Why has IVF become a US election issue?

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IVF fertility treatment has become embroiled in the debate about abortion and reproductive rights, one of the key issues that divide the Republican and Democratic parties ahead of the Nov. 5 U.S. presidential election.

The U.S. Senate is set to vote on Tuesday on a bill to enshrine federal protections and expand insurance coverage for fertility treatments.

The Senate failed to pass the same bill in June after most Republicans voted against it, but Republican presidential candidate Donald Trump has since said he backed government or insurance funding for such treatment.

In vitro fertilization, or IVF, emerged as an election issue after the Alabama Supreme Court ruled in February that frozen embryos were considered children. All of the court's members are elected Republicans or were appointed by a Republican governor.

Trump has lost ground with women voters since Vice President Kamala Harris became the Democratic candidate last month.

He has sought to contain the backlash against the Alabama Court decision, as well as the political damage his party has received since the U.S. Supreme Court overturned the landmark 1973 Roe v. Wade decision in 2022.

Trump has taken credit for appointing conservative justices to the Supreme Court, creating a 6-3 conservative majority that overturned Roe v. Wade and ended a federal right to abortion, opening the door for individual states to decide on the issue.

Harris, known as a staunch defender of reproductive rights, has made access to abortion, contraception and fertility treatments like IVF a centrepiece of her campaign, arguing that these rights are at risk if Trump were to be re-elected.

What is IVF?

IVF is a fertility treatment that involves combining eggs and sperm in a laboratory to create an embryo for couples having difficulty conceiving.

More than 2% all of births in the United States are a result of assisted reproductive technology, mostly through IVF, according to the Centers for Disease Control and Prevention.

IVF is expensive, even with health insurance, and can cost thousands of dollars in drugs and medical procedures.

The treatment typically involves the creation of multiple embryos in order to maximise the chance of a successful pregnancy, leaving some unused and eventually destroyed as medical waste.

Why did IVF become a political issue?

The Alabama Court ruling said frozen embryos created and stored for IVF should be considered children, exposing clinics to wrongful death claims in the event they are destroyed in the thawing process. 

The court ruling was based on an amendment to the Alabama state constitution approved by voters in 2018 that made it official policy to uphold "the sanctity of unborn life and the rights of unborn children".

In response to the court ruling, the Alabama Attorney General's office said it had "no intention" of prosecuting providers of IVF treatment, or families who use their services.

In March, Alabama Governor Kay Ivey signed into law a measure aimed at protecting IVF, prompting several in clinics in the state to resume treatment.

Democrats and reproductive rights groups are concerned the Alabama court ruling could encourage other Republican-led states to follow suit.

Since the U.S. Supreme Court ruling that toppled Roe v. Wade, Republican-dominated legislatures have banned or severely limited abortion in nearly two dozen states, including Alabama. 

What influence do Christian evangelicals have?

U.S. evangelical voters, who staunchly support Trump, have widened their campaign against abortion to include IVF.

The Southern Baptist Convention, the largest Protestant denomination in the United States with more than 14 million members, voted in June to condemn the use of IVF.

The Southern Baptists said the process routinely created more embryos than could be implanted and that led to the destruction of hundreds of thousands of frozen embryos, which the church considers human life.

The roughly 80 million Americans who describe themselves as born-again or evangelical Protestants make up a powerful voting bloc that helped Trump win the 2016 presidential election.

What is Trump's view on IVF?

Trump and some other Republicans argue IVF and other fertility treatments are pro-family and should not be lumped in with terminating pregnancies.

During a campaign event, Trump said on Aug. 29 he would require the government or insurance companies to pay for IVF if he were elected in November, a move likely aimed at appealing to women and suburban voters.

Trump did say how his administration would cover the cost of IVF treatments and changes to the U.S. tax code, or whether he would seek congressional action on his proposals.

Not all states currently require insurance companies to cover IVF.

What is Harris' view on IVF?

Harris has long been an advocate of reproductive rights, including access to abortion, birth control, abortion medication and fertility treatments.

On the campaign trail and during last week's presidential debate, Harris has attacked Trump's abortion position and painted Republicans as a threat to women's rights, including access to fertility treatments.

The issue of fertility treatments has also been brought up by Harris' running mate, Minnesota Governor Tim Walz.

During his first campaign rally with Harris in Philadelphia in August, Walz revealed that he and his wife underwent fertility treatments to conceive their daughter.

"That includes IVF," Walz told a crowd of supporters. "And this gets personal for me and my family."

His wife later clarified it was not IVF, but intrauterine insemination treatments, more commonly known as artificial insemination.

(Reporting by Anastasia Moloney; Editing by Jon Hemming.)