Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Curr Opin Obstet Gynecol. 2023 Aug 1;35(4):306-310. doi: 10.1097/GCO.0000000000000888. Epub 2023 May 23.
The 2022 Supreme Court ruling in Dobbs vs Jackson marks a frightening new reality in America. Physicians and patients have been left confused and concerned regarding the broader implications of this ruling. Now that the constitutional right to an abortion has been overturned and the power has been relinquished to individual states, there is justifiable concern regarding the impact on in-vitro fertilization (IVF). This review explores the ways IVF and fertility care are at risk in the context of our new reality.
The decision to overturn the right to an abortion without specifying a viability standard opens the door to interpretation of when 'life' begins. Laws that do not specifically exempt IVF, or that include language suggesting that 'life begins at fertilization' pose a real threat to IVF. The potential for personhood laws poses a threat to embryo freezing and disposition, preimplantation genetic testing and culpability among other concerns.
Limitations to IVF may become an unintended consequence to the Dobbs decision, making IVF less efficient, more costly and unsafe, and inevitably limiting access to care. It is therefore crucial that public health legislation be rooted in science and not dictated by religion or politics. Physicians must act alongside legislators to protect reproductive freedom and access to care.
目的综述:2022 年美国最高法院在多布斯诉杰克逊案中的裁决标志着美国出现了一个令人恐惧的新现实。医生和患者对这一裁决的更广泛影响感到困惑和担忧。既然堕胎的宪法权利已经被推翻,权力已经下放给各州,那么人们有理由担心这对体外受精(IVF)的影响。本综述探讨了在新现实背景下,IVF 和生育护理面临的风险。
最新发现:在没有具体规定生存能力标准的情况下推翻堕胎权利的决定为何时“生命”开始的解释打开了大门。那些没有特别豁免 IVF 的法律,或者包含“生命始于受精”等语言的法律,对 IVF 构成了真正的威胁。人身权法的潜在威胁对胚胎冷冻和处置、植入前基因检测以及其他相关问题的责任提出了挑战。
总结:多布斯裁决可能会对 IVF 产生限制,使 IVF 效率降低、成本增加且不安全,并不可避免地限制护理的获得。因此,公共卫生立法必须基于科学,而不是由宗教或政治决定。医生必须与立法者合作,保护生殖自由和获得护理的机会。