In Vitro Fertilization is Essential Healthcare for Patients With Rheumatic Disease

Infertility presents a profound physical, emotional, and financial burden, particularly for rheumatology patients who often face substantial barriers to family building. The 2024 Alabama Supreme Court ruling in LePage v. Center for Reproductive Medicine equating embryo destruction with wrongful death introduced new legal uncertainties, sparking concerns about access to in vitro fertilization (IVF) and reproductive health services across the United States. Although Alabama's subsequent legislative action granted temporary protections for fertility providers, the broader implications of embryo personhood laws remain unresolved. For patients with rheumatic diseases, timely access to assisted reproductive technology (ART) is essential. However, barriers such as limited ART awareness, concerns about safety and success, social and religious stigma, and financial and legal restrictions disproportionately impact this population. The consequences of restrictive policies extend beyond females, affecting men and same-sex couples who rely on IVF to expand their families. Infertility is a recognized medical condition, and restricting ART access is medically and ethically indefensible. As physicians, researchers, and advocates, we must actively oppose legal decisions and policies that limit ART availability, including insurance restrictions, discriminatory practices, and embryo personhood legislation. Protecting and expanding ART access is critical-not only for rheumatology patients but for the one in eight couples and one in four physicians affected by infertility. Ensuring equitable, evidence-based reproductive care is imperative to safeguarding the right to family building for all.