June 5, 2025 • 14 mins
Sean Tipton is Chief Advocacy and Policy Officer for the American Society for Reproductive Medicine. We'll discuss a new(ish) movement called "Ethical IVF" which is an intentionally nice-sounding misnomer of a move that aims to make IVF much more difficult and expensive.
Executive Team | American Society for Reproductive Medicine | ASRM
ASRM Center for Policy & Leadership Releases Fact Sheet on Misleading Terminology, “Restorative Reproductive Medicine” and "Ethical IVF" | American Society for Reproductive Medicine | ASRM
Executive Team | American Society for Reproductive Medicine | ASRM
ASRM Center for Policy & Leadership Releases Fact Sheet on Misleading Terminology, “Restorative Reproductive Medicine” and "Ethical IVF" | American Society for Reproductive Medicine | ASRM
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I saw the term ethical IVF, and as I read
about ethical IVF, it's not at all clear to me
that what the supporters of it are proposing is actually
ethical to you know, for me, it seems like they're
on a somewhat different mission that might perhaps be summarized
(00:22):
by a headline over at Axios Conservative support builds for
IVF guardrails, And I think that guardrails is another word
that understates what some of these people are trying to do.
Joining us to talk about this is Sean Tipton, who
is Chief Advocacy and Policy Officer for the American Society
(00:46):
for Reproductive Medicine that's as r M dot org. Sean,
thanks for joining us on KOWA.
Speaker 2 (00:54):
Happy to be with you.
Speaker 1 (00:56):
So let's just define a term. What what is ethical IVF?
What does it mean in theory, and then we'll start
getting into the nuts and bolts of it or and
actually hold on, let me interrupt myself there. Not only
what does it mean in theory, but as far as
the people who seem to think it's a good idea,
(01:17):
what is the the issue or quote unquote problem that
they think they're trying to solve with this, Well, well.
Speaker 2 (01:27):
I think ethical IVF, as it's being seen in the
news lately, is in fact a term put out by
opponents of IVF, people who would argue that IVF is
an unethical medical technology. Now, I would argue that ethical
IVF is what our members have been doing for forty years,
that is, providing needed medical care in an ethic in
(01:50):
a context that takes into account ethics, because we recognize
that reproduction is a different kettle of fish when it
comes to medicine. It's not you can't say between the
patient and the physician, because obviously the point is to
produce another human being, and to do that requires two people.
So it's so it's a different telefish. But but I
(02:11):
would I take issue with with the implication that somehow
the medicine that our members have been providing their patients
for all this time is in any way unethical.
Speaker 1 (02:21):
So, and just to be clear, I'm fully on your
side on this, But that makes for boring radio sometimes,
So I'm going to play Devil's advocate a little bit
as we go through here. Okay, sure, So my understanding
is that the folks who dislike at least some of
IVF is are our religious people who believe that the
(02:47):
process creates embryos that then end up some of them
end up being discarded or destroyed, and they view that
as as basely as murder. And so if I were
one of them, my question would be, well, why can't
you do IVF without having to do that?
Speaker 2 (03:09):
Well, I think it's important to understand that human beings
are really inefficient at reproduction. We're not very good at it.
I think it's because we're very complex organisms. You know,
you may remember from your high school biology class. You know,
you've got to take twenty three chromosomes from the mother,
twenty three from the father. They have to line up
(03:30):
just stright to produce the forty six that the health
of humans have, and that things can go around in
that process. So, you know, most fertilized eggs, whether through
natural conception or through medically assist conception, do not become
born children. They just don't. And that's unfortunate, but it's
(03:50):
also nature. It's part of the reality we're trying to
improve on that. Our members are in the business of
helping people overcome their medical problems so they have children.
