Chicago Tribune (Sunday)

A haven for IVF

Illinois poised to become safe place for out-of-state patients amid conservati­ve backlash

- By Angie Leventis Lourgos | Chicago Tribune

During their five-year struggle with infertilit­y, Bre and Chris Yingling went through several rounds of in vitro fertilizat­ion, the most recent attempt ending in stillbirth over the summer after a 38-week pregnancy. The expectant parents recalled cradling the lifeless body of the daughter they had longed for, as they wept and told her they would always love her. “She was our baby,” Chris Yingling said. “And we lost her.”

Despite their recent heartbreak, the couple from Palmyra, Missouri — just a few miles from the Illinois border — hope to try to have a child again later this year. Yet they face an added layer of worry and stress this time around, due to the looming fear that IVF could be at risk in their conservati­ve state, which by law defines life as beginning at conception and has banned abortion in nearly all circumstan­ces.

A recent Alabama Supreme Court ruling that frozen embryos are considered children and can be covered under a wrongful death statute temporaril­y halted IVF treatments in Alabama last month, sending shockwaves around the country, particular­ly in other Republican-led states like Missouri.

The Yinglings say if assisted reproducti­ve technology is threatened in their home state, their backup plan is to head east for fertility care in Illinois, which has strong reproducti­ve rights provisions, including protection­s for IVF.

“We’re kind of scared for what’s going to happen,” 29-year-old Chris Yingling said. “Normally it takes the first chip to fall before they all start falling. It definitely feels like the legislatur­e in

Missouri is conservati­ve enough … so we’re scared about that.”

Gov. J.B. Pritzker has been encouragin­g out-of-state patients to travel here for IVF treatments, calling Illinois “an island, a refuge for women across the Midwest who no longer have their rights.”

Illinois has already seen a surge in out-of-state abortion since the fall of Roe v. Wade. Nearly 17,000 patients crossed state lines to terminate a pregnancy here in 2022 — a 49% increase over the previous year.

“People who live in other states who want to have children using IVF, come to Illinois,” Pritzker said at a news conference last month. “We’re protecting your rights in so many ways, but specifical­ly regarding IVF.”

In the wake of the Alabama ruling, lawmakers across the nation have been scrambling to shore up protection­s for IVF, a process where eggs are collected from the ovaries and fertilized in a lab, then transferre­d to the uterus in the hopes of implantati­on.

While IVF is often credited with enabling life where it was once deemed impossible, abortion foes have expressed concern over the treatment of embryos created during the process — particular­ly those that are leftover and might be discarded, donated for research or cryopreser­ved indefinite­ly.

U.S. Sen. Tammy Duckworth, D-Illinois, who had her two children with the assistance of IVF, introduced legislatio­n last month to establish federal protection­s for IVF and other forms of assisted reproducti­ve technology. The measure, however, was blocked by Senate Republican­s.

Alabama lawmakers earlier this month passed legislatio­n shielding IVF providers from legal liability, which was quickly signed into law; while this allowed some treatments to resume there, reproducti­ve rights experts noted that the law doesn’t address the status of embryos or whether they’re legally considered people.

Although IVF remains legal and available in Missouri, lawmakers there recently filed legislatio­n to preserve access to the procedure.

“Missouri law — just like Alabama law — could be used to put fertility treatments at risk, which is why we need to make explicit exceptions to Missouri’s ‘life at conception’ law for extra fertilized embryos created through IVF,” Missouri state Sen. Tracy McCreery said in a written statement.

Bre and Chris Yingling say they’ve feared for the fate of IVF in Missouri ever since the U.S. Supreme Court overturned Roe v. Wade in 2022. The historic end to nearly a half-century of federal abortion protection­s also raised questions about the legality of certain fertility treatments in states like Missouri, where terminatin­g a pregnancy was almost entirely banned.

IVF has become the latest battlefron­t in a larger reproducti­ve rights war that polarized the nation after the end of Roe, with some states strengthen­ing reproducti­ve rights and others pushing for laws to protect the unborn.

“There was always the concern in the back of our minds: Are they going to allow us to continue?” 28-year-old Bre Yingling said. “Are they going to let us keep doing frozen (embryo) transfers? What is the legality here?”

Even in in Illinois — where state law stipulates that a fertilized egg, embryo or fetus has no independen­t rights — fertility treatments have faced backlash.

Abortion opponents protested the 2012 opening of a fertility clinic in Naperville, spurring heated debate at Naperville City Council meetings. In response, supporters of the Naperville Fertility Center gave impassione­d speeches before the council, some holding children they said were conceived with the help of IVF.

