I. Introduction: The Invisible Constraint

The rapid evolution of reproductive technologies has forced courts and legislatures to confront questions that once seemed purely theoretical. In vitro fertilization (IVF) has become routine medical practice, while emerging techniques such as in vitro gametogenesis (IVG)—an experimental method of generating eggs or sperm from ordinary somatic cells such as skin cells—suggest that future reproduction may involve the large-scale creation and management of embryos.[1] Although such developments remain scientifically and politically contingent, advances in stem-cell-derived gametes and genomic sequencing could expand the scale of embryo creation and selection, thereby intensifying the regulatory and legal stakes of reproductive governance. Even at a preclinical stage, IVG suggests that reproduction may increasingly unfold within laboratory-based and institutionally structured frameworks.[2]

Since Dobbs v. Jackson Women’s Health Organization,[3] legal debate has largely focused on whether reproductive autonomy remains protected as a substantive constitutional right.[4] This blog asks a different question: when the state restructures reproductive governance—by redefining embryos, prohibiting their disposition, or altering regulatory frameworks—what procedural obligations follow?

Substantive due process asks whether certain forms of state regulation impermissibly infringe constitutionally protected liberty interests; procedural due process concerns how it must regulate when doing so.[5] Even where no fundamental right is recognized, the Constitution requires fair procedures when the state deprives individuals of recognized liberty or property interests.[6] Research on procedural justice further suggests that the legitimacy of the state depends not only on outcomes, but on the fairness and predictability of decision-making processes.[7] In the assisted reproductive technologies context, the erosion of procedural safeguards risks replacing constitutional order with government arbitrariness.

II. The Vanishing Question of Procedure

Since Dobbs v. Jackson Women’s Health Organization repudiated the constitutional right to abortion, debates over reproduction have largely been framed in binary terms: either reproductive autonomy is a fundamental right, or it is not.[8] What has followed is not a careful recalibration of how states regulate reproduction, but a proliferation of blunt legal interventions. Recent reporting by organizations such as the Guttmacher Institute indicates that multiple states have enacted or proposed legislation recognizing forms of fetal or embryonic personhood, often with significant implications for assisted reproductive technologies.[9]

Notably absent from these developments is sustained attention to procedural due process, the requirement that when the government deprives individuals of liberty or property, it must do so through fair and predictable procedures.[10] A skeptic might argue that if no substantive right exists, no procedural protection is triggered. This reasoning overlooks a central feature of due process doctrine. Procedural due process does not protect “fundamental rights” alone; it protects any “liberty” or “property” interest created by existing law, including interests shaped by state-created regulatory frameworks, contractual arrangements, or settled practices.[11] As the Supreme Court explained in Perry v. Sindermann, constitutionally protected property interests, for instance, may arise from “mutually explicit understandings,” even where no formal entitlement is guaranteed by statute.[12]

This blog does not contend that participation in assisted reproduction creates a freestanding constitutional right. Rather, it argues that once the state affirmatively structures, licenses, and regulates a reproductive medical framework, it assumes procedural obligations when altering that framework in ways that arbitrarily infringe settled reliance interests. Patients who have invested genetic material, significant financial resources, and years of medical reliance on IVF may have reliance interests analogous to the mutually explicit understandings recognized in procedural due process doctrine.

III. The Alabama Example

In most areas of law, decisions with profound personal consequences—termination of parental rights, involuntary commitment, or denial of public benefits—trigger procedural safeguards designed to ensure fairness and predictability.[13] The regulation of assisted reproductive technologies, however, increasingly operates outside this framework.

Critics may respond that general legislation does not require individualized hearings.[14] Under cases such as Bi-Metallic Investment Co. v. State Board of Equalization, 239 U.S. 441 (1915), when a rule applies to the public, due process does not mandate case-by-case adjudication.[15] That principle is well established. But the concern here is not the absence of individualized hearings; it is the absence of legitimate, transitional governance when legal rules are abruptly redefined in ways that disrupt settled reliance interests.

When a legislature or court suddenly reclassifies embryos, the deprivation of genetic material and decisional authority may follow automatically, without notice, safe-harbor periods, or prospective application. Procedural justice research suggests that individuals are more likely to accept regulatory outcomes when decision-making processes are perceived as fair, transparent, and respectful.[16] Abrupt legal shifts without transitional mechanisms undermine not only expectations but institutional legitimacy.

The Alabama Supreme Court’s 2024 decision in LePage v. Center for Reproductive Medicine exemplifies this dynamic.[17] The court’s interpretation of the state’s wrongful death statute effectively reclassified embryos in a manner that significantly altered the legal framework within which IVF patients had structured their reproductive decisions, without providing a procedural mechanism to mitigate the consequences of that shift.

No notice period or prospective application was offered.[18] Had transitional safeguards been provided—such as prospective limitation of liability, grandfathering provisions, or time to transfer embryos—the regulatory change might have avoided the appearance of judicial arbitrariness. Instead, deprivation operated immediately and categorically.

As articulated in Mathews v. Eldridge, 424 U.S. 319 (1976)—a case involving the termination of Social Security disability benefits—due process analysis evaluates the private interest at stake, the risk of erroneous deprivation, and the probable value of additional procedural safeguards.[19] Although Mathews arose in an administrative benefits context rather than general legislation, its framework highlights a broader constitutional concern: when legal change creates a significant risk of unjustified deprivation of structured private interests, the availability of procedural mitigation mechanisms becomes normatively and institutionally consequential.

