IVF access, protocol in Colorado expand despite Alabama embryo ruling

The couple sat on the edge of the bed in their Denver home, tightly holding hands, as the minutes slowly ticked by.

A lot was riding on that moment on an early April morning. Kristina Turczyn and her wife, Mindy Taylor, had decided that this would be their last round of in vitro fertilization — it was too taxing physically, emotionally and financially. And based on previous rounds, they knew this was likely the one viable embryo they had left.

After five long minutes, Turczyn said, two lines appeared on the pregnancy test. The spouses looked at each other, stunned.

Then, “I literally felt the earth shift beneath my feet,” said Turczyn, now 38. “Just everything changed in that moment. You spend all this time going through this process … and there are no guarantees. And then you see two little lines that you’ve worked so hard for, and it just feels amazing. It feels amazing and magical and fragile.”

The use of in vitro fertilization, or IVF, was thrust to the forefront of national attention by a ruling last month from the conservative Alabama Supreme Court that declared that frozen embryos from fertility treatments had the same rights as children. The ruling reignited political debates across the country about whether life begins at an egg’s fertilization, an idea that had been considered fringe until the late 1980s and early 1990s.

Providers, patients and lawmakers worried about the decision’s future implications, while members of both major political parties have scrambled since then to try to protect the fertility treatments.

Two of Colorado’s Democratic federal lawmakers, U.S. Sen. John Hickenlooper and U.S. Rep. Yadira Caraveo, a longtime pediatrician, announced their backing of a bill to prevent bans on IVF and other assisted reproductive technology.

At the state level, Colorado policymakers have taken steps in recent years to increase access to IVF as they’ve also shored up abortion rights.

A 2020 law mandated insurance coverage of IVF for large-group health plans. And in 2022, the Democratic-majority legislature voted to guarantee the right to abortions and all types of reproductive care in state law. Lawmakers again this year defeated a “fetal personhood” bill pressed by conservatives that would have recognized a fetus as a person in state law.

Coloradans who spoke to The Denver Post said they felt mostly protected in the state, though they’re concerned about potential impacts from the Alabama ruling on families seeking reproductive assistance in the future, including for LGBTQ or other marginalized people.

For Turczyn and her wife, as a queer couple, IVF was essential to getting pregnant. In December, Turczyn gave birth to baby Leo.

People from a variety of circumstances and backgrounds use IVF to get something they’ve dreamed about their entire lives, Turczyn said, so “why wouldn’t we use that?”

Abortion rights advocates hope to cement the state’s existing protections and expand access to abortion in the Colorado Constitution through a ballot measure this fall. Lawmakers also aim to tighten insurance coverage gaps for IVF.

Fertility treatments are common

Republican lawmakers have tried to distance themselves from the Alabama ruling, wrestling with past stances that life begins at conception while also supporting the use of IVF, including for their own families.

Alabama’s state legislature in late February passed a bill protecting providers and patients from criminal and civil liabilities, though some argue it doesn’t go far enough. The National Republican Senatorial Committee issued a memo stating that no GOP Senate candidates supported restricting access to fertility treatments and encouraging candidates to reject such attempts, angering anti-abortion groups.

Abortion activists and legal experts, however, have warned for years that GOP efforts to restrict abortion — including granting legal rights to embryos and fetuses — could put reproductive care and fertility treatments like IVF in jeopardy.

“The protection of abortion, which is on one end of the spectrum of reproductive health care, actually goes a long way to protect IVF by denying personhood and other constructs,” said Karen Middleton, the president of Cobalt, a Colorado reproductive rights group.

In the U.S., about 1 in 10 women between the ages of 15 and 44 reported using some kind of fertility service between 2017 and 2019, according to a Pew Research Center analysis, while 42% of adults in the 2023 survey said they or someone they knew personally had used fertility treatments.

The Alabama court’s majority ruled that couples whose frozen embryos were destroyed in a fertility clinic accident had a claim to bring suit under that state’s wrongful death law.  Following the ruling, some clinics immediately suspended IVF services, fearing legal repercussions if they froze, donated or discarded unused embryos — a typical part of the process.

In IVF, mature eggs are taken from the ovaries and then fertilized by sperm in a lab. A fertilized egg, or embryo, is then placed in a uterus. Other eggs can be frozen for future transfers.

Patients can use their own eggs and sperm, or they can use embryos from a donor. The process involves months of testing and taking hormones, injections and other medications for each round, along with medical procedures for egg retrievals and transfers.

When Stephenie Bishop of Littleton first heard about the Alabama ruling, she said she was mad. She thought about the families who were already in the middle of an IVF cycle when the ruling came down and clinics temporarily shut down, interrupting an already intense and exhausting process.

No one should have a say in something they don’t understand, she said. And that’s coming from someone who once was against the use of IVF, she said, because of how unnatural it seemed — until she learned more about it and, later, went through it herself.

“Traumatic and stressful and painful”

It was a similar frustration with decision-makers that led then-state Rep. Kerry Tipper, a Lakewood Democrat, to first introduce legislation in 2020 proposing to mandate insurance coverage of IVF for large-group policies. It passed and the coverage requirement took effect in 2023.

Tipper was undergoing IVF treatment herself at the time. Although the vast majority of infertility is treatable, she said, she found that policy and coverage decisions about IVF were often based on misinformation or political control.

Passing the law felt like it legitimized the treatment as health care, Tipper said, while increasing Colorado residents’ access to it. She is now Denver’s city attorney.

“I just realized that it was an equitable issue that people aren’t necessarily comfortable talking about,” she said. “It can be really traumatic and stressful and painful.”

In the 2023 Pew Research Center survey, a majority of respondents — 61% — said insurance should cover fertility treatments.

Bishop and her husband had been trying for years but weren’t able to have a baby due to medical reasons, so they started fertility treatments in 2019, first through intrauterine insemination, or IUI, and then IVF. They tried different methods and switched clinics multiple times during their journey.

Their insurance didn’t offer IVF coverage for their first baby, but after the state law went into effect, their plan covered up to $15,000 for the second. Although Bishop’s insurance paid for some infertility treatment before the law’s passage, she repeatedly had to argue against denials and appeal rejections. She also paid much more out of pocket.

“It was less stressful, I feel like,” Bishop said of the second financial process, “because you don’t want to fight with the insurance company. You don’t want to be told that they’re not going to help you.”

Despite the physical, mental and emotional difficulties of the process — which people can truly understand only if they’re going through it — it was all worth it, Bishop said.

Her first son, Rigley, is now 2. In January, she gave birth to August, also conceived through IVF.

The insurance coverage change also made a difference for Nicole Dallek’s family. She and her husband paused their journey for a few months after they found out insurance would cover some of the costs when the law took effect.

Dallek, 36, said that without that new coverage, the Lakewood couple would have been on the hook for more than $26,000 for one cycle, and they might have had to take out a loan, as other families have done to pay for IVF.

The wait paid off. Dallek is now pregnant and due in July.

As a school district employee, Dallek was able to get the coverage through her employer. But Coloradans who have individual or small-group health plans aren’t guaranteed coverage, since those plans are exempt from the requirement.

State Rep. Meg Froelich, a Greenwood Village Democrat, has introduced a bill that would require the state to study the issue and come up with a cost analysis in hopes of adding new requirements to the law to expand access.

There are other hurdles, too, including some found by the Rev. Tawana Davis. She is the executive director of Soul 2 Soul Sisters, a racial and reproductive justice nonprofit that advocates for Black women.

Since the mandate became law, Davis has worked to make sure the Denver-based nonprofit’s employees receive insurance coverage for fertility treatments and to help secure access for community members.