Measure 1 Will End IVF in North Dakota

Tomorrow, the citizens of North Dakota will have the opportunity to vote on Measure 1, a ballot measure that opponents say will insert "personhood" into the state's constitution, although supporters of the bill deny this is the case. The overarching goal of this ballot measure is to end abortion in North Dakota, but the reality is that it will also end IVF and, possibly, significantly reduce the options for palliative and end-of-life care.

If the measure passes, the following sentence will be inserted into the North Dakota Constitution: "The inalienable right to life of every human being at any stage of development must be recognized and protected."

The "at any stage of development" is the crux of the issue, at least for folks who care about a woman's right to choose and reproductive medicine. The terminology essentially could grant constitutional rights to a fertilized egg, giving said egg the same constitutional protection as a person. And although the ramifications of this particular language are being highly debated, this could mean that if someone at an infertility clinic destroys a fertilized egg in the process of IVF, that person could be at risk for criminal charges. Because of this, the legal team for Sanford IVF, the only fertility clinic in North Dakota, says the clinic will need to close.

As Stephanie Dahl, MD, a North Dakota OB/GYN and reproductive endocrinologist, explains, “Measure One will halt our ability to offer assisted reproductive technologies, including in vitro fertilization, to our patients and deny couples suffering from infertility a medical solution to their disease and a vital option by which to build their families.”

Dahl's colleague, Steffen Christensen, MD, medical director of Stanford IVF in Fargo, ND, said in an opinion piece he wrote about Measure 1 that, if it passes, "patients will have to travel to other states for treatment. A poorly written piece of legislation will curtail our IVF program. I have been called a liar by the proponents, but I can only relate our legal department’s opinion. It is clear that no one understands all the implications of this measure if it passes."

The American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART), along with others, oppose Measure 1 and urge others to do so.

Charles Coddington, MD, President of SART said in a prepared statement, “Measure One would insert the government into very personal medical decisions and ignore the individual choice of health care. In vitro fertilization procedures will not be possible because all fertilized eggs without regard to their viability, chromosomal abnormalities or carrier status for genetic disorders must be recognized and protected.”

“Measure One represents an attack on family planning, an attack on a woman's access to health care, an attack on the privacy of the physician-patient relationship and an attack on the rights of women and their families in North Dakota,” added ASRM President Rebecca Z. Sokol, MD, MPH.

Last month, a poll from the University of North Dakota showed that 50% of voters supported Measure 1, 33% opposed it, and 17% were undecided. A more recent poll, which was conducted by a private company, revealed that 45% of voters oppose the bill, 39% support it, and 16% remain undecided.