Science Friday - COVID Vaccines For Kids Under 5, IVF Status After Roe V. Wade. June 17, 2022, Part 1

Episode Date: June 17, 2022

FDA Approves COVID Vaccines For Kids Under Five Parents of young kids may finally breathe a big sigh of relief. On Friday the FDA granted emergency use authorization for COVID-19 vaccines for kids under the age of five. The agency approved a two-dose regimen from biotech firm Moderna and three-dose regimen from Pfizer. Small children could begin getting vaccinated as early as next week. Umair Irfan, staff writer at Vox, joins Ira to talk about COVID vaccines for little kids, the largest forest fire in New Mexico’s history and a Google engineer who claims an AI chatbot is sentient and more.     What Would Happen To IVF If Roe V. Wade Is Overturned? An overturn of Roe v. Wade could have rippling effects far beyond access to abortions. Some state laws designed to ban or severely restrict abortion could also disrupt the process of fertilizing, implanting, and freezing embryos used in in vitro fertilization. That’s because some of these laws include language about life beginning at conception, raising questions about in vitro fertilization’s (IVF) legality. Roughly 2% of all infants in the United States are born following the use of some form of artificial reproductive technology. While that figure might seem small, it’s nearly double what it was just a decade ago. Ira talks with Stephanie Boys, associate professor of social work and adjunct professor of law at Indiana University, about the legal implications of an overturn of Roe v. Wade on IVF treatment. Later, Ira also interviews Dr. Marcelle Cedars, director of the division of reproductive endocrinology at UC San Francisco and president of the American Society for Reproductive Medicine, about the science behind IVF and what people often get wrong about when and how life begins.   Transcripts for each segment will be available the week after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Flato. Later in the hour, we'll be talking about the potential ramifications of an overturn of Roe versus Wade on in vitro fertilization. And we'll be answering your questions live on the air. So give us a call. On number 844-724-8255, that's 844-Sai Talk, where you can tweet us at SciFRI. The first big news on the COVID vaccine front, where parents and caregivers of young kids may finally breathe a, big sigh of relief. The FDA has approved COVID-19 vaccines for kids under the age of five. Today, the FDA granted emergency use authorization for the vaccines from both Pfizer and Moderna.

Joining me now to unpack this latest vaccine news and talk about other top science stories this week is my guest, Omer Fon, staff writer for Vox based in Washington. Welcome back to Science Friday, Omer. Thanks for having me back. Let's talk about these newly approved vaccines for young kids and infants. Tell us about that. Yeah, so this has been a long time coming. And that's largely because adults were, frankly, a higher priority during the COVID-19 pandemic.

You know, thankfully, very young children have faced lower risk from the disease. But that low risk is not zero. You know, we've had close to 400 children up to the age of four die from COVID-19 in the United States. And so this is still an important gap. There's about 18 million children. And now finally, the regulators say that they have. have enough data, but it required the manufacturers to sort of tweak their formulation because, you know, a lot of immunologists will tell you kids are not little adults. And so they had to

retest these vaccines at lower doses to make sure that they didn't cause more severe side effects. So the Pfizer vaccine is actually administered as three doses at one-tenth of the adult dose for children under five, whereas the Moderna vaccine is administered at a quarter of the adult dose over two doses. And how soon could these be available? Well, now that the FDA has approved it. The Centers for Disease Control has to put out its guidelines, but very likely it could be as soon as Tuesday, because, you know, Monday is a federal holiday. And White House advisors have said that, you know, states around the country and other local health departments have already begun to pre-order these vaccines. And so they could be available right away. And regulators and health officials say that over the next few weeks, just about any parent who wants to get their child vaccinated will be able to do so. Yeah, that's certainly good news for them. And it's important for little kids to get vaccinated.

Right? Yeah, you know, I mentioned that kids can, you know, still get sick and die from this disease, but also kids play an important role in transmission, you know, as kids are going to be going back to school and interacting with each other, they can spread the disease to each other, and then also spread it to other family members. So the more people that we get vaccinated and that are closed off as roots of transmission, the less likely it is that we will see more major outbreaks, and we will also lower the risk of other more dangerous variants coming to fruition. It has taken quite some time, has it not, to get these vaccines that kids, kids under five? Why is that?

