decades-long trend: National Center for Health Statistics, Centers for Disease Control and Prevention, “Fertility of Men and Women Aged 15–49 in the United States.” Delayed childbearing, the report also notes, increased ninefold between 1972 and 2012.

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“When I was much younger”: Jan Moir, “The Rules Every Woman Should Live By: She’s One of the World’s Most Celebrated (and Colorful) Feminists. At 81, Gloria Steinem Reveals What She’s Learned,” Daily Mail, March 16, 2016, dailymail.co.uk/​debate/​article-3468553/​The-rules-women-live-s-one-world-s-celebrated-colourful-feminists-81-Gloria-Steinem-reveals-s-learned.html.

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Chapter 14

Portions of this chapter were previously published in The Guardian on May 13, 2018, under the title “Their Embryos Were Destroyed. Now They Mourn the Children They’ll Never Have.”

Facts about the Ohio and California tank failures were gathered from the author’s own reporting, legal documents, news reports, state health department findings, and documentation that affected patients received from University Hospitals Cleveland Medical Center and Pacific Fertility.

“After the March 2018 mishap”: Nicholas Iovino, “Tank Manufacturer Accuses Fertility Clinic of Falsifying Data in Frozen Eggs Trial,” Courthouse News Service, May 27, 2021, courthousenews.com/​tank-manufacturer-accuses-fertility-clinic-of-falsifying-data-in-frozen-eggs-trial/.

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One recent example: Neil Vigdor, “ ‘We Had Their Baby, and They Had Our Baby’: Couple Sues over Embryo ‘Mix-Up,’ ” New York Times, November 9, 2021, nytimes.com/​2021/​11/​09/​us/​fertility-clinic-embryo-mixup.html.

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at least nine: Anar Murphy, Sindhu Gollapudi, and Michael G. Collins, “Legal Case Study of Severe IVF Incidents Worldwide: Causes, Consequences, and High Emotional, Financial, and Reputational Costs to Patients and Providers,” North American Proceedings in Gynecology & Obstetrics 2, no.1 (2022): 22, doi.org/​10.54053/​001c.37563.

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nearly 30 percent: “FertilityIQ Protocol: How to Pick a Fertility Doctor,” FertilityIQ, accessed February 3, 2023, fertilityiq.com/​topics/​ivf/​fertilityiq-protocol-how-to-pick-a-fertility-doctor.

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misdiagnosed, mislabeled, or mishandled: Dov Fox, “What Happens When Reproductive Tech Like IVF Goes Awry?” Wired, July 17, 2019, wired.com/​story/​when-ivf-goes-awry.

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restrict federal funding: National Academies of Sciences, Engineering, and Medicine, Fetal Research and Applications: A Conference Summary (Washington, D.C.: National Academies Press, 1994), doi.org/​10.17226/​4797.

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states are left to: Kirstin R. W. Matthews and Daniel Morali, “Can We Do That Here? An Analysis of US Federal and State Policies Guiding Human Embryo and Embryoid Research,” Journal of Law and the Biosciences 9, no. 1 (2022): 124, doi.org/​10.1093/​jlb/​lsac014.

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complex patchwork: I. Glenn Cohen, “The Right(s) to Procreate and Assisted Reproductive Technologies in the United States” in The Oxford Handbook of Comparative Health Law, ed. Tamara K. Hervey and David Orentlicher (Oxford, United Kingdom: Oxford University Press, 2021), 1009.

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In contrast: Vishan Dev Singh Jamwal and Arun Kumar Yadav, “The Assisted Reproductive Technology (Regulation) Act, 2021: A Step in the Right Direction,” Indian Journal of Community Medicine 48, no. 1 (2023): 4–6, doi.org/​10.4103/​ijcm.ijcm_169_22.

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CLIA doesn’t extend: American Society for Reproductive Medicine (ASRM) and the Society for Reproductive Biologists and Technologists (SRBT), “Comprehensive Guidance for Human Embryology, Andrology, and Endocrinology Laboratories: Management and Operations: A Committee Opinion,” Fertility and Sterility 117, no. 6 (2022): 1183–1202, doi.org/​10.1016/​j.fertnstert.2022.02.016.

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required to report: In 1992, Congress passed the Fertility Clinic Success Rate and Certification Act—the only federal legislation that specifically pertains to assisted reproductive technology—which requires all U.S. clinics performing ART to report data annually to the CDC. In addition to providing pregnancy success rates, clinics must provide details of treatment cycles, including infertility diagnosis, number of embryos transferred, and use of fresh or frozen embryos and donor or non-donor eggs. The CDC works in consultation with SART and ASRM to report ART success rates each year.

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donor tissue: This includes the screening and testing of reproductive tissue, such as donor eggs and sperm, to ensure it’s free from disease.

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disclosure of medical errors: ASRM and SRBT Committee Report, “Comprehensive Guidance.”

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“might improve the uniformity”: ASRM, “Oversight of Assisted Reproductive Technology,” updated 2021, asrm.org/​globalassets/​_asrm/​advocacy-and-policy/​oversiteofart.pdf.

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Arizona passed: Arizona Revised Statutes, 2018, Section 25-318.03, “Marital and Domestic Relations,” law.justia.com/​codes/​arizona/​2018/​title-25/​section-25-318.03.

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“Just like a judge”: Kathy Ritchie, “Arizona Governor Signs Bill to Change Laws Concerning Frozen Embryos,” KJZZ, April 5, 2018, kjzz.org/​content/​633242/​arizona-governor-signs-bill-change-laws-concerning-frozen-embryos.

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a Virginia judge: Matthew Barakat, “Judge Uses a Slavery Law to Rule Frozen Embryos Are Property,” Associated Press, March 9, 2023, apnews.com/​article/​embryos-slavery-chattel-custody-virginia-82e1f36ecbcf35ec4659e8e2c3443c4f.

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embryos as “juridical persons”: Hannah C. Catchings, “A ‘Modern Family’ Issue: Recategorizing Embryos in the 21st Century,” Louisiana Law Review 80, no. 4 (2020): 1521–1556, digitalcommons.law.lsu.edu/​lalrev/​vol80/​iss4/​12/.

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foreshadows: Gerard Letterie and Dov Fox, “Legal Personhood and Frozen Embryos: Implications for Fertility Patients and Providers in Post-Roe America,” Journal of Law and the Biosciences 10, no. 1 (2023): 1–13, doi.org/​10.1093/​jlb/​lsad006.

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legal gray area: Julianna Goldman, “Why Many IVF Patients Worry About the Antiabortion Movement,” Washington Post, July 29, 2023, washingtonpost.com/​wellness/​2023/​07/​29/​dobbs-abortion-ivf-embryos-impact/.

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courts struggled: American Bar Association, “In Case of Divorce, Destroy the Eggs,” December 9, 2015, americanbar.org/​groups/​litigation/​committees/​minority-trial-lawyer/​practice/​2015/​in-case-of-divorce-destroy-the-eggs/.

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1.5 million frozen embryos: Gerard Letterie, “In Re: The Disposition of Frozen Embryos: 2022,” Fertility and Sterility 117, no. 3 (2022): 477–480, doi.org/​10.1016/​j.fertnstert.2022.01.001.