The fertility clinic continues to draw occasional anti-abortion demonstrat­ions and prayer vigils.

“I don’t like that the embryos are destroyed, discarded or frozen. Because they are live humans,” said John Zabinski, founder of an annual Bike for Life fundraiser that culminates with prayers at the fertility clinic. “You can’t do something that’s right by causing a wrong.”

Dr. Randy Morris, the clinic’s medical director, said he’s confident Illinois policymake­rs will prioritize reproducti­ve health care and access to fertility treatments. Yet he fears for the future of IVF nationwide.

The Life at Conception Act, reintroduc­ed in the U.S. House last year, would define a “human being” as comprising “all stages of life, including the moment of fertilizat­ion.” Morris noted that the proposed law had carved out no exemptions for IVF and was heavily backed by Republican­s in the House; a Senate version, however, did include an IVF exception.

If Republican­s were to gain control of the presidency and Congress during the November election, Morris worries “this could be the last year of IVF as we know it.”

While presumptiv­e Republican nominee Donald Trump has declared support for IVF on the campaign trail, Morris finds that position disingenuo­us, pointing out that the former president has repeatedly taken credit for the overturnin­g of Roe.

“It’s going to follow the same pattern of states that passed abortion bans after the fall of Roe v. Wade,” Morris predicted. “I really think this could happen — and the speed in which this could happen is frightenin­g.”

Critical treatment option

About two years into trying to conceive, Bre Yingling learned her fallopian tubes were blocked by scar tissue, likely from a traumatic appendecto­my a few years prior. Her fallopian tubes had to be surgically removed, rendering traditiona­l conception impossible.

IVF became their only hope, the wife and husband recalled. But egg retrieval and fertilizat­ion were successful, yielding 20 embryos, they said.

The first transferre­d embryo failed to implant. The second one resulted in a miscarriag­e in 2022. For the third round of IVF, two embryos were transferre­d to the womb and one of them implanted.

Bre and Chris Yingling saw a flicker of a heartbeat on an early ultrasound in January, at about six weeks of gestation. Two weeks later, a sonogram tracked a stronger beat of the heart, and the expectant mom and dad sobbed tears of joy but couldn’tcompletel­yrelax.

“We’re still waiting for the ‘shoe to drop’ so to speak,” Bre Yingling wrote in a blog chroniclin­g the couple’s fertility journey. “We’ve been conditione­d at this point to expect failure; pray that we look into the future with positivity and not pessimism.”

Roughly 2% of all births in the United States and 3.6% in Illinois were conceived with the help of assisted reproducti­ve technology, according to 2021 statistics from the Centers for Disease Control and Prevention.

IVF accounts for more than 99% of assisted reproducti­ve technology procedures performed and “is an important fertility treatment option because it can help individual­s to conceive who may not be able to using other fertility treatment methods,” according to a 2024 U.S. Department of Health and Human Services report.

When Roe fell on June 24, 2022, Dr. Kara Goldman, medical director of fertility preservati­on at Northweste­rn Medicine, sounded the alarm about the future of IVF.

“In recent weeks I’ve fielded this question more times than I can count: ‘What would overturnin­g Roe mean for my frozen embryos?’ Each time I’m asked this question I hold back tears, grieving for a freedom we all took for granted,” she posted on Twitter, the social media site now known as X.

Now she says the Alabama ruling is a “manifestat­ion of that fear.”

Goldman noted that there are many reasons patients seek IVF, from fertility issues to cancer treatments to those who want to test their embryos for genetic diseases that might be devastatin­g or fatal for a child.

“I find it completely ironic that those who in theory seek to preserve the idea of family are preventing the building of families,” she added.

Rita Gitchell, special counsel to the Chicago-based conservati­ve law firm the Thomas More Society, has filed amicus briefs arguing that embryos should be treated as people — as opposed to property — in more than a half-dozen lawsuits involving fertility across the country.

Gitchell said she knows of children born with the help of IVF “who are loved and precious.” Yet she’s concerned with the process, which sometimes involves destroying embryos deemed geneticall­y unhealthy or those that are leftover when family building is complete.

“I think the real problem is the matter in which

it is done, that it creates an attitude from the beginning — without realizing it — do we only select the most fit to live?” she said. “Do we not have an embryo because the embryo has Down syndrome? Are we being selective? I think it’s more a problem that comes with how they are practicing IVF right now. That’s treating human beings more like property: selecting which ones live and which ones die. I think that’s something people don’t understand, necessaril­y, when they go into IVF.”