Yeah, you know, I mean, again, because adults are at greater risk, the priority was trying to get older people vaccinated. But it's also trickier to vaccinate and do just clinical research in general on young children. I mean, babies, you know, are nonverbal. So how do you get notice about like side effects or any kinds of complications that they're experiencing? And similarly, you know, parents are much more reluctant to enter their young children into clinical trials. And so it's a much narrower, much more finicky pool of subjects that you have to study. and you have to be a lot more careful working with children.

And so researchers have had to really be delicate in conducting these trials. And it's taken a long time to get this information to the point where they think that this is safe and effective. Good points. Let's talk about vaccines, a different one. This next story is about another vaccine that's been around a little longer than the one for COVID. And I'm talking, of course, the flu shot. Now, it appears that researchers in Australia looked at how exercise influences immune response to the flu shot. Is that right?

Yeah, that's right. I read this piece by Belinda Smith at the Australia in Broadcasting Corporation, and she wrote about this study that looked at 550 adults between the ages of 18 and 87, and researchers studied their immune response to the influenza shot, specifically looking at their antibodies. These are the proteins your immune system uses to target the virus. Now, they found that looking at younger adults between 18 and 35, they found that young adults tend to have higher baseline levels of antibodies. So exercise didn't seem to have as big an effect on them. But as people get older, their immune systems sort of get weaker over time.

And it turns out exercise actually gives you a pretty substantial boost. And the researchers found that those who met the WHO, the World Health Organization's recommended amount of weekly physical activity, they were more likely to quadruple their antibody levels in their blood compared to people who are inactive. Wow. So, of course, we want to know why that is. Do we or the researchers know why? No, and that's not quite clear yet. You know, this is sort of an association study.

we don't know what the mechanism is. It could be that, you know, when your body is stressed by exercise, you know, the tiny tears you get when you lift weights or the strain on your lungs from running, that might prime your body to be more ready to produce antibodies and other kinds of immune response. But it could also be that the kind of people that get more exercise are generally healthier to begin with and have a much more robust immune system. So that's going to take a while to tease out. But what they did find is that the type of exercise does matter.

That strength and resistance training led to a higher immune response then, say, 45 minutes on an exercise bike. So this is just a general vote of confidence for getting a lot of exercise and its role in public health. Yeah. Let's pivot now away from vaccines and viruses to wildfires. The largest wildfire in New Mexico's history is raging at this moment, but it was partially ignited on purpose. What's going on there?

Right. Yeah, my colleague, Neil Donisha, just wrote a piece about this on Vox. And, yeah, this was a result of two deliberately. ignited prescribed burns. And these fires basically ran out of control. They merged and have converged to become the largest fire in New Mexico's history, larger than about 320,000 acres. But the logic there was that, you know, by conducting these controlled burns, forest managers are hoping to reduce the risk of major dangerous wildfires because fires are, you know, a natural part of the ecosystem. And as humans have suppressed them for generations,

that's actually increased the risk of dangerous fires. And so the thinking is that by having these deliberate fires periodically, we can mitigate that risk over time. But the risk is not zero, even when you're doing these controlled burns. And as average temperatures rise, as drought conditions continue to be severe, you know, there's a massive drought across the western United States. The window for conducting these burns safely is shrinking. And so there's sort of a tension here that we need fires to help mitigate the risk, but the opportunities we have for conducting them are also shrinking. Yeah, I imagine they'll be looking carefully into what happened. Yeah, the U.S. Forest Service put a pause on all prescribed burns right now, but other forest managers throughout the country are worried that we're going to miss the opportunity to conduct controlled burns in other parts of the country where the risks may be lower and the benefits may larger. So there's a huge trade-off here.

Yeah, they're not thinking of doing away with the burns, but how to do them more carefully or what happened here. Yeah, exactly. And so they're talking to local officials and one of the more interesting things that developments we've seen is the use of indigenous burning practices. So the Native Americans who have lived in these, areas have often conducted prescribed burns on their own for cultural reasons. And there's been this push to bring that knowledge back to land managers and also to help reconcile with some of the historical injustices those people have faced. Let's move to more of a nature interesting nature story. It's one about changing climate, wreaking havoc on the natural world. And I'm talking about a story about how a warming climate has altered the genes, altered the genes of the purple-crowned fairy wrens in Australia, and if you don't know what these are, I urge you to Google them. The purple crown

fairy wrens, they're beautiful, but the genes are being altered by climate change? Yes and yes. I mean, indeed, these are gorgeous birds, and it would be a tragedy to lose them. I've read about this in a piece by Mickey Perkins at the age, and so these researchers in Australia, they studied these birds over 17 years, and they were looking specifically at a segment of their DNA called telomere. So these are kind of like extensions of DNA at the ends of strands. Think of like the aglets at the end of shoelaces. And generally, they're very long, early in life, and over the lifetime of an organism, they shrink. So they're sort of a proxy for aging.

