During their five-year struggle with infertility, Bre and Chris Yingling went through several rounds of in vitro fertilization, the most recent attempt ending in stillbirth over the summer after a 38-week pregnancy.
The expectant parents recalled cradling the lifeless body of the daughter they had longed for, as they wept and told her they would always love her.
“She was our baby,” Chris Yingling said. “And we lost her.”
Despite their recent heartbreak, the couple from Palmyra, Missouri — just a few miles from the Illinois border — hope to try to have a child again later this year. Yet they face an added layer of worry and stress this time around, due to the looming fear that IVF could be at risk in their conservative state, which by law defines life as beginning at conception and has banned abortion in nearly all circumstances.
A recent Alabama Supreme Court ruling that frozen embryos are considered children and can be covered under a wrongful death statute temporarily halted IVF treatments in Alabama last month, sending shockwaves around the country, particularly in other Republican-led states like Missouri.
The Yinglings say if assisted reproductive technology is threatened in their home state, their backup plan is to head east for fertility care in Illinois, which has strong reproductive rights provisions, including protections for IVF.
“We’re kind of scared for what’s going to happen,” 29-year-old Chris Yingling said. “Normally it takes the first chip to fall before they all start falling. It definitely feels like the legislature in Missouri is conservative enough … so we’re scared about that.”
Gov. J.B. Pritzker has been encouraging out-of-state patients to travel here for IVF treatments, calling Illinois “an island, a refuge for women across the Midwest who no longer have their rights.”
Illinois has already seen a surge in out-of-state abortion since the fall of Roe v. Wade. Nearly 17,000 patients crossed state lines to terminate a pregnancy here in 2022 — a 49% increase over the previous year.
“People who live in other states who want to have children using IVF, come to Illinois,” Pritzker said at a news conference last month. “We’re protecting your rights in so many ways, but specifically regarding IVF.”
In the wake of the Alabama ruling, lawmakers across the nation have been scrambling to shore up protections for IVF, a process where eggs are collected from the ovaries and fertilized in a lab, then transferred to the uterus in the hopes of implantation.
While IVF is often credited with enabling life where it was once deemed impossible, abortion foes have expressed concern over the treatment of embryos created during the process — particularly those that are leftover and might be discarded, donated for research or cryopreserved indefinitely.
U.S. Sen. Tammy Duckworth, D-Illinois, who had her two children with the assistance of IVF, introduced legislation in January to establish federal protections for IVF and other forms of assisted reproductive technology. The measure, however, was blocked by Senate Republicans.
Alabama lawmakers earlier this month passed legislation shielding IVF providers from legal liability, which was quickly signed into law; while this allowed some treatments to resume there, reproductive rights experts noted that the law doesn’t address the status of embryos or whether they’re legally considered people.
Although IVF remains legal and available in Missouri, lawmakers there recently filed legislation to preserve access to the procedure.
“Missouri law — just like Alabama law — could be used to put fertility treatments at risk, which is why we need to make explicit exceptions to Missouri’s ‘life at conception’ law for extra fertilized embryos created through IVF,” Missouri state Sen. Tracy McCreery said in a written statement.
Bre and Chris Yingling say they’ve feared for the fate of IVF in Missouri ever since the U.S. Supreme Court overturned Roe v. Wade in 2022. The historic end to nearly a half-century of federal abortion protections also raised questions about the legality of certain fertility treatments in states like Missouri, where terminating a pregnancy was almost entirely banned.
IVF has become the latest battlefront in a larger reproductive rights war that polarized the nation after the end of Roe, with some states strengthening reproductive rights and others pushing for laws to protect the unborn.
“There was always the concern in the back of our minds: Are they going to allow us to continue?” 28-year-old Bre Yingling said. “Are they going to let us keep doing frozen (embryo) transfers? What is the legality here?”
Even in in Illinois — where state law stipulates that a fertilized egg, embryo or fetus has no independent rights — fertility treatments have faced backlash.
Abortion opponents protested the 2012 opening of a fertility clinic in Naperville, spurring heated debate at Naperville City Council meetings. In response, supporters of the Naperville Fertility Center gave impassioned speeches before the council, some holding children they said were conceived with the help of IVF.
The fertility clinic continues to draw occasional anti-abortion demonstrations and prayer vigils.
“I don’t like that the embryos are destroyed, discarded or frozen. Because they are live humans,” said John Zabinski, founder of an annual Bike for Life fundraiser that culminates with prayers at the fertility clinic. “You can’t do something that’s right by causing a wrong.”
Dr. Randy Morris, the clinic’s medical director, said he’s confident Illinois policymakers will prioritize reproductive health care and access to fertility treatments. Yet he fears for the future of IVF nationwide.
The Life at Conception Act, reintroduced in the U.S. House last year, would define a “human being” as comprising “all stages of life, including the moment of fertilization.” Morris noted that the proposed law had carved out no exemptions for IVF and was heavily backed by Republicans in the House; a Senate version, however, did include an IVF exception.
