Politicians in Montana are critical of IVF treatments after the Alabama ruling

Kalispell resident Margo Nieman remembers everything it took to get pregnant — medication, money and the time she spent worrying about her attempts to have a child through in vitro fertilization get, would work.

“I really wanted to be pregnant. I wanted to feel the baby growing inside me, I wanted to be able to take care of him that way and bond with him and just go through the whole thing with my husband,” Nieman said.

Nieman recently reflected on her journey in light of an Alabama Supreme Court decision that temporarily restricted access to IVF in that state.

In a February 16 ruling, the Alabama Supreme Court declared that embryos created through IVF were children, a decision with significant implications for the embryos remaining in the process.

Several hospitals and clinics in the state have temporarily suspended IVF services, and a number of lawmakers in Montana and across the country, doctors and advocates are raising concerns about the impact the decision could have elsewhere.

The case caused concern across the country until the ruling was finally changed in March to grant IVF providers and recipients civil and criminal immunity, allowing many clinics to resume treatments. Experts say more work will be needed to fully protect fertility services in states.

Protecting fertility services is critical for Montanans — especially in a state where access to IVF treatments is inherently limited, Nieman said.

She received her treatments in Seattle while she and her husband Cliff lived in Washington. But in Montana, people travel to Spokane or Bozeman to undergo IVF treatment. Dr. Stacy Shomento is the only provider administering it in Montana and she practices at Billings Clinic Bozeman.

Nieman said the couple spent about $40,000 over several years on IVF, including three different embryo transfers, in which fertilized embryos are placed in the uterus.

Getting to that final step is a long and arduous process, she said.

According to the Mayo Clinic, the IVF cycle begins with the use of laboratory-made hormones to help the ovaries release multiple eggs.

Sometimes women have to start over again due to a variety of complications, such as ovulation occurring too early or too many follicles developing, increasing the risk of ovarian hyperstimulation syndrome.

“I have stopped cycles just because something was wrong with my blood work,” Nieman said. “Apart from the emotional toll, you are forced back – you start over, pay extra money because the monitoring has already been done and you have already taken medication, and you have to go back and do it all again.”

The next step in the process is fertilization and transfer of the embryos.

Nieman and her husband met her expectations, she said. Friends had undergone IVF without success. They decided to test two embryos in the first transfer, a step their doctor had warned them against – pregnancy with twins carries increasingly higher risks, especially as women get older. Neiman was 36 years old when she underwent the embryo transfer.

Nieman was worried throughout her pregnancy, especially since she was already having problems with an ectopic pregnancy, where a fertilized egg begins to grow outside the uterus.

Despite the risks, Nieman gave birth to healthy twins. She later experienced a second successful transfer, which resulted in the birth of a son. There was another viable embryo that the couple paid to store, which they eventually tried unsuccessfully to transfer.

In Washington, Nieman said patients must choose to pay to store their embryos, give the embryo to another IVF patient, give it to medical research or discard it. Healthcare providers cannot make decisions about the embryos on behalf of the patient.

Nieman said she is grateful that her IVF pregnancies were successful and she no longer has any embryos to store. She can't help but feel sad for the women currently going through the process, especially as the process continues to draw the attention of lawmakers.

MONTANA LAWMAKERS are divided over protecting the process.

Gov. Greg Gianforte said in a statement that he opposes restrictions on IVF.

“The Governor knows that many families in Montana who have had difficulty conceiving have turned to IVF and fertility treatments to have children and expand their families. He is against restrictions on IVF treatments,” said a spokesman for Gianforte.

They also noted that “we need to foster a culture that values ​​life from conception to natural death.”

But when Gianforte served as the state's general representative in 2017, he co-sponsored a life at conception law that aimed to guarantee the right to life for a human being at all stages, including fertilization – the same belief that is at the heart of it is the current ruling by the Supreme Court of Alabama.

Ryan Busse, Gianforte's Democratic opponent for governor, said he supports the treatment.

“It is not my job to decide with women and couples in the doctor’s office when they want to start a family,” said Busse.