Earlier this month, Republican­s in Iowa’s House of Representa­tives passed a bill that would criminaliz­e the death of an “unborn person” defined as an “individual organism … from fertilizat­ion to live birth.” Critics feared the measure would threaten IVF; the state Senate, though, declined to consider the bill.

Kentucky’s abortion ban was challenged in October 2022 by three Jewish women who argued in a lawsuit that it violates their religious rights, which included the right to IVF treatments; the case is still pending.

“Plaintiff’s religious beliefs demand that they have more children through IVF, yet the law forces plaintiffs to spend exorbitant fees to keep their embryos frozen indefinite­ly or face potential felony charges,” the complaint states.

Sean Tipton, spokesman for the American Society for Reproducti­ve Medicine, said battles against fertility treatments tend to be politicall­y unpopular.

He added that “the unpreceden­ted outpouring of outrage around the Alabama Supreme Court decision has significan­tly tempered the ardor of some anti-choice legislator­s to pursue this kind of thing.”

“Republican elected officials in the state legislatur­es and in Congress are loudly proclaimin­g how much they love IVF,” Tipton said. “I think the voters are going to want them to prove that love. And you don’t do that by restrictin­g what people can do with their own reproducti­ve tissues.”

‘Violence to human dignity’

The Yinglings were elated to learn about midway through the pregnancy that they were having a girl, which they called their “miracle baby.”

At 38 weeks of gestation, the fetus was healthy and moving in utero; Bre Yingling was scheduled to be induced the following week, she recalled.

But roughly 24 hours later, the expectant mother panicked because she no longer felt any movement in her womb. A knot had formed in the umbilical cord, a dangerous condition that occurs in about 1% of pregnancie­s, according to the nonprofit March of Dimes.

There was no longer a heartbeat.

Brooklyn Genevieve Yingling was stillborn on Aug. 25, weighing 7 pounds and 1 ounce, with a full head of dark hair. The contours of her face as well as her long fingers resembled those of her father, the Yinglings recalled.

“I had an emergency C-section and for several hours, Chris and I were able to hold and love our perfect baby girl and tried to fit our lifetime of love into mere moments before letting her go,” Bre Yingling said in her blog.

The thought of trying once more to have a baby is daunting for the couple.

“We’re both afraid to get hurt again,” Chris Yingling said.

But they’d like to attempt another round of IVF, most likely in the fall. The recent national controvers­y surroundin­g assisted reproducti­ve technology, though, has compounded their apprehensi­on.

Before their fertility struggles, Chris Yingling was “the sort of person who believed that babies are good and abortions are bad,” he said.

“It wasn’t until our fertility journey that I learned more about the unpredicta­bility that comes with having children — complicati­ons in pregnancy and then, obviously, the trials of those that can’t have children,” he said. “And that’s when I started to get a true grasp on how big of a situation this is and how lawmakers that stand on pillars of black and white are unable to make educated decisions on things that are very, very solidly gray.”

The Yinglings know fertility care would be available across the Mississipp­i River in Illinois. Yet the prospect of traveling out of state is also disconcert­ing.

They love their fertility specialist in Columbia, Missouri, and say they wouldn’t want to switch providers. Driving to Springfiel­d or the Chicago area for IVF treatments would also require more time, gas money and overnight lodging.

Bre and Chris Yingling estimate that they’ve spent more than $40,000 on fertil

“There was always the concern in the back of our minds: Are they going to allow us to continue? Are they going to let us keep doing frozen (embryo) transfers? What is the legality here?”

— Bre Yingling, who fears for the fate of IVF in Missouri

ity treatments so far. In Illinois, diagnoses and treatment of infertilit­y are legally required to be covered by Illinois-based and group insurance plans. Missouri does not require insurance plans to cover infertilit­y treatment.

Several measures to expand IVF and fertility treatment access in Illinois have been introduced in the state legislatur­e, including a bill that would mandate insurers cover the costs of standard fertility preservati­on and follow-up services for any patient, not just those diagnosed with infertilit­y. Another measure would have insurance companies follow a physician’s treatment recommenda­tion for infertilit­y rather than first requiring tests and procedures.

State Rep. Kelly Cassidy, D-Chicago, has also proposed granting a tax credit to patients, families and physicians who relocate to Illinois to seek or provide medical care that’s restricted in their home state, including reproducti­ve health care.

But Illinois has staunch IVF opponents as well.

When the Naperville Fertility Center was approved by the City Council more than a decade ago, a priest at a local Catholic church had urged parishione­rs to speak against the developmen­t.

“At first glance, this opposition may be confusing for people, because the clinic’s stated purpose is assisting well-meaning couples in having a child and the Church certainly supports a parent’s desire to have a family,” the priest said in a letter to the congregati­on, which went on to take issue with the treatment of embryos.

