A decision from the Alabama Supreme Court has led to a halt in IVF services at some locations and a flurry of protests from providers in the fertility space.

The court ruled on Feb. 16 that under state law, frozen embryos are considered children, stating in the decision that “the Wrongful Death of a Minor Act applies on its face to all unborn children, without limitation.”

The decision was in response to two wrongful death cases brought by three couples whose frozen embryos were destroyed in an accident at an Alabama fertility clinic. 

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Justices ruled that an 1872 state law allowing parents to sue over the death of a minor child “applies to all unborn children, regardless of their location.”

“Unborn children are ‘children’ … without exception based on developmental stage, physical location, or any other ancillary characteristics,” Justice Jay Mitchell wrote in the ruling.

This includes “unborn children who are located outside of a biological uterus at the time they are killed.”

Pro-life advocacy group Live Action reacted to the decision in a statement.

“Each person, from the tiniest embryo to an elder nearing the end of his life, has incalculable value that deserves and is guaranteed legal protection,” Lila Rose, president and founder of Live Action, said in the statement.

Fox News Digital reached out to Live Action for additional comment.

In the Alabama court’s ruling, the chief justice referenced upholding “the sanctity of unborn life,” phrasing that appears in the Alabama Constitution. (Photo by Jessica Rinaldi/The Boston Globe via Getty Images)

In the court’s ruling, Chief Justice Tom Parker referenced upholding “the sanctity of unborn life,” a phrase that appears in the Alabama Constitution.

“Even before birth, all human beings bear the image of God, and their lives cannot be destroyed without effacing his glory,” Parker said in the ruling.

IVF providers halt services

In response to the court’s ruling, the largest hospital system in Alabama — the University of Alabama at Birmingham (UAB) — announced on Wednesday that it would be suspending its in-vitro fertilization treatments.

“The UAB Division of Reproductive Endocrinology and Infertility has paused in-vitro fertilization (IVF) treatments as it evaluates the Alabama Supreme Court’s decision that a cryopreserved embryo is a human being,” the hospital said in a statement provided to Fox News Digital. 

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“We are saddened that this will impact our patients’ attempt to have a baby through IVF, but we must evaluate the potential that our patients and our physicians could be prosecuted criminally or face punitive damages for following the standard of care for IVF treatments,” the statement continued. 

The hospital noted that other components of fertility treatments — “everything through egg retrieval” — remain in place, and only the actual egg fertilization and embryo development are paused.

On Thursday, two additional fertility providers — Alabama Fertility Specialists and the Center for Reproductive Medicine in Mobile, Alabama — both announced that they would be pausing their IVF treatments, according to local reports. 

A laboratory worker fills a test tube at an IVF clinic. In response to the court’s new ruling, some Alabama providers have suspended their IVF services. (Jack Atley/Bloomberg via Getty Images)

Doctors weigh in

Dr. Asima Ahmad, co-founder and chief medical officer of Carrot Fertility and a practicing reproductive endocrinologist and fertility specialist based in Chicago, Illinois, shared her opinions on the ruling. 

“Access to IVF is now at stake in Alabama due to the recent ruling from the Alabama Supreme Court,” she said in a statement to Fox News Digital.

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“This decision could have serious consequences for people who are desperately seeking to have children, including clinics shutting down, doctors moving out of the state for fear of practicing, pricing increases, and changes in medical practice to avoid lawsuits, which might not be ideal for the patient.”

Ahmad warned that the ruling could result in “profound damage” to fertility care access.

“IVF is a crucial part of reproductive science and allows women to have children who otherwise couldn’t.”

“As physicians, it is our fundamental duty to do no harm, and this could take away our ability to practice medicine in a way that we think is most ethical and safe for our patients,” she added.

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, reacted to the ruling’s impact on IVF availability in an interview with Fox News Digital.

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“IVF is a crucial part of reproductive science and allows women to have children who otherwise couldn’t,” he said.

“Freezing eggs is an important part of the process, because it allows women to utilize these eggs later on when the timing is better or when they have found the right partner.”

An embryologist works on a petri dish at a fertility clinic. Approximately 13.4% of U.S. women between ages 15 to 49 experience infertility, according to the Centers for Disease Control and Prevention. (AP Photo/Sang Tan)

Freezing embryos also allows a couple more options in terms of timing, Siegel said, which may increase the chance of a viable child.

“It is important that a frozen embryo not be used casually or frozen without plan for use, but I believe that IVF is an important option that brings children to couples,” he said.