Tanner Smith, a Republican gubernatorial candidate from Kalispell, saw room for regulation.

“I believe that life begins at conception, and we are wading in murky waters right now,” Smith said. “There needs to be some sort of restriction on IVF just to keep the bad guys out of it.”

Some valley lawmakers agree with Smith's sentiments. Republican Sen. John Fuller told Inter Lake that he is working with a family to push legislation that would provide “sideboards” for IVF so the state doesn't engage in the “great slaughter of embryos.”

“I realize that IVF has been a family lifesaver for some families, but I also realize that it has been used by the medical industry as a money-maker – I believe that with all my heart,” Fuller said.

He compared the IVF market to slavery, saying it involves “people being bought and sold”.

House Speaker Matt Regier told Inter Lake that the Alabama ruling highlighted two things: the role of the courts and the question of where human life begins. In Montana, Regier said, courts often overturn laws restricting reproductive health care.

“The question of where life begins and how to protect innocent life belongs in the legislature, the people’s house, not in the courtroom,” Regier said in a statement.

MANDATORY and federal candidates also discuss. U.S. Sen. Jon Tester, a Democrat up for re-election this year, said in a statement: “Montanans of all stripes don’t want the federal government telling them what to do.”

“They don’t want politicians or judges restricting their personal freedoms,” Tester said.

The senator has co-sponsored legislation to protect access to IVF, including the Access to Family Building Act, introduced in January and currently on hold, which would establish a legal right to access IVF treatments.

Tester's Republican counterpart, Sen. Steve Daines, also expressed support for the treatment.

Tim Sheehy, a Republican businessman challenging Tester for his Senate seat, also expressed support for IVF treatments but is backed by an anti-abortion group, Susan B. Anthony Pro-Life America, which is pushing moves to expand access to treatments attacked.

Libertarian Sid Daoud, a Kalispell city councilman who is also running for Tester's seat, told Inter Lake that he supports IVF treatments but does not believe government is the solution to the problems associated with it. He said “[as Libertarians]we let each person make that decision for themselves.”

House Democrats also express support for IVF. Like Republican Rep. Ryan Zinke, who said in a statement that he believes “IVF is making the miracle of parenthood possible for many families.” He added that he “clearly supports continued access to the treatment.”

Monica Tranel, a Democrat running against Zinke, also expressed support.

Republican Rep. Matt Rosendale appears to differ from other federal delegates, although his office did not respond to requests for comment. In January, he co-sponsored a Life at Conception Act in the House of Representatives.

In March, Rosendale sent a letter to the Department of Veteran Affairs objecting to the expansion of IVF treatments to eligible unmarried veterans and eligible veterans in same-sex marriages.

“An IVF embryo is the earliest stage of life that exists outside the uterus,” Rosendale said in a press release. “This expansion will create a surplus of embryos that will likely result in abandoned or cruelly discarded human life.”

THE CONVERSATION Restricting access to IVF is worrying, said Dr. Tim Mitchell, who works in maternal-fetal medicine in Missoula.

Different people have different illnesses. In cases of infertility, artificial insemination is often one of the only options for a successful pregnancy, he said.

He said an example of this is women who are diagnosed with cancer during their childbearing years. Due to the side effects of chemotherapy, women often choose to have their eggs retrieved and frozen for later use in IVF.

There aren't many other options for treating infertility, Mitchell said. He said that there are the same hormonal medications that can help stimulate the release of an egg and other procedures such as intrauterine insemination or timed insemination. During insemination, doctors inject sperm into the uterus rather than the entire fertilized embryo.

“It is frightening to see a court that uses such strong religious language present such misinformation. “This ultimately creates a hurdle for families looking to expand their family,” Mitchell said, referring to the Alabama high court’s decision.

Nieman is glad she had the option of IVF. She said she wants to see access protected for women across the country.

“I'm frustrated because in a state like Alabama, which has some of the most restrictive abortion laws in the country, it makes it harder for people who desperately want to get pregnant and have children. That seems backwards to me,” Nieman said.

Anna Harden

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