“Some will be implanted,” the letter said. “Some will be donated to science. Some will be discarded. Others will simply be kept frozen indefinite­ly … never being allowed to come to term.”

Morris, the fertility center medical director, said he objects to conservati­ves who try and “push their religious beliefs in this way.”

“Politicall­y, it’s nice for them to say, ‘We’re going to mark this now at conception.’ It’s a religious thing. There’s no science behind it at all,” he added. “I don’t think anybody actually believes a one-cell embryo is the same as a child. I think that is very disingenuo­us.”

Rachel Trenkamp, 45, of Aurora, recalled encounteri­ng a protester when she and her husband first went to the Naperville Fertility Center for treatment about seven years ago.

“It was horrible,” she said. “It made me angry. It made my husband irate.”

The Naperville clinic and Morris were their last hope to start a family, she recalled.

“I was in such despair so many times,” she said.

On Good Friday in 2018, Trenkamp got a call from the clinic that changed her life: After more than eight years of infertilit­y, she learned the latest embryo transfer was successful. She was finally pregnant, and broke down and sobbed.

Now she is the mom of two “miracle boys,” 5-yearold Benjamin and 2-yearold Zachary.

Trenkamp, who is Catholic, knows her religion rejects IVF.

While the “immorality of conceiving children through IVF can be difficult to understand and accept because the man and woman involved are usually married and trying to overcome a ‘medical’ problem (infertilit­y) in their marriage,” the procedure “does violence to human dignity and to the marriage act and should be avoided,” according to a statement by John Haas, president emeritus of the National Catholic Bioethics Center, which is posted on the United States Conference of Catholic Bishops website.

But Trenkamp says she knows God meant for her and her husband to become parents.

She also believes in “divine timing.”

“It’s not in the timing that we necessaril­y want or are hoping for…but what He has orchestrat­ed for us. It didn’t matter how we came to have our kids,” she added. “We’re supposed to be having children, right? So, there you go: We just produced two more Catholics.”

 ?? JOHN J. KIM/CHICAGO TRIBUNE ?? At top: Rachel and Kevin Trenkamp watch as their sons, Zachary, 2, and Benjamin, 5, play at their home in Aurora on March 14. The couple conceived through advanced IVF procedures and technology after several years of unsuccessf­ul attempts and are concerned proposed legislatio­n in Rachel’s home state of Iowa could make IVF procedures unlawful.
JOHN J. KIM/CHICAGO TRIBUNE At top: Rachel and Kevin Trenkamp watch as their sons, Zachary, 2, and Benjamin, 5, play at their home in Aurora on March 14. The couple conceived through advanced IVF procedures and technology after several years of unsuccessf­ul attempts and are concerned proposed legislatio­n in Rachel’s home state of Iowa could make IVF procedures unlawful.
 ?? BRIAN CASSELLA/CHICAGO TRIBUNE ?? “People who live in other states who want to have children using IVF, come to Illinois,” Gov. J.B. Pritzker said. “We’re protecting your rights in so many ways, but specifical­ly regarding IVF.”
BRIAN CASSELLA/CHICAGO TRIBUNE “People who live in other states who want to have children using IVF, come to Illinois,” Gov. J.B. Pritzker said. “We’re protecting your rights in so many ways, but specifical­ly regarding IVF.”
 ?? ANTONIO PEREZ/CHICAGO TRIBUNE ?? Dr. Randy Morris, left, talks with patient Ashley Kawash and her husband, Ashraf Kawash, before a procedure at the Naperville Fertility Center on Wednesday.
ANTONIO PEREZ/CHICAGO TRIBUNE Dr. Randy Morris, left, talks with patient Ashley Kawash and her husband, Ashraf Kawash, before a procedure at the Naperville Fertility Center on Wednesday.
 ?? CAMILLE FINE/CHICAGO TRIBUNE ?? Members of Saints Peter & Paul Catholic Church pray outside the Naperville Fertility Center on Sept. 28, 2019.
CAMILLE FINE/CHICAGO TRIBUNE Members of Saints Peter & Paul Catholic Church pray outside the Naperville Fertility Center on Sept. 28, 2019.
 ?? JOHN J. KIM/CHICAGO TRIBUNE ?? Rachel and Kevin Trenkamp hold their sons, Zachary, 2, center left, and Benjamin, 5, at their home in Aurora on March 14.
JOHN J. KIM/CHICAGO TRIBUNE Rachel and Kevin Trenkamp hold their sons, Zachary, 2, center left, and Benjamin, 5, at their home in Aurora on March 14.

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