In the summer of 2022, Allison Mertzman and her wife, Leanne, asked their fertility clinic to destroy their embryos.
The married couple were living in California but storing their nine embryos for $3,000 per year at the clinic in Michigan, where Mertzman had resided before. After having two daughters through in vitro fertilization, the couple had decided they wanted more children. But Mertzman was diagnosed with breast cancer in 2021, and the women were waiting for a better time for implantation.
Then, in June 2022, the U.S. Supreme Court’s Dobbs decision overturning the constitutional right to abortion triggered laws in several states establishing “fetal personhood,” or legal rights for embryos beginning at fertilization. The couple wondered: If their frozen embryos were damaged while being moved across states with personhood laws, perhaps because of failed temperature controls, what would the legal ramifications be?
For the then-37-year-old Mertzman and her wife, state abortion and fetal personhood laws had a chilling effect: They chose not to take the risk.
“I was strong-armed into destroying my embryos,” Mertzman said. “I wasn’t ready to implant them for multiple reasons, but overturning Roe v. Wade was the tipping point.”
The laws aren’t just triggering confusion and anguish among IVF patients like Mertzman; they’ve also left clinicians who are tasked with making, storing, testing, and discarding embryos afraid they could face liability.
Fertility doctors worry that the new abortion laws will criminalize standard fertility care and expose them to felony charges or wrongful death lawsuits that are not covered by medical malpractice insurance policies.
Doctors who provide or assist with illegal abortions in states that have bans, such as Texas and Alabama, already face civil penalties of $100,000 or more, revocation of their medical licenses, or prison, including a potential life sentence. Thirteen states have total or near-total abortion bans.
At least 24 states have put some form of fetal personhood language directly into their abortion restrictions or broader civil or criminal statutes. Alabama, Georgia, Louisiana, and Missouri have some of the most sweeping fetal personhood laws related to pregnancy and embryos. In Louisiana, IVF embryos cannot be intentionally destroyed.
“I think when you have states define personhood at any stage of pregnancy, it opens the door for liability,” said Jessica Waters, a senior scholar in residence at American University. “We’re seeing states try to even criminally charge doctors from other states, so it’s not so far a reach that we will see IVF doctors have liability.”
Waters said standard IVF practices, such as discarding abnormal embryos, or mechanical errors that occur when flash-freezing embryos could also result in lawsuits under wrongful death statutes. These are all “real possibilities,” Waters said.
She said she hopes to see more efforts by states and the federal government to protect IVF doctors from these laws.
“Trump declared himself an IVF president, but under his watch in post-Dobbs, what we’re seeing is a climate where people engaged in reproductive healthcare can’t do their jobs,” Waters said. “I think it really interferes with the good practice of medicine.”
When asked for comment about a lack of prosecutorial safeguards for IVF doctors, White House spokesperson Olivia Wales touted President Donald Trump’s efforts to make IVF more available and less costly. Trump this year proposed a rule that would allow employers to voluntarily expand coverage of fertility benefits, including IVF treatments.
“No president has done more to help Americans struggling to start families than President Trump, whose administration has created a new fertility benefit option and slashed the cost of fertility drugs,” Wales said. “The administration will continue to explore additional policies to build on these historic successes.”
Legal Risks for IVF Doctors
In the meantime, the state laws are prompting doctors to seek more legal consultations, a costly step that can add to their financial pressures.
IVF clinics may also face surging insurance premiums and legal compliance costs in the most restrictive states, said Benjamin McMichael, a professor focused on healthcare law at the University of Alabama.
“We have gone from ‘Embryos are property’ to ‘Embryos are people,’” McMichael said. “And that could change the nature of underlying tort damages, because, certainly, the average person is worth more than property.”
For anti-abortion activists, the difference between an embryo and a person is negligible.
“Personhood laws ensure that there are no arbitrary distinctions about which human lives are acceptable or unacceptable,” said Emma Waters, a senior policy analyst for the Heritage Foundation, which has helped craft fetal personhood laws. “They underscore that the human embryos we create have a right to life.”
Alabama is the only state that gives broad civil and criminal immunity to doctors and allied professionals providing IVF care. Last year, Louisiana enacted legislation protecting clinicians providing IVF care from criminal liability.
That still wasn’t enough to calm Nicole Ulrich’s nerves. Ulrich, director of advocacy at the Fertility Institute of New Orleans, said she avoids even discussing the option of destroying embryos with patients, because Louisiana forbids intentionally destroying embryos left over from IVF treatment.