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“Certainly, if your religious beliefs indicate that life begins at conception, or in forming an embryo, than you should abstain,” he added. “For others, it is an important option.”

Approximately 13.4% of U.S. women between the ages of 15 and 49 experience infertility, according to the Centers for Disease Control and Prevention (CDC).

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When it comes to reaping the rewards of exercise, women may have a leg up.

A new study published in the Journal of the American College of Cardiology found that females may get more benefits than men when doing the same amount of physical activity.

Researchers from the Smidt Heart Institute at Cedars-Sinai in Los Angeles analyzed the physical activity data of 412,413 U.S. adults.

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The participants all responded to the National Health Interview Survey database between 1997 and 2019, providing details about the frequency, duration, intensity and type of physical activity, according to a press release from the hospital.

In terms of cardiovascular exercise, the researchers found that men gained their maximum “survival benefit” from doing “moderate to vigorous aerobic physical activity” for about five hours per week.

For women, that same level of benefit was achieved after just 2½ hours of that exercise intensity per week.

Women continued to gain more benefits after that time, however.

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Examples of “moderate to vigorous aerobic physical activity” include brisk walking or cycling, the study detailed.

For strength training exercises, men hit their maximum benefit from three weekly sessions, while women achieved the same outcome with just one session per week.

“We found not only that progressively greater amounts of physical activity reduced mortality risk, but also that the amount of regular exercise needed to achieve the same degree of risk reduction was different in females versus males,” said senior author Susan Cheng, M.D., MPH, director of the Institute for Research on Healthy Aging in the Department of Cardiology in the Smidt Heart Institute.

For strength training exercises, men hit their maximum benefit from three weekly sessions, while women achieved the same outcome with just one session per week. (iStock)

“In effect, women did not need to exercise for as much time as men to achieve the same benefit,” she told Fox News Digital. 

“Put another way, for a given amount of time and effort put into exercise, women had more to gain than men.”

Co-lead author Martha Gulati, M.D., director of preventive cardiology in the Department of Cardiology at the Smidt Heart Institute at Cedars-Sinai, noted in the release that women have historically and statistically lagged behind men in engaging in exercise.

“Exercise doesn’t discriminate, no matter your gender. You have to put the work in to be healthy.”

“The beauty of this study is learning that women can get more out of each minute of moderate to vigorous activity than men do,” Gulati said. 

“It’s an incentivizing notion that we hope women will take to heart.”

While mortality risk decreased for all adults, it was reduced by 24% for women and 15% for men, according to Cheng.

In terms of cardiovascular exercise, the researchers found that men gained their maximum “survival benefit” from doing “moderate to vigorous aerobic physical activity” for about five hours per week. (iStock)

“We hope that the results of this study will help to motivate females who are not currently engaged in regular physical activity to understand that they are in a position to gain substantial benefit, technically even more than their counterpart males, for each increment of regular exercise they are able to invest in their longer-term health,” Cheng told Fox News Digital. 

“Part of what makes females and males different is that when it comes to living longer and living healthier, different types of investments are linked to different types of gains.” 

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The researchers hope that these findings will help women who may feel too busy or too intimidated to take on a new exercise routine without feeling that they have to compare themselves to men.

“They can be on their own path to success and every bit of progress will count,” Cheng said.

While mortality risk decreased for all adults, it was reduced by 24% for women and 15% for men, according to the researchers. (iStock)

Chris Pruitt, a certified personal trainer with the American Sports and Fitness Association (ASFA) who is based in Maryland, was not involved in the study but said it aligns with observations that women and men may require different approaches to achieve similar health outcomes.

“In my experience, individual responses to exercise can vary widely, and it’s fascinating to see this backed by research,” he told Fox News Digital. 

“Biological differences between genders, including hormonal variations and body composition, likely play a significant role in these observed differences,” Pruitt went on. 

“Women may use energy or recover from exercise differently than men, leading to these distinct benefits from less exercise.”

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This research illustrates the importance of personalized fitness programs that consider gender differences, he said.

“It suggests that fitness advice should be more tailored to the individual’s goals and abilities and their gender-specific physiological responses to exercise.”

Potential limitations

The chief limitation of the study is that all physical activity data was self-reported — which creates the possibility for inaccuracies.

“In the future, direct measures of exercise could be analyzed using wearable devices,” Cheng said. 