If telomeres get too short, there's too many genetic mistakes as an organism replicates, and that leads to aging. But what these researchers found is that periods of hot, dry weather led these birds to be born with much shorter telomeres. So effectively, they were genetically aging at a much faster pace. And now researchers project that as average temperatures continue to rise and as parts of the world become, more arid. This will start to have a genetic, you know, consequence in this bird population and lead to more declines. That's really interesting. Sort of an epigenetic thing going on there. Okay, I want to see if I can get to our last story, and maybe a bonus one we can throw in, before we run out of time, because this is a bit of a wild ride. A Google engineer believes that

the AI chat bot lambda is sentient. What's going on there? Right. Natasha Tiki at the Washington Post wrote a profile of this engineer. His name is Blake. Le Moyne and he has been you know interacting with this chat bot for the past few months and internally raised concerns that he believes that this is sentient but that sparked a huge disagreement within the company you know Google researchers looked into it and their team the other researchers there concluded that they weren't true or that actually that the chat bot wasn't sentient and because of that disagreement you know they put Lemoine on paid administrative leave and then he decided to go public with this information and try to raise this alarm bell to the general public to say that you

essentially we may have something that may be conscious in a way that we may have never created before. And many other researchers are waiting into this, right, into the debate? Right. You know, some researchers disagree about whether or not this specific chat bot was sentient. But a lot of them are saying that this is an important warning sign that, you know, we need the tipping point for an AI that is self-aware, maybe closer than we realize. And we really need to start coming up with answers to hard questions now. Like, how do you even determine that it's sentient? What are your obligations to it? What if you're wrong?

And then who gets to make all these decisions? Is this a product? If something is alive of a private company like Google, does the public have an interest in keeping somethings like this going? I mean, it's hard to say, but we need to answer them now. And putting the kibosh on talking about it, I thought that was very unusual, because I think if a tenured professor at a university had said this week, they'll be talking about it.

Right. I mean, I think it also shows the tension. I think Google realizes the implications of what might happen if they have some software that may have a podcast. public interest. And so I think that there is that tension there that when you have a private company that has something that can have a huge, you know, social consequences. We really need to start thinking about that. All right. See if I can squeeze my last topic in there because I love it. As temperatures are soaring in Texas, renewable energy has filled in the gaps to prop up

the stressed power grid. Tell us about that. Yeah, this is particularly true in Texas, which you may know has sort of an isolated grid from the rest of the country. So they really need to generate all their old power that they need. And you may remember the blackouts we have last year. And so people were worried that that would happen this summer because there was a lot of outages on the grid and that this summer was supposed to be really hot. But even though Texas faced a heat wave this week and record power demand, it turns out renewable energy actually came to the rescue. So this Sunday, which had a record heat energy demand, renewable energy, wind, and solar provided close to 40% of the electricity on Texas's power grid. Wow. Isn't that amazing where all that oil comes

from? They relied on all that power. Well, I mean, Texas, This is the largest wind energy producer in the country, so people kind of miss that part of the story, too, sometimes. Yeah, well, great, great story, Omer. Thank you for taking time to be with us today. My pleasure. Thank you for having me. Omer Afon, Steph writer for Vox based in Washington, D.C. We have to take a break, and when we come back, we'll be talking about the impact of Roe v. Wade overturning of IVF and the science behind fertility.

We're going to talk about it. Our number is 844-724-8255. If you'd like to join the discussion, please. 844-724-8255. I'm Irafledo. This is Science Friday from WNYC Studios. This is Science Friday. I'm I'm Ilaeto. We're continuing our coverage of the ripple effects of what an overturn of Roe versus Wade on access to reproductive health care in this industry might ripple into. This week we're looking into in vitro fertilization or IVF, as you may know. roughly 2% of all infants in the U.S. were born using some form of artificial reproductive technology.