If Republicans were to gain control of the presidency and Congress during the November election, Morris worries “this could be the last year of IVF as we know it.”
While presumptive Republican nominee Donald Trump has declared support for IVF on the campaign trail, Morris finds that position disingenuous, pointing out that the former president has repeatedly taken credit for the overturning of Roe.
“It’s going to follow the same pattern of states that passed abortion bans after the fall of Roe v. Wade,” Morris predicted. “I really think this could happen — and the speed in which this could happen is frightening.”
Critical treatment option
About two years into trying to conceive, Bre Yingling learned her fallopian tubes were blocked by scar tissue, likely from a traumatic appendectomy a few years prior. Her fallopian tubes had to be surgically removed, rendering traditional conception impossible.
IVF became their only hope, the wife and husband recalled. But egg retrieval and fertilization were successful, yielding 20 embryos, they said.
The first transferred embryo failed to implant. The second one resulted in a miscarriage in 2022. For the third round of IVF, two embryos were transferred to the womb and one of them implanted.
Bre and Chris Yingling saw a flicker of a heartbeat on an early ultrasound in January, at about six weeks of gestation. Two weeks later, a sonogram tracked a stronger beat of the heart, and the expectant mom and dad sobbed tears of joy but couldn’t completely relax.
“We’re still waiting for the ‘shoe to drop’ so to speak,” Bre Yingling wrote in a blog chronicling the couple’s fertility journey. “We’ve been conditioned at this point to expect failure; pray that we look into the future with positivity and not pessimism.”
Roughly 2% of all births in the United States and 3.6% in Illinois were conceived with the help of assisted reproductive technology, according to 2021 statistics from the Centers for Disease Control and Prevention.
IVF accounts for more than 99% of assisted reproductive technology procedures performed and “is an important fertility treatment option because it can help individuals to conceive who may not be able to using other fertility treatment methods,” according to a 2024 U.S. Department of Health and Human Services report.
When Roe fell on June 24, 2022, Dr. Kara Goldman, medical director of fertility preservation at Northwestern Medicine, sounded the alarm about the future of IVF.
“In recent weeks I’ve fielded this question more times than I can count: ‘What would overturning Roe mean for my frozen embryos?’ Each time I’m asked this question I hold back tears, grieving for a freedom we all took for granted,” she posted on Twitter, the social media site now known as X.
Now she says the Alabama ruling is a “manifestation of that fear.”
Goldman noted that there are many reasons patients seek IVF, from fertility issues to cancer treatments to those who want to test their embryos for genetic diseases that might be devastating or fatal for a child.
“I find it completely ironic that those who in theory seek to preserve the idea of family are preventing the building of families,” she added.
Rita Gitchell, special counsel to the Chicago-based conservative law firm the Thomas More Society, has filed amicus briefs arguing that embryos should be treated as people — as opposed to property — in more than a half-dozen lawsuits involving fertility across the country.
Gitchell said she knows of children born with the help of IVF “who are loved and precious.” Yet she’s concerned with the process, which sometimes involves destroying embryos deemed genetically unhealthy or those that are leftover when family building is complete.
“I think the real problem is the matter in which it is done, that it creates an attitude from the beginning — without realizing it — do we only select the most fit to live?” she said. “Do we not have an embryo because the embryo has Down syndrome? Are we being selective? I think it’s more a problem that comes with how they are practicing IVF right now. That’s treating human beings more like property: selecting which ones live and which ones die. I think that’s something people don’t understand, necessarily, when they go into IVF.”
Earlier this month, Republicans in Iowa’s House of Representatives passed a bill that would criminalize the death of an “unborn person” defined as an “individual organism … from fertilization to live birth.” Critics feared the measure would threaten IVF; the state Senate, though, declined to consider the bill.
Kentucky’s abortion ban was challenged in October 2022 by three Jewish women who argued in a lawsuit that it violates their religious rights, which included the right to IVF treatments; the case is still pending.
“Plaintiff’s religious beliefs demand that they have more children through IVF, yet the law forces plaintiffs to spend exorbitant fees to keep their embryos frozen indefinitely or face potential felony charges,” the complaint states.
Sean Tipton, spokesman for the American Society for Reproductive Medicine, said battles against fertility treatments tend to be politically unpopular.
He added that “the unprecedented outpouring of outrage around the Alabama Supreme Court decision has significantly tempered the ardor of some anti-choice legislators to pursue this kind of thing.”
“Republican elected officials in the state legislatures and in Congress are loudly proclaiming how much they love IVF,” Tipton said. “I think the voters are going to want them to prove that love. And you don’t do that by restricting what people can do with their own reproductive tissues.”
‘Violence to human dignity’
The Yinglings were elated to learn about midway through the pregnancy that they were having a girl, which they called their “miracle baby.”
At 38 weeks of gestation, the fetus was healthy and moving in utero; Bre Yingling was scheduled to be induced the following week, she recalled.
