Key takeaways:

• Several states have introduced legislation regarding reproductive medicine that concerns some policy experts.
• The bills seem to follow trends seen in early abortion policy that eventually led to restrictions.

Several states have introduced legislation that would establish new reporting and data-collection requirements for assisted reproductive technology, raising questions about how the measures could affect fertility care, according to experts.

Christopher P. Moutos, MD, a physician member of the American Society for Reproductive Medicine, and colleagues published an article in The New England Journal of Medicine that describes what they call “an emerging threat” in the U.S.

Just last year, Arkansas enacted a restorative reproductive medicine (RRM) law, becoming the first U.S. state to do so, according to the article. It has been more than 6 months since the law has gone into effect, and “stakeholders are still working to determine how it should be interpreted and implemented.”

“RRM emphasizes treating underlying causes of infertility with methods such as fertility awareness, lifestyle changes and endometriosis surgery — an approach promoted by the Heritage Foundation, a conservative think tank with a ‘pro-life’ agenda,” Moutos and colleagues wrote. “Though RRM aims to ‘restore natural fertility,’ strict adherence to it can delay or limit patients’ access to the full spectrum of proven interventions for infertility, such as in vitro fertilization (IVF).”

However, it was not the only important bill introduced in Arkansas in 2025: The “To Create the Assisted Reproductive Technology Reporting Act,” which was “taken nearly verbatim from model legislation published by the Heritage Foundation,” halted in committee and was recommended for interim study analysis. Since then, Texas and Oklahoma have also introduced “strikingly similar bills,” according to the perspective.

This proposed legislation argues that there is insufficient oversight for assisted reproductive technology (ART) and creates “new guidelines for data that must be collected and reported to the state.”

“The bill undermines established clinical definitions by introducing its own definitions of medical terms. Furthermore, language in the bill diminishes the experience of patients with infertility and casts doubt on the expertise of assisted reproductive care providers,” Moutos and colleagues wrote. “Proposals within this bill potentially lay the groundwork for future personhood-based legislation that could grant legal rights and protections to embryos created by means of IVF.”

Healio spoke with Moutos to learn about the paper, concerning legislation and more.

Healio: Why did you decide to study this? Why is it important for experts to know about?

Moutos: My goal as a reproductive endocrinologist is not just to help patients when it comes to medical treatment, surgical treatment and clinical issues. It’s also to advocate for patients and help shape public policy to the extent that I can in the best interest of women’s reproductive healthcare. There’s been a trend in many states where there’s a progression of infringement on women’s reproductive rights that’s starting to take away their autonomy. We’ve seen it with restricting access to abortion, and now there’s a concerning trend when it comes to potential limitations on fertility care and IVF, and disposition of embryos.

Healio: The study discusses a wave of state-level bills that are promoted as transparency or fertility clinic reporting measures. Will you describe some of those bills? What are they framed as and what would they really do?

Moutos: There were two bills in 2025 — one in Arkansas, one in Texas — and this year, there’s one that I know of in Oklahoma. [That’s] not to say that it hasn’t popped up in other states; those are just the ones I’m aware of at this time. They’re framed as a way to improve transparency about ART — essentially, what they’re getting at is IVF.

They’re concerning in the sense that there’s misguided definitions of medical terminology that are not consistent with established medical definitions of things, even as basic as the fact that infertility is a disease. That’s the medical consensus across many major medical associations, that infertility is a disease vs. these bills don’t define infertility as a disease but instead as a symptom. And there’s other examples that kind of start to muddy the waters as to questioning the authority of trained, educated medical professionals and their judgment and their decisions vs. people who maybe don’t have the appropriate medical background [who are] looking to shape definitions based off of possibly other motives beyond just what’s in the best interest of patient care and as well as patient autonomy.

Healio: How would these bills impact both patients and providers?

Moutos: On the surface, these bills don’t look as concerning, but when you kind of dive into these deeper, it’s following a very clear pattern that we saw with abortion regulations and what’s called trap laws or targeted regulation against abortion providers. Those laws started with initiatives to collect data on abortion procedures, framed as being in the public’s best interest. That escalated and progressed to, in many areas, total bans on abortions, which should be a decision that patients should make in conjunction with their medical team based off their values and what the appropriate path forward is given the clinical situation.

So, these bills targeting IVF regulations and ART are following a very similar concerning pattern of starting with collecting data on ART through reporting requirements, which can then be used to justify personhood laws and restrictions on ART procedures — a similar pattern to the TRAP laws in place currently. Limitations could be restrictions on how patients are able to handle their cryopreserved materials or limits on how physicians carry out IVF cycles. These bills seek to establish a human life with legal rights as occurring from the “moment” of fertilization, whether it happens in the body or in vitro in an embryology lab through IVF. From a medical standpoint, there is no single moment of fertilization. It’s a process. And [there are] many other examples of misguided interpretations of scientific reality that show inconsistencies with what the bills frame as medical truth vs. what the actual medicine and science shows.

Healio: In the study, you write that proposals within an Arkansas bill “potentially lay the groundwork for future personhood-based legislation.” How does it lay that foundation? What would the implications be there?

Moutos: In short, the Alabama Supreme Court a couple of years ago determined that cryopreserved embryos were protected by wrongful death regulations, with potential legal penalty. So that could potentially happen if personhood bills come into fruition through legislative as opposed to the judicial processes, where embryos are considered having the same legal rights whether they’re in a woman’s body, regardless of the gestational age, or still in cryopreserve in the embryology lab. Things that are standard for embryology protocols and practices that are carried out based off of medical indications or patient preferences, such as discarding an embryo, could potentially be seen as a wrongful death or some other legal penalty.

Healio: Should OB/GYNs in these states discuss any of these bills with their patients? What should they say?

Moutos: I think when it comes to these types of bills or any other types of bills affecting women’s reproductive care, it’s important to as best you can stay in tune with what’s happening — not just at the national level but the local level, too — and that there definitely is a benefit and a need to make sure that patients are aware of what is trying to be passed. And not everything is a bad initiative. Patient advocacy, provider advocacy, doctor advocacy — these are all important components to making sure that healthcare policy and regulation is shaped in a way that makes sense, is scientifically and medically sound, and benefits patients.

Healio: What is the take-home message here?

Moutos: The bigger picture is that we have a duty not just to provide high-quality clinical care, but to do what we can in other aspects to make sure we’re preserving and advancing the interest of women’s health, women’s reproductive care, so that way we can practice the standard of care, and patients can seek care in a way that fits with their medical needs and personal priorities while preserving their autonomy.

For more information:

Christopher P. Moutos, MD, can be reached at primarycare@healio.com.