And while that number might seem small, it's nearly double what it was just a decade ago. If Roe is overturned, roughly half of states would ban or severely restrict access to abortion, but how many of those laws would ban in vitro fertilization also? To get a legislative lay of the land, I recently spoke with states, Stephanie Boyes, Associate Professor of Social Work and Adjunct Professor of Law at Indiana University based in Indianapolis. I think it's really hard to say exactly until we see these laws go on to the books. What I'm looking at is the language of when they say that abortions can no longer be performed. There are sort of three camps going on right now. There are those states that would ban abortion after a certain number of weeks. Six weeks seems to be fairly common. It's pretty difficult to actually get an abortion prior to six weeks of pregnancy. So there are those states and those wouldn't affect IVF. And then there are states that are specifically using language that discusses the word implantation.

And when we talk about implantation, with IVF, the eggs are retrieved, they are fertilized outside of the human body, and then they are transferred to a female uterus. And at that point, implantation happens. So if we talk about implantation, we could still have a creation of embryos, and it wouldn't affect too much the fertility treatment services going along with. with IVF. What I'm concerned about, specifically with IVF, is those states such as Oklahoma that have already defined abortion as not being permissible after fertilization or conception. If we talk about fertilization or conception with IVF, that happens in the Petri dish. It's very, very unclear what would happen to the process of IVF, because if we're now saying, okay, these embryos have rights, are we saying that you can no longer cryopreserve embryos?

Are we saying that we can no longer destroy embryos? Because those are things that are happening very commonly in the United States right now. If it's a crime to destroy the embryos and these embryos that are in storage have lost the people or they've lost track of the people who created them and now it's up to, the storage facility to keep them alive and pay for that, if they wanted to go ahead and not preserve them, and if they're considered to be human life, then it would be a crime to let them just go away. Would it, would not? Absolutely. It absolutely would. One of the issues in the United States is we don't have many regulations at all on IVF. We don't have a lot of data on what these clinics

are doing. And so no one is really sure in the United States. United States, how many embryos we have cryopreserved. Estimates are generally, it's over a million at this point and growing pretty quickly. And so if states were to say life begins at conception, it would absolutely become a crime to destroy these embryos. So we've got all of these embryos that are already created. So that's one side of the issue. And then for couples that are coming in or individuals coming in wanting IVF treatment, now would they be allowed to cryoperserve? Because what some countries have done is just done away with cryopreservation. There have been countries in Europe that have experimented with just not permitting cryopreservation,

just saying all embryos that are created in an IVF cycle must be transferred also in that cycle. So in about five days after the creation of the embryos. Back in 2019, I know you decided to look into the ramifications of fertility treatments if Roe v. Wade was over returned, and that was right about when Justice Brett Kavanaugh was sworn in. Did you think that this would become a reality? No, I honestly didn't think that this would become a reality. I wrote that paper for a policy advocate audience. I wanted folks to be informed about the ramifications of overturning Roe v. Wade on IVF treatments, because I feel like there are a lot of policymakers and lot of lawmakers out there who haven't thought through all of the unintended consequences of

overturning Roe. And so I wrote this paper to inform policy advocates about how they could go out, explain this issue to lawmakers, and hopefully convince policymakers of the importance of maintaining Roe v. Wade and the precedent. And what about genetic testing of embryos before implanting them, which is very common? How would that be affected by overturning Roe v. Wade. So going along with IVF, once the embryos are created, most couples are offered an additional service, which is called PGT, pre-implantation genetic testing, where the embryos are biopsied, and they're biopsied for any sort of genetic abnormalities.

It's also up in the air. I think it would go before courts, if this would be permitted. would we be allowed to discard of embryos with abnormalities? Parallel to what some of the states have been doing where states have banned abortion based on certain reasons if the abortion was because of a genetic abnormality that was found after the pregnancy was created when there's genetic testing during the pregnancy.

With PGT, we can actually do genetic testing before a pregnancy is even created, before implantation. And it actually gets very, very complicated as well with people crossing state lines. People might live in one state. There aren't actually a lot of labs in the United States doing PGT. And so you might live in one state where it's illegal, but yet have your embryos frozen and transferred to another state where the labs will do PGT, do the testing, send them back to the state where you're getting your services where it's illegal. Could the overturn of Roe v. Wade lead to a push to better regulate the IVF industry?

I absolutely think that it would lead to a push to regulate the IVF industry as well as the fertility industry. As I said before, there are very few regulations in the United States right now. It's very often referred to as the Wild West. And so I think we would see more regulation or at least a push for regulation. in my 2019 paper, I looked at what some other countries had done. And generally other countries who have this legal ideology of life beginning at conception, while also wanting to balance the availability of IVF services, there are generally three things that come up.