But yes, the reality is they're there are people as
there are with almost any topic in this country who
take different stands on it, We are perfectly fine. If
you have an ethical concern with IVF, then you should
not participate in it, and that's fine. We would never
(04:12):
want anybody to participate in IVF against their will. But
for a lot of people, that's the best and maybe
own shot they're going to have in order to have
the children that they so desperately want. And so you
do it, you oversee it, so it's done ethically. But
if you don't want to do it, if you have concerns,
then that's fine. Oftentimes people can those concerns can be accommodated. So,
(04:35):
for example, there are cultures. One of the parts of
IVF is you get a seamen sample and get the
sperm out of it that is collected via masturbation. Some
cultures don't allow men to do that. There are workarounds
for that. If you don't want to produce more than
one embryo to use, that's fine. It makes it less efficient,
it makes it more expensive, but that's something that physicians
(04:57):
can work with patients to achieve it. That's what the
patients want.
Speaker 1 (04:59):
To do, all right. Let's stick with that last bit
for a moment. And again, I would like just for
people who may be hearing, they've heard a little about IVF,
and mostly they've heard Republicans, including President Trump, saying they
support it. But now there's this whole ethical IVF thing,
which what they're trying to do is to force the
medical providers to only make enough embryos that will actually
(05:22):
be implanted, and if they have more to then sort
of give them up for adoption or something like that
so that no embryos get destroyed. But I would like
to just dumb it down for us for a second,
because I don't want to assume that people know any
particular thing. Why. You were talking about efficiency and costs,
and I think those are the answers, but I would
(05:43):
like you to elaborate. Why does the ordinary process of
IVF produce more embryos than are likely to be used.
Speaker 2 (05:53):
Yeah, so the goal of in vitro fertilization is to
produce one healthy child, right, we can all agree on
that to do that, it takes more than one egg
and more than one sperm. You know, the the average
ejaculate from a man and then average number of sperm
an ejaculate for men is you know, many many million
women produce hundreds of thousands of eggs, one every month
(06:16):
in a natural cycle. In an IVF cycle, something has
not been working, so the woman is given medication to
allow the doctor to retrieve more than one egg. Usually,
you know you want to get five or six. You
take those, you mix them with the sperm. You see
which of the of those eggs are going to fertilize,
and if you're lucky, you know you'll get maybe three
(06:36):
or four that do fertilize them begin to develop. Well,
you only want to use one of those at a time,
because even having twins or triplets is much more risky
for the mother and the baby. And so what we
do is you take these three embryos, these frozen eggs
that are developing, You use one, you freeze the other ones,
and then you could go back later and use them
(06:57):
again if they want to have a sibling, if the
first pregnancy doesn't pan out and produce a child, whatever,
And you're halfway through the process at that point. So
it's a lot more efficient, a lot less expensive. The
key to us is decisions about what to do with
those tissues belong in the hands of the patients. After
consulting with their physician. So the women, the would be parents,
(07:22):
need to decide what they're going to do with these
embryos which have been created in their quest for a child.
That decision's got to stay with them. It cannot be
made by politicians or beer craps.
Speaker 1 (07:31):
So without getting into you know, specific numbers about how
much IVF costs, because it's going to vary from patient
to patient and maybe even geographically, but typically, and I
haven't been through all that, but my understanding is that
there is not necessarily a very high probability that any
(07:52):
given implanted embryo will take. So maybe you can tell me,
like a what a typical probability is. Again, I realize
it will depend on the health of the of the
woman and all this stuff, but what's an average probability
that an embryo will take?
Speaker 2 (08:05):
So so we one of the ways to look at
it is per cycle or per attempt. So if you
start an IVF procedure and you have some embryos, the
single cycle success rates probably bordering on a for a healthy,
relatively young woman, you know, we're talking thirty five to
forty percent. And then you can try it again and
(08:27):
it gets higher. So of patients who start an IVF procedure,
probably sixty to seventy percent will have a child by
the end of three or four tribes.
Speaker 1 (08:34):
Right, Okay, so that's the key. So now I want
you to give me a cent of and if you want,
you could put a maybe a national average if you want,
of the cost on this. What would how would the
cost differ if well, if three embryos were created at
once and then one was used, right, and and the
(08:59):
first one didn't take and they had to implant another.