IV. Why IVG Raises the Stakes

Emerging technologies such as IVG will only amplify these procedural deficits. IVG would enable the creation of large numbers of embryos from somatic cells, increasing the frequency and complexity of decisions about storage, testing, and disposition. In some cases, abrupt legal reclassification could leave patients without access to what may be their only medically feasible pathway to genetically related parenthood or could render years of reproductive planning legally precarious. As reproduction becomes more regulated through licensing regimes, statutory definitions, insurance mandates, hospital oversight, and potential embryo registries, the consequences of abrupt legal reclassification by courts or legislatures grow more significant.

As reproductive technology governance becomes more structurally regulated, its insulation from individualized procedural protection becomes more consequential. When complex regulatory systems operate without mechanisms to manage reliance or provide transitional safeguards, the risk of systemic arbitrariness increases—not because of case-specific misjudgment, but because legal change leaves no room for mitigation.

Without mechanisms to surface contradictions in policy—such as promoting childbirth while chilling the technologies that enable it—the law risks becoming not only restrictive but internally incoherent. IVG does not simply expand scientific possibilities; it intensifies the need for governance structures that account for reliance, predictability, and the cumulative effects of regulatory change.

V. Conclusion: Procedural Legitimacy and Reproductive Governance

Reframing the regulation of reproductive technologies as a procedural due process problem does not require resurrecting Roe. It requires only recognition that even where the state may regulate reproduction, the legitimacy of that regulation depends on how change is implemented. Even where regulatory authority shifts from administrative agencies to legislatures or courts, the underlying demand for procedural fairness does not disappear; it becomes more difficult to enforce and more consequential when absent. Procedural safeguards demand transparency, neutrality, and meaningful opportunities for affected parties to anticipate and respond to regulatory shifts—features that procedural justice research identifies as central to legal legitimacy. They obligate states to justify not only what they regulate, but how regulatory change is structured and whom it disrupts.

When these safeguards disappear, reproductive governance risks sliding from constitutional order toward arbitrary power. The erosion of procedural norms normalizes a vision of reproduction as an administrative permission rather than a domain structured by reasoned and predictable legal processes. Even where substantive reproductive rights are contested, the durability and legitimacy of reproductive regulation depend on procedures that respect reliance, mitigate abrupt disruption, and constrain arbitrariness.

Reproductive technology governance without procedural fairness does not simply narrow autonomy; it undermines the constitutional commitment to law as a system of reasoned and accountable decision-making.

References

[1] See Nat’l Acads. of Scis., Eng’g & Med., Heritable Human Genome Editing 89–92 (2020).

[2] See Henry T. Greely, The End of Sex and the Future of Human Reproduction 1–20, 120–50 (Harvard Univ. Press 2016).

[3] Dobbs v. Jackson Women’s Health Org., 597 U.S. 215 (2022).

[4] See, e.g., Elizabeth Price Foley, Dobbs and the Future of Substantive Liberty, 64 Santa Clara L. Rev. 159 (2024).

[5] See, e.g., Erwin Chemerinsky, Constitutional Law: Principles and Policies § 10.1 (6th ed. 2019).

[6] Board of Regents v. Roth, 408 U.S. 564, 569–70 (1972); Mathews v. Eldridge, 424 U.S. 319, 332–35 (1976).

[7] Tom R. Tyler, Why People Obey the Law (1990).

[8] Dobbs v. Jackson Women’s Health Org., 597 U.S. 215 (2022); see, e.g., Elizabeth Price Foley, Dobbs and the Future of Substantive Liberty, 64 Santa Clara L. Rev. 159, 181 (2024).

[9] See Guttmacher Inst., State Policy Trends 2025: Full-Year Analysis (Feb. 4, 2026), https://www.guttmacher.org/2025/12/state-policy-trends-2025-full-year-analysis; Guttmacher Inst., State Policy Trends: Midyear Analysis (June 16, 2025), https://www.guttmacher.org/2025/06/state-policy-trends-midyear-analysis; Guttmacher Inst., First Quarter 2024 State Policy Trends (May 8, 2024), https://www.guttmacher.org/2024/05/first-quarter-2024-state-policy-trends.

[10] U.S. Const. amend. XIV, § 1; Mathews v. Eldridge, 424 U.S. 319, 332–35 (1976).

[11] See Board of Regents v. Roth, 408 U.S. 564, 569–70 (1972); Perry v. Sindermann, 408 U.S. 593, 601–02 (1972).

[12] See Perry v. Sindermann, 408 U.S. 593, 601 (1972).

[13] Santosky v. Kramer, 455 U.S. 745, 753–54 (1982); Goldberg v. Kelly, 397 U.S. 254, 267–71 (1970).

[14] Bi-Metallic Inv. Co. v. State Bd. of Equalization, 239 U.S. 441 (1915).

[15] See Bi-Metallic Inv. Co. v. State Bd. of Equalization, 239 U.S. 441, 445 (1915).

[16] Tom R. Tyler, What Is Procedural Justice?, 22 Law & Soc’y Rev. 103 (1988).

[17] LePage v. Ctr. for Reprod. Med., P.C., 2024 WL 1161240 (Ala. Feb. 16, 2024).

[18] The Alabama Supreme Court’s 2024 decision in LePage v. Center for Reproductive Medicine, No. SC-2022-0579 (Ala. Feb. 16, 2024), exemplifies this dynamic.

[19] Mathews v. Eldridge, 424 U.S. 319, 335 (1976).