One is that the countries might limit the number of embryos that are created each cycle, so that we have less excess embryos created. The second is that some countries will actually require that all embryos created in a cycle are transferred so that we don't have any leftover. Some countries ban the use of cryopreservation so that we, again, don't have any leftover embryos. My thought is that we're going to see a lot of lobbying in this area from health care providers and from the pharmaceutical industry because IVF is such a lucrative industry. a lot of lobbying for exceptions for IVF within these laws that define life as beginning at conception or fertilization. Thank you, Stephanie, Stephanie, for taking time to be with us today. Thank you so much for having me on.

Stephanie Boys is an associate professor of social work and adjunct professor of law at Indiana University. And if you would like to get in on the conversation, we'd like to have you. If you're wondering or have questions about how an overturn of role, Roe v. Wade could impact fertility treatments, or you're just curious about the science behind IVF or about the science behind conception and fertilization? We're happy to revisit the birds and bees with you on this one. So give us a call. Our number is 844-724-8255. That's 844 SciTalk, or you can tweet us at SciFRI.

And joining me now to dig deeper into the science behind in vitro fertilization. and take your calls is Dr. Marcel Cedars, Director of the Division of Reproductive Endocrinology at UC San Francisco and President of the American Society for Reproductive Medicine. Dr. Cedars, welcome back to Science Friday. Thank you very much. We just talked about the possible state legislation that defines life beginning at conception when the sperm meets the egg.

Let's talk about how this all works. What's the likelihood that a recent fertilized, embryo would come to term? Well, I think that's a really critical question. And even in nature, the best possible environment for that embryo, only about 25% of fertilized eggs will be a successful birth. 25%, one in four. One in four.

Huh. And that can go down as women get older because of increased genetic risk. So some women may try to do it a few times just to have a success. Well, think about natural conception, how many months it might take a woman to conceive. So we're not even talking about multiple cycles of IVF. We're just talking about the reality in nature, which is why the concept that life begins at conception is really not consistent with scientific knowledge. And that's something I want to get into next because I think, as you point out, at the heart of the controversy, is the definition of when a human life begins, has expressed, I think, in this question from one of our listeners. Why can't science tell us when life begins?

Dr. Cedars? Why can't science tell us when life begins? Well, I think it depends how you define life. And so I think the lawyers of the Supreme Court with the Roe v. Wade decision understood how complex that question is, which is why they talked about viability as in could live outside the womb as an independent sort of entity. And I think that's really the best definition that we have because when life begins is so complicated by religion, by belief, by things that aren't necessarily shared by all of us. And I think it is something that is a complex question. And scientifically, we talk about life as living as an independent an entity. For our listeners who may not be intimately familiar with IVF, Dr. Cedars,

explain for us how the process works a bit, would you? Sure. There's really three main aspects of IVF. The first is to give medications that increase the number of eggs. A woman will ovulate in a single cycle. In a normal cycle with no medications, a single egg is ovulation. A single egg is ovulated. We've seen since IVF was created to improve the efficiency and the success rates that getting more than one egg in any given cycle is useful. So there's about a 10 to 12 day period of taking injections that stimulate the ovary. Then there's the egg retrieval process whereby we take the eggs out of the ovary and bring them into the laboratory. We get sperm. That's same day, put the eggs and sperm together, and then we grow the embryos in the laboratory,

typically till day five or six, at which time they can either be transferred or frozen. Very interesting. This is Science Friday from WNYC Studios. We're talking with Dr. Marcel Cedars, president of the American Society for reproductive medicine about in vitro fertilization. I know that there's a recent advance in IVF allowing embryos to develop longer outside of the body. What are the benefits of this process? And how would an abortion ban at conception impact this method? So in the past, when IVF was new, embryos would be transferred on the second or third day after the egg retrieval. But with improved culture conditions, we can now grow them until day five or six to what's called.