Versus if only one embryo was richieat retrieved and it
didn't take, and then they had to go get or
make another embryo and implant that doing the whole process
the second time. Give me a sense of the cost
difference and other differences.
Speaker 2 (09:19):
It will it will be at least fifty percent less
because you have done two of the of the most
expensive parts of the procedure. That is the medication to
make the woman produce more eggs, the retrieval of those eggs,
and what's called the culturing, so the developing of those
embryos in a laboratory for a couple of days. That's
(09:41):
all done, right, and so if you need to go
back again, you don't have to go back and start
that from scratch. So it's going to save you at
least more on a half the effort and probably more
than half the money.
Speaker 1 (09:51):
Wow. Okay, So do you think that the folks who
were trying to push so get ethical IVF what they mean?
That seems to be either only producing one embryo and
then seeing if it takes and then doing the whole
thing again if it doesn't, or producing more than one
and then what if you have embryos that you're not
(10:14):
going to use?
Speaker 2 (10:16):
Well, I think that's a very key question, right that
they they would want to I'm not sure what they
would want to do. I think those kinds of pushes
sort of defy biological reality. And I'm of the view
that if you're gonna make policy, that policy has to
start with understanding what the real was happening in the
(10:36):
real world, and if you want to pursue this policy,
what what would that probably look like? Because I think
what you're looking at there is forcing women to receive
these embryos and bring them to term, and I don't
think I think when you put it that way, that's
clearly not ethical, not practicing good medical ethics right. Forcing
women to carry a pregnancy, to initiate a pregnancy if
(10:58):
they don't want to, is unbelievably coercive. It's a terrible
thing to contemplate.
Speaker 1 (11:04):
So do you think this is getting any actual traction
or is it just some conservatives making noise and hoping
it gets traction. How much risk is there of legislation
passing somewhere. I doubt it would pass federally, but how
much risk is it of passing in Alabama or Oklahoma
(11:27):
like this?
Speaker 2 (11:28):
I think there's a fair amount of risk. And I think,
you know, it's really troublesome because the implication is that IVF,
as it has been practiced since the nineteen seventies and
for more than two million children in the world, is
somehow not being done ethically. And I think that's just
not the case. I think the term myth clavif is
(11:49):
in fact an attempt to impose a particular, generally religious
based and once you know some specific pieces of religious
that's not wid belief that the fertilized egg has the
same moral and constitutional standing as a born baby. And
I don't think we want to I don't think we
(12:11):
need to see that imposed on everybody.
Speaker 1 (12:12):
But do you think it might pass them? Is their
legislation anywhere right now that you're aware.
Speaker 2 (12:17):
Of, Well, you know, most of the states around the
country are going out of session, and so most of
it has slowed.
Speaker 1 (12:22):
Down, you know.
Speaker 2 (12:24):
I think one of the things that has been happening
is that since you know, a year a little over
a year ago, the Alabama Supreme Court had a case
that said fertilized frozen and as were the same as children.
That shut down IVF in the state. For a while.
There was this outpouring of outrage. So one of the
most conservative anti choice legislators in this whole country passed
the bill to protect IVF access. I think that got
(12:47):
if you are anti choice and have put a whole
lot of investment into life begins at conception, then IVF
poses a danger to you because people start to understand that,
in fact, the ford less rosenada is very very different
from a born person, and you probably need to take
(13:08):
that reality into account when you're making policy. So I
think they're worried about it, and I think they're trying.
But IVF is also really really popular right at this point,
So many people have had IVF, have had family members
who have had IVF, have had friends who've gone through IVF,
and they love the children that have resulted. And so
one thing I can say for certainty about these kind
of legislative threats is we don't know what all the
(13:29):
implications will be. One's going to be fewer happy parents
and happy grandparents and whatever state and acts something like
that that you can count on.
Speaker 1 (13:37):
Sean Tipton is Chief Advocacy and Policy Officer for the
American Society for Reproductive Medicine as RM dot org. And
I'll just tell listeners, you know, keep an eye out
for this thing they're calling ethical IVF or any sort
of similar term. This is really coming from people who
generally don't like IVF and are looking for nice sounding
(14:02):
ways to try to make it anywhere from difficult to
impossible to unaffordable. And I think there's nothing ethical about it.