“My concern is being charged with murder or manslaughter,” Ulrich said. “The new law protects you but is not foolproof or ironclad. It still makes everyone a little nervous.”
She said she explains to patients at the outset that her clinic is not set up for long-term storage. Once embryos are out of state, patients can discuss with their transfer company what to do with embryos.
Some doctors who try to navigate this legal landscape differently fear the consequences. Damla Karsan, founder of Comprehensive Women’s Healthcare in Houston, said performing or aiding an abortion is almost always illegal in Texas. Yet she tries to stay true to the oath she took when she became a physician to help the sick and do no harm.
“I’ve helped multiple patients find care out of state,” Karsan said.
IVF doctors are seeing the changes at their practices. Clinicians say they spend more time counseling patients and answering their questions than before the Dobbs decision took effect.
Patients want to know whether they can limit the number of eggs they make and fertilize during IVF, to limit their liability risk, said Karenne Fru, the founder and medical director at Muna Fertility in Georgia. They want to know whether they are liable if an embryo doesn’t survive the freezing or storage process. They ask what will happen if pre-implantation genetic testing damages their embryos, whether they can transfer multiple embryos all at once, and how to handle miscarriages and ectopic pregnancies.
All the questions are “burdening my staff and myself,” and then some patients decide not to do IVF, Fru said.
But Fru said she makes some adjustments in certain IVF protocols to accommodate patient fears. Sometimes she can stop stimulating a woman’s egg production a day or two earlier than usual, to limit the number of mature eggs they make by 30% — “to optimize outcome but limit risk,” she said.
Patients’ Emotional, Psychological Fallout
When insurance companies and physicians are confused over whether procedures are legal, it can result in delays of necessary or emergency medical treatment and mental anguish for patients. The Heritage Foundation’s Emma Waters said she is “deeply grieved” that women have been made to feel they won’t receive proper medical care because of abortion laws.
Julie Cohen, a senior program manager at the Jewish Fertility Foundation in Birmingham, Alabama, found out eight weeks into her pregnancy in July 2022 that her “baby girl” had lethal anomalies. But at the appointment to sign paperwork for the hospital procedure to deliver her, Cohen said, her insurance company informed her it wouldn’t cover it and she might owe an estimated $20,000. The company thought it wasn’t legal under the state’s abortion ban, despite the state allowing the procedure for lethal fetal anomalies, Cohen said.
The company eventually reversed its denial, but “it was absolute agony to wait,” she said. “I couldn’t imagine what it could be like if someone didn’t have the resources or connections I had.” She was expecting a son by surrogacy this fall.
Lauren Hock had pursued IVF just as Alabama’s abortion and fetal personhood laws unfolded. Her first appointment at the fertility clinic was in June 2022, days after the Dobbs decision. She gave birth to a son in December 2023, two months before Alabama enacted its personhood law.
Then, in August 2025, the 34-year-old accountant was 14 weeks pregnant, again by IVF, when she started to hemorrhage. If the situation became life-threatening, her doctor told her, the state’s abortion ban meant the hospital would have to approve a procedure to end the pregnancy.
Four weeks later, she began hemorrhaging again. This time, the fetus died. So Hock’s doctors no longer needed permission for the procedure.
“People are failing to understand how dire these situations can be and how personal, high-stress, and emotional they could be,” Hock said. “I would have done anything to save my baby at that point, but I also could have lost my life with my baby’s life.”
Hock tried again, because she wanted a larger family. She is expecting her second child by IVF in March.
But the laws are making some women rethink their reproductive choices.
“More and more patients are coming to me scared and need help with decision-making,” said Lauren Berman, a clinical psychologist in Atlanta and a former committee chair with the American Society for Reproductive Medicine. “They wonder if they should move, get pregnant, or even have children after all.”
The new laws have also led many doctors to leave states with the strictest abortion and personhood laws.
According to a study published last year, after the Dobbs decision the number of OB-GYNs in the most restrictive states significantly decreased compared with states with no abortion restrictions.
With the Trump administration attacking nondiscrimination protections for LGBTQ+ people, Mertzman and her wife feared that their parental rights were also at stake. LGBTQ+ parents face significant legal hurdles and varying state laws for establishing parentage through assisted reproduction, said Sonia Suter, the Kahan Family Research professor at the George Washington University Law School.
“In this environment where there’s a lot of antipathy towards nontraditional families, any LGBTQ+ family has legitimate concerns,” Suter said.
Mertzman said she doesn’t regret her decision to have her embryos destroyed.
“I think there were parts I grieved,” she said, “but in the current day and age, I’m confident we made the right choice.”