called the blastocy stage. It's important to know, as would happen in your body, about half of these fertilized eggs don't even make it to the blastocyst stage in the laboratory. But the advantage of doing that is it's a bit like asking the embryos to run a marathon, and you've been able to identify the healthiest of the embryos, which has led to the biggest improvement in IVF safety,

which is the fact that we can now transfer just a single embryo. And so we've markedly decreased the risk of even a twin pregnancy and certainly eliminated the risk of a triplet pregnancy. And multiple pregnancies in the past have been the greatest risk, both to the mother and the resultant child in terms of complications. So being able to grow the embryo longer, select a better embryo, transferring only one, has been hugely important to improving the safety and health of IVF. And the embryos may go through genetic screening that often occurs before embryos

are implanted, correct? They may or may not. On that day five or six, go through genetic screening. That would allow you to identify an embryo, for instance, that might be affected by tasting. which is a universally fatal disease and really mortality for young children. Parents could identify an embryo that might be affected by something like TASX and then exclude those embryos from transfer so that there's a greater likelihood of having an healthy child. I want to go to some of the tweets and phone calls were coming in. We're going to take a lot more calls after the break, which is just about a minute and a but I have a tweet from Serena on Twitter.

She says, worried about impact of demise of Roe v. Wade on IVF, young doctors in training are saying they will not take jobs in states that prevent full care of infertility patients. This will make the poor access to infertility treatment in this country even worse. Your comment? Your comment?

I think that's spot on. This is access to care, whether it's general health care or access to fertility care is severely compromised in the U.S., and unfortunately, it's many of the same states that would have the most restrictive abortion laws are states that already have poor access to care for general maternity care, have higher maternity mortality rates. And so I think that's absolutely true, especially since most obstetrician gynecologists these days are women. they may choose to either train or practice in states that get in between the patient and the doctor

in terms of making the best evidence-based decision. All right. We have a lot more calls on number 844-724-8255 if you'd like to get in on the conversation. We'll be right back after this short break with Dr. Cedar and your phone calls and questions. This is Science Friday. I'm Ira Flato. If you're just joining us, we're talking about the impact of a. row v. Weight overturn. What impact might that have on in vitro fertilization? My guest is Dr. Marcel

Cedars, Director of the Division of Reproductive Endocrinology, and UC San Francisco, and she is also President of the American Society for Reproductive Medicine. Our number 844-724-8255, site, 844 SciTalk, if you like, or you can tweet us at SciFRI. So many people have questions. Let's go right to them. Let's go to the phone. Let's go to Emily in the Bronx. Hi, Emily. Hi, thanks for this taking my call. Go ahead. Hi. So just to start, I want to say I have two children who are conceived via IVF, and I appreciate the conversation about this.

My question is about how before the last few months in this news with Roe v. Wade, most of the conversation that I've been in around IVF has been around genetic testing and genetic manipulation and what the future holds for regulations. in those areas. And that alone was its own big, scary topic, and I thought that would be the main focus in the scientific and medical community. So I'm curious how now this, how the conversation may have shifted and if the two pieces are being talked about together. Good question, Dr. Cedars. I think our bigger concern is really more basic, because if there are additional laws like the current law that was recently passed in Oklahoma that states that life begins at fertilization, our concern is can we continue to practice IVF in a safe and efficient manner? So can we cryopreserve at fertilized eggs?

Can we continue to do pre-implantation genetic testing? Those issues that were brought up by the prior speaker. And that's a serious question in terms of how. how do we continue to do IVF in the best, safest way for patients? So other families can be built the way yours has been. So I think we really have focused on these very basic questions about what these laws might mean. Thanks for the call. Let's go to the next.

Let me go to a tweet. This is an interesting tweet because it's from Rebecca on Twitter. She says it sounds like the richer people will have their interest. protected with commercial interests lobbying for IVF, while poor women will be impacted by lack of access to abortion? Dr. Cedars? Well, I think that's a very good point. I mean, ASRM has been very active in supporting all regulation that restricts decisions between a doctor and a patient, and that includes abortion. And we have joined with the American College of obstetricians a gynecologists on a number of amicus briefs. We were strong supporters during COVID of allowing

consultations for abortion to occur with telehealth and not requiring in-person visits since most abortions in the U.S. are by medical treatment and not surgical. So in our minds, these are intimately created or connected. Reproductive health is really the ability to conceive and build a family when you want to and to not have a child when you don't want to. So it's really a spectrum. And these two things cannot be disassociated. So I wouldn't disagree with you. And that's why we're advocating for abortion rights and leaving these decisions to doctors and patients. Go to the phones to Lisa in Rockaway, New Jersey. Hi, Lisa. Hello.