Thank you so much for spending time with us, Sean.
I appreciate it.
Speaker 2 (14:15):
I'm grateful for the opportunity to keep it up with
good work.
Speaker 1 (14:17):
All right, Thank you
I saw the term ethical IVF, and as I read
about ethical IVF, it's not at all clear to me
that what the supporters of it are proposing is actually
ethical to you know, for me, it seems like they're
on a somewhat different mission that might perhaps be summarized
(00:22):
by a headline over at Axios Conservative support builds for
IVF guardrails, And I think that guardrails is another word
that understates what some of these people are trying to do.
Joining us to talk about this is Sean Tipton, who
is Chief Advocacy and Policy Officer for the American Society
(00:46):
for Reproductive Medicine that's as r M dot org. Sean,
thanks for joining us on KOWA.
Speaker 2 (00:54):
Happy to be with you.
Speaker 1 (00:56):
So let's just define a term. What what is ethical IVF?
What does it mean in theory, and then we'll start
getting into the nuts and bolts of it or and
actually hold on, let me interrupt myself there. Not only
what does it mean in theory, but as far as
the people who seem to think it's a good idea,
(01:17):
what is the the issue or quote unquote problem that
they think they're trying to solve with this, Well, well.
Speaker 2 (01:27):
I think ethical IVF, as it's being seen in the
news lately, is in fact a term put out by
opponents of IVF, people who would argue that IVF is
an unethical medical technology. Now, I would argue that ethical
IVF is what our members have been doing for forty years,
that is, providing needed medical care in an ethic in
(01:50):
a context that takes into account ethics, because we recognize
that reproduction is a different kettle of fish when it
comes to medicine. It's not you can't say between the
patient and the physician, because obviously the point is to
produce another human being, and to do that requires two people.
So it's so it's a different telefish. But but I
(02:11):
would I take issue with with the implication that somehow
the medicine that our members have been providing their patients
for all this time is in any way unethical.
Speaker 1 (02:21):
So, and just to be clear, I'm fully on your
side on this, But that makes for boring radio sometimes,
So I'm going to play Devil's advocate a little bit
as we go through here. Okay, sure, So my understanding
is that the folks who dislike at least some of
IVF is are our religious people who believe that the
(02:47):
process creates embryos that then end up some of them
end up being discarded or destroyed, and they view that
as as basely as murder. And so if I were
one of them, my question would be, well, why can't
you do IVF without having to do that?
Speaker 2 (03:09):
Well, I think it's important to understand that human beings
are really inefficient at reproduction. We're not very good at it.
I think it's because we're very complex organisms. You know,
you may remember from your high school biology class. You know,
you've got to take twenty three chromosomes from the mother,
twenty three from the father. They have to line up
(03:30):
just stright to produce the forty six that the health
of humans have, and that things can go around in
that process. So, you know, most fertilized eggs, whether through
natural conception or through medically assist conception, do not become
born children. They just don't. And that's unfortunate, but it's
(03:50):
also nature. It's part of the reality we're trying to
improve on that. Our members are in the business of
helping people overcome their medical problems so they have children.
But yes, the reality is they're there are people as
there are with almost any topic in this country who
take different stands on it, We are perfectly fine. If
you have an ethical concern with IVF, then you should
not participate in it, and that's fine. We would never
(04:12):
want anybody to participate in IVF against their will. But
for a lot of people, that's the best and maybe
own shot they're going to have in order to have
the children that they so desperately want. And so you
do it, you oversee it, so it's done ethically. But
if you don't want to do it, if you have concerns,
then that's fine. Oftentimes people can those concerns can be accommodated. So,
(04:35):
for example, there are cultures. One of the parts of
IVF is you get a seamen sample and get the
sperm out of it that is collected via masturbation. Some
cultures don't allow men to do that. There are workarounds
for that. If you don't want to produce more than
one embryo to use, that's fine. It makes it less efficient,
it makes it more expensive, but that's something that physicians
(04:57):
can work with patients to achieve it. That's what the
patients want.
