Alabama ruling would be unlikely to get through the Senate, the lesson from the Dobbs decision is never to assume that the current state of play will remain in place.

“There was sort of a failure of imagination,” she said of the belief Roe would never be overturned. “People had been accustomed to having the right to an abortion, even if they never accessed it or needed it their whole life. And so when it was overturned, it was sort of a shock to the system. And now we believe people when they say, ‘I’m going after IVF, I’m going after personhood.’ So it doesn’t affect us now, but we have to be on our toes for the potential for federal legislation to do the exact same thing as what happened in Alabama.”

The conversation then shifted away from IVF specifically when Fenner was also asked to elaborate on the concept of abortion being considered a lifesaving procedure.

To that point, she enumerated a number of conditions in which that would be the case, including patients developing cancer, severe infections, blood clotting disorders and preeclampsia, a condition of pregnancy with very high blood pressures that if untreated, can lead to stroke and fatal seizures.

“So there are many conditions that can impact or threaten a woman’s life that would require an abortion,” she said.

Another question was: “Do these most vulnerable human beings deserve the same respectful treatment as any of the rest of us?” 

Slotkin said she is asked this question all the time from constituents who talk about their faith and their strong feelings of conscience on abortion, but also from women who say while they never personally would have an abortion or advocate for an abortion, they’ve never walked in another woman’s shoes and would never tell another woman how to live, especially in the case of a violent rape or incest.

She also said many women who consider themselves pro-life are surprised to find out the dilation and curettage procedure (D&C) that’s used for those suffering a miscarriage is considered part of abortion care.

“They’re sort of shocked and they say, ‘But this is how I was able to go on and have my children.’ So I think there’s just a lot of misconceptions about why women have abortions,” she said. “But also something that I think guides my thinking on this is that people have very strong views personally, but that doesn’t mean they get to tell other people how to live. If you feel personally strong about it, that’s up to you. Don’t impose that on other people, especially when you don’t know what people are going through.”

Fenner echoed that position, saying there are a myriad of reasons why a patient would seek to terminate a pregnancy and it is not the place for politicians to interfere.  

“I understand there’s differences here, but we have to really think as we see now how these decisions then can grow and expand to all other areas when we don’t think about it [and] start to legislate medical care,” said Fenner. “I think it’s very, very important again that these decisions are left between the patient and the provider.”

Fenner was also asked her perspective about pregnant women in states that ban abortions but need an emergency abortion to save their life. She said her colleagues in those states are seeing patients with life-threatening conditions and risk being prosecuted if they provide the abortion services needed to save the lives of those patients.  

“Otherwise, those women are being stabilized, maybe giving a transfusion or other therapies and being transported to a neighboring state,” she said. “Many colleagues in neighboring states like New Mexico, Colorado, are seeing just a huge influx of women, sick women who may have conditions like diabetes or renal disease and that where a pregnancy really threatens their health that are coming to those states.”

Fenner noted that in states like Idaho, almost all of the obstetricians and gynecologists have left the state, forcing patients to drive three hours to find a delivery room where there’s someone who can deliver their baby. 

“So as we see this happening, we’re going to see women who don’t survive,” she said. “These laws then that would prohibit that really are basically saying that their lives don’t matter and that these women should stay there and have catastrophic events. We are seeing that in Michigan, we see women coming from far around to receive help.”

The end of the town hall returned to a question about IVF from a participant in Pinckney, who asked Fenner what was happening with the frozen embryos in the aftermath of Alabama’s new IVF law.

While the Alabama Legislature approved bills last week to extend criminal and civil immunity to IVF providers, and they were signed into law by Gov. Kay Ivey on Wednesday, Fenner said the issue remains up in the air.

“Talking to colleagues there, they don’t know. They’re scared,” she said. “All of us who have embryos, we have triple safety systems to make sure the electricity doesn’t go out, that the coolers don’t thaw, that we have as much security as we can. Now these are very, very precious specimens. That has always been the case.”

Fenner said IVF patients generally have a consenting process for their frozen embryos where they can pay a small fee to have them stored, but after a certain amount of time, they can decide to have them either destroyed, used for research or donated to another couple.

“So those are sort of the normal processes that would occur,” she said. “But right now, it’s quite a legal conundrum. And for those families that have those embryos, I think they’re not sure what to do either. They can’t get them out of the state to where they can be used in a different state as well. So it’s really tragic what’s gone on there.”

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