Hey there, go ahead. So it's so upsetting because if somebody who has been through four IVF retrievals and have only gotten one good embryo plus a fifth with a donor, this is the type of situation where it's really scary. When you have an abnormal embryo, if you're asked or told that you have to transfer that embryo, something that's not compatible with life, It puts you in a really upsetting and scary situation. I had a miscarriage in which I had to have a D&E at 12 and a half weeks.

It was the worst experience I've ever been through, and as somebody who wanted to be pregnant that badly, to have people telling me that they know more than science, perhaps because religion is intertwined into it, it's just beyond my comprehension. Dr. Cedars, what if you get to say? about that. With you, that's exactly what we're concerned about is that patients will be put into these very difficult situations or be told that they can't discard embryos once they've completed

childbearing and they might be forced to donate them. And so you might have an affected, you know, a genetic child that, you know, is being raised by another family, which is a wonderful gift if you choose to do it, but if you don't choose to do it, it could be quite difficult. Thank you, Lisa. Thank you, Lisa. This brings me to a tweet, actually. That's sort of the same that came in. It says, if embryos are granted personhood, does that mean, Beth asks, that cryopreserved

have to be born? Would women who have fertilized eggs frozen be compelled to carry them to term? And I think that's what Lisa was talking about. I think that is, would they be compelled to carry them to term, or would they be compelled to continue to pay storage on them indefinitely if they chose to transfer them from a state that restricted their ability to make decisions to a state that didn't? Would they be forbidden from doing that? That can now happen to ship embryos from one state to another, but just as they're restricted. on the side of abortion, being able to bring in abortion medications to states through the mail or through delivery, could you be forbidden to transfer your embryos out of state to discard them?

And what about where the embryos are stored in the infertility clinics? Would those clinics be required by law to keep those embryos viable or else be accused of murder? Well, I mean, I think that's a scary point because not all embryos will survive freezing and thawing. As I mentioned before, not all embryos will survive culture in the laboratory. So will the physician or the laboratory be accused of murder if an embryo doesn't survive? When we know, as your very first wise question, we know in nature only one out of four is capable of going to birth. Our number 844-724-8255. I have lots of folks.

Let's go out to the coast to Ethan in Portland. Hi, Ethan. Welcome to Science Friday. Hi, how are you? Hi, go ahead. Yeah, I just wanted to make the point that I think that a lot of the people who are pro-life and going to sort of make these abortion and IVF fans do so in saying, like, where we want to have a family.

And I just had my third daughter born two weeks ago today with IVF. And I want to make the point that without that ability to have IVF, I couldn't have had the family my wife and I dreamed of. Wow, wow. Congratulations to you. Thank you. Yeah, it's making possible. IVF is making, you know, children possible for a lot of people.

Now, I understand, Dr. Cedar, that you have spoken to colleagues who are planning to encourage patients to undergo IVF to be able to screen for genetic abnormalities ahead of getting pregnant, so that if abortion for genetic issues becomes a crime, then you won't get pregnant and risk need having an abortion later. Is that correct? Well, I don't know that people have been encouraging patients to do that at the present time, but I think that's a theoretic possibility that will be there. So if you happen to be in a state that prevents abortion, say, after six weeks, so it wouldn't interfere with the process of IVF, but it would eliminate the risk of doing a termination later in pregnancy, even if the embryo, the fetus was found to be carry a genetic deficiency, it may push patients who might not otherwise need IVF to do IVF. It might push physicians and patients to discuss

doing genetic testing that perhaps they wouldn't otherwise do. Let's go to Dan in Oxford, Connecticut. Hi, welcome to Science Friday. Hello? Hi, Dan. Yes, go ahead. Yeah, hi. I just wanted to get the doctor. comments. I got a patent actually pending right now for the cryopreservation process. We use a, using a sterling engine. So this would be a new method that wouldn't really need liquid nitrogen, so it might be safer for the lab technicians. And I just wanted to see the

doctors heard about this like solid state freezing as opposed to liquid nitrogen and get her comments on that. Okay. Okay. Yeah, I haven't really heard that much about it, so I can't comment, but I think in terms of the issue of viability and whether or not you'd be able to freeze excess embryos and then what you can do with an embryo once it's frozen, I think those issues would be the same regardless of the technology that you use to freeze them. Thanks, Dan. Good luck with your patent. Thank you. Another Twitter coming in from Erica who says there is a huge financial aspects for patient.