The researchers hope that these findings will help women who may feel too busy or too intimidated to take on a new exercise routine without feeling that they have to compare themselves to men. (iStock)

“A very large study of people whose exercise is digitally tracked and measured could one day give us even more detailed information on differences not only between women and men, but also within women and within men.”

“There is still a lot more work we need to do to figure out how to best tailor exercise recommendations to each individual person to best meet their individual needs.”

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Josh York, founder and CEO of the New York-based fitness training company GYMGUYZ, reviewed the study and said he does not think the findings should influence people’s fitness routines.

“There are a lot of things you need for good health and fitness, including proper nutrition and a healthy lifestyle,” he told Fox News Digital.

“There are a lot of different variables at play when it comes to assessing a person’s exercise needs and requirements.”

As each individual is different, a fitness expert said that “sweeping assumptions” about each gender’s exercise needs and outcomes don’t take into account variations in individuals’ circumstances. (iStock)

While the study looked at maximal survival benefit, York noted that some people might be motivated by other goals, such as looking a certain way.

“At the end of the day, exercise doesn’t discriminate, no matter your gender,” he said. “You have to put the work in to be healthy. If someone puts more work in, has a healthy diet and lives in a safe environment, they are going to get better results, because physical health is influenced by your habits and mental well-being.”

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As each individual is different, York said that “sweeping assumptions” about each gender’s exercise needs and outcomes don’t take into account variations in individuals’ circumstances.

“I don’t think people should use this as guidance to reduce their exercise regimens,” he said.

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Someone with COVID-19 might expect to experience fatigue, cold and flu symptoms, and loss of taste and smell — but a paralyzed diaphragm would likely not be on the radar.

It was certainly a surprise to Gerald Branim, 55, a runner from Tennessee. His life took a drastic turn when COVID-19 damaged his lungs and diaphragm to the extent that he was unable to run or walk for a year.

Branim and his doctor, Matthew Kaufman of the Institute of Advanced Reconstruction in New Jersey, joined Fox News Digital in an interview to discuss Branim’s ordeal and recovery.

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When Branim got COVID in Feb. 2021, he was a fit, healthy 52-year-old who ran marathons. 

In spite of that, the infection caused significant lung damage. He spent two weeks in the hospital and three months out of work.

For two months after leaving the hospital, Branim used a walker as he continued struggling with lung complications.

“For someone who had run marathons, it was quite humbling to have to walk with a walker for three months,” he said.

After rounds of high-dose steroids and lots of antibiotics, Branim’s chest X-rays finally showed that his lungs had cleared — but he was still having trouble functioning.

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“I still couldn’t go upstairs without my oxygen dropping severely,” he recalled. “I couldn’t run 100 yards without my oxygen dropping into dangerous levels. I was severely out of breath.”

“That’s when they started saying something else was going on — that this shouldn’t be happening.”

“I couldn’t run 100 yards without my oxygen dropping into dangerous levels. I was severely out of breath.”

After 10 months of not being able to walk or run, Branim’s condition was finally diagnosed via a “sniff test,” which is also called a chest fluoroscopy or a video chest X-ray, where the patient is asked to breathe in and out. 

Any paralysis will show up on the scan, as the diaphragm won’t move upon breathing.

What to know about diaphragm paralysis

Diaphragm paralysis — which is a “pretty rare condition,” according to Kaufman, Branim’s doctor — is paralysis of the diaphragm muscle, which is the primary breathing muscle. 

Previous studies have estimated that the condition affects only about 1.31% of the population. In about 95% of cases, only one side is paralyzed, the doctor noted.

“We have two diaphragms, one on the right, one on the left,” he said.

Branim, far right, is pictured with his doctor, Matthew Kaufman, center, and another patient at the half-marathon they ran together after Branim’s surgery. (Institute for Advanced Reconstruction)

In cases where both sides are paralyzed, symptoms will be much more severe, usually requiring the patient to be put on oxygen.

“It’s become sort of a phenomenon,” Kaufman told Fox News Digital. “The phrenic nerve, which is the nerve that controls the diaphragm, seems to be an area where the COVID virus can have an impact.”

In some ways, he said, the condition can be considered part of long COVID, which is when symptoms of the virus linger for weeks, months or even years after infection.

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Most people with diaphragm paralysis won’t have difficulty breathing while sitting. Symptoms will typically emerge with exertion, such as walking or exercising, or when changing positions, such as lying flat in bed or bending over to tie their shoes, Kaufman said.

