Barbara and I were a happily married couple when we decided to try and have a family. We had no idea it would be difficult to get pregnant. For most of our young, single lives we feared getting pregnant. Then, when we wanted to, we couldn’t. Like so many couples, we turned to fertility medicine.

I’ve written about our ups and downs with fertility medicine in my memoir, Not Your Father’s America. Early on, Barbara got pregnant. Twenty-three weeks later, she went into pre-term labor, which couldn’t be stopped, and gave birth to a tiny little girl whose life couldn’t be sustained outside of Barbara’s body. It was a heartbreaker.

Many attempts later, Barbara became pregnant again, this time with triplets. Having lost a baby born too soon, we feared how a high-risk triplet pregnancy might end. We consulted several Perinatologists about whether to “reduce” the pregnancy from three to two. After balancing atop what felt like a moral precipice and a medical dilemma for weeks, we decided to have triplets. And thankfully, we had a great outcome.

But today, post Roe, a reduction involving an embryo or nascent fetus would likely be considered an abortion, and a crime, even though intended to protect the life of the mother and assure the safe development and delivery of the other two fetuses.

According to reporting by CNN journalists Jessica Schneider and Tierney Sneed, now that the Supreme Court has thrown out Roe v. Wade, fertility medicine is in the crosshairs of anti-abortion forces spread across a disturbing number of states. And the doctors who practice In Vitro Fertilization (IVF), in which a sperm fertilizes an egg outside the body, are threatened, too.

Data published by the US Centers for Disease Control and Prevention indicates that approximately 2 in every 100 children born in the US are conceived through IVF. Now, experts say, the elimination of woman’s right to choose “could open up the legal terrain for states to seriously interfere with in vitro fertilization.”

When an individual or couple undergoes the IVF process, the work begins in a lab, where a sperm fertilizes an egg after weeks of preparation. The goal is to ultimately transfer a healthy embryo into a woman’s uterus. But first, the embryo must grow to blastocyst stage, which typically occurs between five and seven days after fertilization.

In other words, as our fertility doctor explained to us, conception is a process, not a “moment.” And because approximately half of all embryos are chromosomally abnormal, embryologists like to make as many embryos as possible. This way, they can choose to transfer the healthy embryos, while discarding the others. Those who are anti-choice are likely to see this essential selection process as “abortion.”

Now that Roe v. Wade has been overturned, an array of measures targeting IVF could, and probably will, threaten not only the future of fertility medicine but also the opportunity for many couples to start a family. To be safe, the CNN reporters say, some who are already using IVF may move their embryos out of states expected to be hostile to abortion.