It's ideal to create as many embryos as you can in one cycle because you may not be able to pay for another one. I wouldn't have had my daughter now if I couldn't freeze embryos after a cycle limiting that could be detrimental. I think that's a very good point. And again, as I said, going to stimulation of the ovary versus, for instance, Louise Brown, who was a single egg opulated, the first IVF birth in 19, 1978 in England, increasing the number of eggs in a single cycle does increase the safety as well as the success rate because it allows you to have to go through the process less. And so the caller is absolutely right. It particularly as most states don't have mandated coverage despite infertility being

considered a disease, that if patients are paying out of price, pocket as efficient as we can make the process for patients, the less expense they'll have. Talking about in vitro fertilization with Dr. Marcel Cedars, president of the American Society for Reproductive Medicine and Director of the Division of Reproductive Endocrinology at UC San Francisco. This is Science Friday from WNIC Studios. Let's go out to the phones to Cheryl and Santa Cruz. Hi, Cheryl. Yes, oh, okay, sorry.

Here we go. I'm in my car. Can you hear me? Yes, go ahead. I hope you're not driving. I'm not. No, I pulled over. Thank you.

I just wanted to say that since this whole thing has come up, that any type of fertilized human egg would be in jeopardy, you know, in regards to what you're talking to today, as well as stem cell research. because I do believe they need fetal tissue, and I do believe I heard, correct me if I'm wrong, that they actually fertilize human eggs in order to use the fetal cells to make stem cells. And so all that would have to stop. And then what happens if throw versus weight gets reversed, does that mean any woman who's pregnant will be supported by the federal and state government in order to carry that baby to a healthy term and help them adopt,

put it up for adoption if they don't really want to have a child. Interesting. Interesting questions. Cheryl, let's go to the first part about stem cell research, Dr. Cedars. Yeah, I think it's an interesting question. I mean, nowadays, a lot of stem cell research are done with skin cells or other type of cells, and we're not using embryos, human embryos as much. Generating new stem cell lines from human embryos are actually not covered,

not allowed by the national government in the U.S. It's one of the problems with abortion and IVF having been closely linked really since the 1980s. We've been unable to do federally funded embryo research in the U.S. So for us, unfortunately, there are already restrictions about that. Countries like the UK that may have more guidelines for how to practice IVF actually allow embryo research up to 14 days of age. So I'm not sure that this specifically will hurt that research since most has shifted to what are called IPS cells that don't involve embryos.

but it certainly may continue to restrict embryo research. Thank you, Cheryl, for that question. Yes, and may I make one more comment? Sure. Yeah, so I appreciate people having whatever religion they want as well as having moral, but I also don't want them to make me sign up for their religion or their morals, and I thought there was a separation between church and state, So having laws that give us, you know, we're supposed to have freedoms here in the United States

and we've tried so hard to get our freedoms. We shouldn't have them taken away by people who say their religion doesn't like what we're doing. So, you know, there's that old adage if you don't like a person, don't have one. Okay, Cheryl, thank you for your comments. A lot of people are going to be talking about this, Dr. Cedars. this is certainly going to explode rather than go away. No, I think you're right. And to the one caller who was talking about abortion decisions in general and to the last caller,

I think you're right. And as the young man who just had his third child, I've had patients who are Catholics and they say my whole life I've been told to build a family and raise them in the church, the only way I can do that is through IVF, how can someone tell me that's wrong? And they've chosen to go forward because the bigger priority in their mind is being able to build their family. And so I think that the abortion wars have been such a prominent part of U.S. politics for so long that I'm surprised and disappointed to see us moving in the direction it appears that we are. Well, I want to thank you for taking time to be with us and answering our questions today, Dr. Cedars. Thank you. Dr. Marcel Cedars,

president of the American Society for Reproductive Medicine, Director of the Division of Reproductive Endocrinology, UC San Francisco. Here's Kathleen Davis with some of the folks who help make this show happen. Thanks, Ira. Nehima Ahmed is our manager of Impact Strategy. Melissa Mayers is our office manager. Annie Nero is our individual giving manager. Charles Berkwist is our radio director. And I'm Kathleen Davis, radio producer. And thanks for listening.

Lily, thank you, Kathleen. And we helped this hour from audio engineers Lisa Gosselin and Kevin Wolfe. B.J. Liderman composed our theme music. And if you missed any part of the program or you would like to hear it again, yeah, this is certainly that kind of program. Subscribe to our podcast or ask your smart speaker to play Science Friday. Have a great weekend. I'm Ira Flato.