Some people are more susceptible than others, the doctor noted.

“We know that viruses tend to attack nerves in the body, as we’ve seen in Bell’s palsy,” he said. “And now we’re seeing it with COVID causing injury to the phrenic nerve.”

Branim set a goal of running a half-marathon within a year of his surgery date, which he achieved alongside his doctor in April 2023. (Institute for Advanced Reconstruction)

Because the condition is rare to begin with, he said, it’s not something that’s universally known.

“And then you take a condition like COVID, which causes respiratory symptoms from inflammation in the airways and lungs, and then you tie in what we consider to be a neuromuscular problem,” Kaufman said.

“A lot of times, the physician or patient will attribute it to airway inflammation, when in fact it’s a problem related to nerves and muscles that are part of the respiratory system.”

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In some cases, patients will recover on their own, Kaufman said.

“We usually recommend a period of about six to 12 months of physical therapy, breathing exercises and cardiovascular fitness to try to see if this will come back on its own,” he said.

If improvement is not noticed in that time frame, surgical intervention becomes a possibility.

Branim emphasized the importance of patients serving as their own advocates. “Doctors are human — they don’t know everything,” he said. “So you have to advocate for yourself.” (Institute for Advanced Reconstruction)

In 2020 and 2021, Kaufman said he saw an uptick of patients who experienced diaphragm paralysis after having COVID. Although he is still seeing some cases, they are starting to trail off a bit.

“That could be because the classic COVID is not as virulent or severe,” he said. “Or maybe it’s because more people are immunized.”

Although the condition is generally not life-threatening, it can be more severe in patients who have existing respiratory conditions.

Racing toward recovery

After Branim’s diagnosis, his lung doctor advised him to continue to give it time to heal.

“But it wasn’t getting any better,” he said. “And I just wasn’t satisfied with that being my new quality of life.”

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That’s when Branim turned to Google to research surgical options. He came across an article by Kaufman, a plastic and reconstructive surgeon who specializes in an area called peripheral nerve microsurgery.

Kaufman specializes in conditions that cause either pain or paralysis due to nerve damage of the peripheral nervous system. 

After meeting with Kaufman in a telehealth visit, Branim was identified as a prime candidate for the surgery, which is called phrenic nerve reconstruction. 

“It wasn’t getting any better — and I just wasn’t satisfied with that being my new quality of life.”

If he had waited much longer, he said, his diaphragm muscle would have atrophied and the surgery would no longer have been possible.

After a lot of back and forth with the insurance company, Branim finally got the green light to travel from Nashville to New Jersey for the procedure.

The surgery went smoothly, although Branim was told that it wouldn’t be an immediate improvement. Once the nerve is fixed, the muscle still needs time to strengthen and rehabilitate.

Studies have estimated that the condition affects only about 1.31% of the population. In about 95% of cases, only one side is paralyzed. (Institute for Advanced Reconstruction)

“Dr. Kaufman told me that it would probably take a year or two to recover fully, and was preaching patience — but I’m not a patient man in the slightest sense of the word,” Branim laughed.

He set a goal of running a half-marathon within a year of his surgery date.

After four weeks, Branim slowly began exercising again. After six months, he decided to lace up his running shoes and give it a try.

“My very first run after the surgery, I ran five miles,” he said. “I literally cried. At that point, it was like a light switch had been flipped.”

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Within six months, Branim had not only regained his ability to run, but exceeded his original goals, culminating in a half-marathon in April 2023.

In a triumphant twist, Kaufman, who is also a runner, joined his patient in completing the race in Asbury Park, New Jersey.

Now, Branim aims to raise awareness about diaphragm paralysis, an often-overlooked condition that is not on most doctors’ or patients’ radars.

Previous studies have estimated that the condition affects only about 1.31% of the population. In about 95% of cases, only one side is paralyzed. (iStock)

“None of my doctors had even heard of this surgery,” he said. “Had I not found the article about Dr. Kaufman and another runner online, I would have never been able to have the surgery — and I would absolutely not be running today.” 

Branim emphasized the importance of patients serving as their own advocates.

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“Doctors are human — they don’t know everything,” he said. “So you have to advocate for yourself.”

For patients who are experiencing shortness of breath with exertion that persists for several months, Kaufman recommends visiting a primary care physician or pulmonary physician to get the necessary testing.

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“While most tests will find more common ailments, it definitely makes sense to keep a paralyzed diaphragm on the list of things to rule out.”

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