But roughly 24 hours later, the expectant mother panicked because she no longer felt any movement in her womb. A knot had formed in the umbilical cord, a dangerous condition that occurs in about 1% of pregnancies, according to the nonprofit March of Dimes.
There was no longer a heartbeat.
Brooklyn Genevieve Yingling was stillborn on Aug. 25, weighing 7 pounds and 1 ounce, with a full head of dark hair. The contours of her face as well as her long fingers resembled those of her father, the Yinglings recalled.
“I had an emergency C-section and for several hours, Chris and I were able to hold and love our perfect baby girl and tried to fit our lifetime of love into mere moments before letting her go,” Bre Yingling said in her blog.
The thought of trying once more to have a baby is daunting for the couple.
“We’re both afraid to get hurt again,” Chris Yingling said.
But they’d like to attempt another round of IVF, most likely in the fall. The recent national controversy surrounding assisted reproductive technology, though, has compounded their apprehension.
Before their fertility struggles, Chris Yingling was “the sort of person who believed that babies are good and abortions are bad,” he said.
“It wasn’t until our fertility journey that I learned more about the unpredictability that comes with having children — complications in pregnancy and then, obviously, the trials of those that can’t have children,” he said. “And that’s when I started to get a true grasp on how big of a situation this is and how lawmakers that stand on pillars of black and white are unable to make educated decisions on things that are very, very solidly gray.”
The Yinglings know fertility care would be available across the Mississippi River in Illinois. Yet the prospect of traveling out of state is also disconcerting.
They love their fertility specialist in Columbia, Missouri, and say they wouldn’t want to switch providers. Driving to Springfield or the Chicago area for IVF treatments would also require more time, gas money and overnight lodging.
Bre and Chris Yingling estimate that they’ve spent more than $40,000 on fertility treatments so far. In Illinois, diagnoses and treatment of infertility are legally required to be covered by Illinois-based and group insurance plans. Missouri does not require insurance plans to cover infertility treatment.
Several measures to expand IVF and fertility treatment access in Illinois have been introduced in the state legislature, including a bill that would mandate insurers cover the costs of standard fertility preservation and follow-up services for any patient, not just those diagnosed with infertility. Another measure would have insurance companies follow a physician’s treatment recommendation for infertility rather than first requiring tests and procedures.
State Rep. Kelly Cassidy, D-Chicago, has also proposed granting a tax credit to patients, families and physicians who relocate to Illinois to seek or provide medical care that’s restricted in their home state, including reproductive health care.
But Illinois has staunch IVF opponents as well.
When the Naperville Fertility Center was approved by the City Council more than a decade ago, a priest at a local Catholic church had urged parishioners to speak against the development.
“At first glance, this opposition may be confusing for people, because the clinic’s stated purpose is assisting well-meaning couples in having a child and the Church certainly supports a parent’s desire to have a family,” the priest said in a letter to the congregation, which went on to take issue with the treatment of embryos.
“Some will be implanted,” the letter said. “Some will be donated to science. Some will be discarded. Others will simply be kept frozen indefinitely … never being allowed to come to term.”
Morris, the fertility center medical director, said he objects to conservatives who try and “push their religious beliefs in this way.”
“Politically, it’s nice for them to say, ‘We’re going to mark this now at conception.’ It’s a religious thing. There’s no science behind it at all,” he added. “I don’t think anybody actually believes a one-cell embryo is the same as a child. I think that is very disingenuous.”
Rachel Trenkamp, 45, of Aurora, recalled encountering a protester when she and her husband first went to the Naperville Fertility Center for treatment about seven years ago.
“It was horrible,” she said. “It made me angry. It made my husband irate.”
The Naperville clinic and Morris were their last hope to start a family, she recalled.
“I was in such despair so many times,” she said.
On Good Friday in 2018, Trenkamp got a call from the clinic that changed her life: After more than eight years of infertility, she learned the latest embryo transfer was successful. She was finally pregnant, and broke down and sobbed.
Now she is the mom of two “miracle boys,” 5-year-old Benjamin and 2-year-old Zachary.
Trenkamp, who is Catholic, knows her religion rejects IVF.
While the “immorality of conceiving children through IVF can be difficult to understand and accept because the man and woman involved are usually married and trying to overcome a ‘medical’ problem (infertility) in their marriage,” the procedure “does violence to human dignity and to the marriage act and should be avoided,” according to a statement by John Haas, president emeritus of the National Catholic Bioethics Center, which is posted on the United States Conference of Catholic Bishops website.
But Trenkamp says she knows God meant for her and her husband to become parents.
She also believes in “divine timing.”
“It’s not in the timing that we necessarily want or are hoping for…but what He has orchestrated for us. It didn’t matter how we came to have our kids,” she added. “We’re supposed to be having children, right? So, there you go: We just produced two more Catholics.”
The Associated Press contributed.