Speaker 1 (04:59):
To do, all right. Let's stick with that last bit
for a moment. And again, I would like just for
people who may be hearing, they've heard a little about IVF,
and mostly they've heard Republicans, including President Trump, saying they
support it. But now there's this whole ethical IVF thing,
which what they're trying to do is to force the
medical providers to only make enough embryos that will actually
(05:22):
be implanted, and if they have more to then sort
of give them up for adoption or something like that
so that no embryos get destroyed. But I would like
to just dumb it down for us for a second,
because I don't want to assume that people know any
particular thing. Why. You were talking about efficiency and costs,
and I think those are the answers, but I would
(05:43):
like you to elaborate. Why does the ordinary process of
IVF produce more embryos than are likely to be used.
Speaker 2 (05:53):
Yeah, so the goal of in vitro fertilization is to
produce one healthy child, right, we can all agree on
that to do that, it takes more than one egg
and more than one sperm. You know, the the average
ejaculate from a man and then average number of sperm
an ejaculate for men is you know, many many million
women produce hundreds of thousands of eggs, one every month
(06:16):
in a natural cycle. In an IVF cycle, something has
not been working, so the woman is given medication to
allow the doctor to retrieve more than one egg. Usually,
you know you want to get five or six. You
take those, you mix them with the sperm. You see
which of the of those eggs are going to fertilize,
and if you're lucky, you know you'll get maybe three
(06:36):
or four that do fertilize them begin to develop. Well,
you only want to use one of those at a time,
because even having twins or triplets is much more risky
for the mother and the baby. And so what we
do is you take these three embryos, these frozen eggs
that are developing, You use one, you freeze the other ones,
and then you could go back later and use them
(06:57):
again if they want to have a sibling, if the
first pregnancy doesn't pan out and produce a child, whatever,
And you're halfway through the process at that point. So
it's a lot more efficient, a lot less expensive. The
key to us is decisions about what to do with
those tissues belong in the hands of the patients. After
consulting with their physician. So the women, the would be parents,
(07:22):
need to decide what they're going to do with these
embryos which have been created in their quest for a child.
That decision's got to stay with them. It cannot be
made by politicians or beer craps.
Speaker 1 (07:31):
So without getting into you know, specific numbers about how
much IVF costs, because it's going to vary from patient
to patient and maybe even geographically, but typically, and I
haven't been through all that, but my understanding is that
there is not necessarily a very high probability that any
(07:52):
given implanted embryo will take. So maybe you can tell me,
like a what a typical probability is. Again, I realize
it will depend on the health of the of the
woman and all this stuff, but what's an average probability
that an embryo will take?
Speaker 2 (08:05):
So so we one of the ways to look at
it is per cycle or per attempt. So if you
start an IVF procedure and you have some embryos, the
single cycle success rates probably bordering on a for a healthy,
relatively young woman, you know, we're talking thirty five to
forty percent. And then you can try it again and
(08:27):
it gets higher. So of patients who start an IVF procedure,
probably sixty to seventy percent will have a child by
the end of three or four tribes.
Speaker 1 (08:34):
Right, Okay, so that's the key. So now I want
you to give me a cent of and if you want,
you could put a maybe a national average if you want,
of the cost on this. What would how would the
cost differ if well, if three embryos were created at
once and then one was used, right, and and the
(08:59):
first one didn't take and they had to implant another.
Versus if only one embryo was richieat retrieved and it
didn't take, and then they had to go get or
make another embryo and implant that doing the whole process
the second time. Give me a sense of the cost
difference and other differences.
Speaker 2 (09:19):
It will it will be at least fifty percent less
because you have done two of the of the most
expensive parts of the procedure. That is the medication to
make the woman produce more eggs, the retrieval of those eggs,
and what's called the culturing, so the developing of those
embryos in a laboratory for a couple of days. That's
(09:41):
all done, right, and so if you need to go
back again, you don't have to go back and start
that from scratch. So it's going to save you at
least more on a half the effort and probably more
than half the money.
Speaker 1 (09:51):
Wow. Okay, So do you think that the folks who
were trying to push so get ethical IVF what they mean?
That seems to be either only producing one embryo and
then seeing if it takes and then doing the whole
thing again if it doesn't, or producing more than one
and then what if you have embryos that you're not
(10:14):
going to use?
Speaker 2 (10:16):
Well, I think that's a very key question, right that
they they would want to I'm not sure what they
would want to do. I think those kinds of pushes
sort of defy biological reality. And I'm of the view
that if you're gonna make policy, that policy has to
start with understanding what the real was happening in the
(10:36):
real world, and if you want to pursue this policy,
what what would that probably look like? Because I think
what you're looking at there is forcing women to receive
these embryos and bring them to term, and I don't
think I think when you put it that way, that's
clearly not ethical, not practicing good medical ethics right. Forcing
women to carry a pregnancy, to initiate a pregnancy if
(10:58):
they don't want to, is unbelievably coercive. It's a terrible
thing to contemplate.
Speaker 1 (11:04):
So do you think this is getting any actual traction
or is it just some conservatives making noise and hoping
it gets traction. How much risk is there of legislation
passing somewhere. I doubt it would pass federally, but how
much risk is it of passing in Alabama or Oklahoma
(11:27):
like this?
Speaker 2 (11:28):
I think there's a fair amount of risk. And I think,
you know, it's really troublesome because the implication is that IVF,
as it has been practiced since the nineteen seventies and
for more than two million children in the world, is
somehow not being done ethically. And I think that's just
not the case. I think the term myth clavif is
(11:49):
in fact an attempt to impose a particular, generally religious
based and once you know some specific pieces of religious
that's not wid belief that the fertilized egg has the
same moral and constitutional standing as a born baby. And
I don't think we want to I don't think we
(12:11):
need to see that imposed on everybody.
Speaker 1 (12:12):
But do you think it might pass them? Is their
legislation anywhere right now that you're aware.
Speaker 2 (12:17):
Of, Well, you know, most of the states around the
country are going out of session, and so most of
it has slowed.
Speaker 1 (12:22):
Down, you know.
Speaker 2 (12:24):
I think one of the things that has been happening
is that since you know, a year a little over
a year ago, the Alabama Supreme Court had a case
that said fertilized frozen and as were the same as children.
That shut down IVF in the state. For a while.
There was this outpouring of outrage. So one of the
most conservative anti choice legislators in this whole country passed
the bill to protect IVF access. I think that got
(12:47):
if you are anti choice and have put a whole
lot of investment into life begins at conception, then IVF
poses a danger to you because people start to understand that,
in fact, the ford less rosenada is very very different
from a born person, and you probably need to take
(13:08):
that reality into account when you're making policy. So I
think they're worried about it, and I think they're trying.
But IVF is also really really popular right at this point,
So many people have had IVF, have had family members
who have had IVF, have had friends who've gone through IVF,
and they love the children that have resulted. And so
one thing I can say for certainty about these kind
of legislative threats is we don't know what all the
(13:29):
implications will be. One's going to be fewer happy parents
and happy grandparents and whatever state and acts something like
that that you can count on.
Speaker 1 (13:37):
Sean Tipton is Chief Advocacy and Policy Officer for the
American Society for Reproductive Medicine as RM dot org. And
I'll just tell listeners, you know, keep an eye out
for this thing they're calling ethical IVF or any sort
of similar term. This is really coming from people who
generally don't like IVF and are looking for nice sounding
(14:02):
ways to try to make it anywhere from difficult to
impossible to unaffordable. And I think there's nothing ethical about it.
Thank you so much for spending time with us, Sean.
I appreciate it.
Speaker 2 (14:15):
I'm grateful for the opportunity to keep it up with
good work.
Speaker 1 (14:17):
All right, Thank you
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