THE BILL ITSELF
HB 993
Informed Consent for Assisted Reproductive Technology
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A bill to be entitled
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An act relating to informed consent for assisted
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reproductive technology; amending s. 742.17, F.S.;
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revising requirements for certain written disposition
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agreements required between a commissioning couple and
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a treating physician; creating s. 742.175, F.S.;
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defining terms; prohibiting health care providers from
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performing in vitro fertilization without first
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obtaining informed consent from the commissioning
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couple; requiring that such informed consent be
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obtained each time a new in vitro fertilization cycle
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is undertaken; requiring health care providers to
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provide the patient certain information; providing
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construction; specifying requirements for the informed
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consent form; requiring health care providers to enter
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into a written disposition agreement with patients to
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track specified elections; specifying requirements for
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such agreements; prohibiting health care providers
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from discarding embryos for nonpayment unless certain
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conditions are met; providing construction; requiring
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health care providers to disclose their policies;
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requiring health care providers to provide certain
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disclosures within a specified timeframe; providing an
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exception; requiring health care providers to provide
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informed consent in the patients' primary language or
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with a qualified interpreter; requiring that the
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informed consent form state whether an interpreter was
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used; requiring health care providers to offer
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patients the opportunity to ask questions and withdraw
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consent without penalty at any time before an embryo
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transfer; requiring health care providers to retain
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certain records for a specified timeframe; requiring
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health care providers to provide patients a copy of
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their records upon request within a specified
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timeframe; providing for disciplinary action;
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providing construction; providing severability;
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amending s. 456.072, F.S.; conforming a provision to
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changes made by the act; providing an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Section 742.17, Florida Statutes, is amended to
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read:
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742.17 Disposition of eggs, sperm, or preembryos; rights
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of inheritance.—A commissioning couple and the treating
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physician shall enter into a written agreement that provides for
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the future use of the embryos by the commissioning couple,
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continued storage with payment, embryo transfer to another
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couple, permission for or prohibition of research donation,
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selections for contingencies under s. 742.175(4)(b), and the
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disposition of the commissioning couple's eggs, sperm, and
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preembryos in the event of a divorce, the death of a spouse, or
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any other unforeseen circumstance.
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(1) Absent a written agreement, any remaining eggs or
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sperm shall remain under the control of the party that provides
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the eggs or sperm.
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(2) Absent a written agreement, decisionmaking authority
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regarding the disposition of preembryos shall reside jointly
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with the commissioning couple.
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(3) Absent a written agreement, in the case of the death
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of one member of the commissioning couple, any eggs, sperm, or
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preembryos shall remain under the control of the surviving
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member of the commissioning couple.
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(4) A child conceived from the eggs or sperm of a person
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or persons who died before the transfer of their eggs, sperm, or
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preembryos to a woman's body shall not be eligible for a claim
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against the decedent's estate unless the child has been provided
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for by the decedent's will.
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Section 2. Section 742.175, Florida Statutes, is created
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to read:
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742.175 Assisted reproductive technology; informed
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consent; required disclosures; embryo disposition.—
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(1) DEFINITIONS.—As used in this section, the term:
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(a) "Assisted reproductive technology" has the same
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meaning as provided in s. 742.13 and includes in vitro
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fertilization, intracytoplasmic sperm injection, embryo culture,
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cryopreservation, and embryo transfer.
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(b) "Commissioning couple" has the same meaning as
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provided in s. 742.13.
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(c) "Cryopreservation" means, with respect to embryos,
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freezing the embryos in an undisturbed environment for the
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purpose of saving them for future procreative use.
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(d) "Cycle" means a single procedure of in vitro
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fertilization, zygote intrafallopian transfer, or gamete
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intrafallopian transfer.
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(e) "Embryo" means the product of fertilization of an egg
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by a sperm until the appearance of the embryonic axis.
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(f) "Health care provider" means a health care
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practitioner as defined in s. 456.001 who is authorized to
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provide assisted reproductive technology services under his or
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her applicable scope of practice.
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(g) "Independently-reported success rate data" means
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public, audited data on assisted reproductive technology
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outcomes, including national and clinic-level reports,
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maintained by the United States Centers for Disease Control and
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Prevention's National ART Surveillance System and the Society
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for Assisted Reproductive Technology.
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(h) "Informed consent" means a voluntary, written, and
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signed authorization, executed after receipt of the disclosures
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required by this section provided in plain language
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understandable to a layperson.
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(i) "In vitro fertilization" means a form of assisted
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reproductive technology in which an egg retrieved from a woman's
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ovaries is fertilized with sperm in a culture medium in a
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laboratory and then transferred to the uterus for the purpose of
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producing a pregnancy.
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(j) "Selective reduction" means an abortion as defined in
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s. 390.011 which reduces the number of fetuses in a multifetal
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pregnancy by one or more to lower maternal and neonatal risks
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and results in the intentional death of one or more fetuses with
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the goal of continuing the pregnancy with fewer fetuses.
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(k) "Single-embryo transfer" means transferring one embryo
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in a given transfer procedure to reduce the risk of multiple
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gestation, consistent with professional guidelines that limit
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the number of embryos transferred by age and prognosis.
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(l) "Transfer" means the process by which a health care
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provider places a fresh or frozen embryo within the uterus,
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fallopian tubes, or other part of a patient's body for the
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purpose of initiating a pregnancy.
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(2) INFORMED CONSENT REQUIRED.—
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(a) A health care provider may not perform in vitro
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fertilization, including ovarian stimulation, egg retrieval,
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fertilization, embryo biopsy, embryo storage, and embryo
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transfer, until each adult patient and, if applicable, both
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members of the commissioning couple have executed the informed
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consent form required under subsection (3).
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(b) A health care provider must obtain informed consent
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each time a new cycle is undertaken and must provide updated
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information to the patient with the latest statistics and
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findings concerning the patient's status with each new cycle.
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(c) This section supplements ss. 742.11–742.17 and does
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not diminish requirements for written agreements regarding
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gamete and embryo disposition under s. 742.17.
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(d) This section does not prohibit a physician from
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providing any additional information the physician deems
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material to the patient's informed decision to undergo in vitro
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fertilization.
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(3) INFORMED CONSENT FORM.—
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(a) The informed consent form must include all of the
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following:
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1. A description of the in vitro fertilization procedure.
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2. Information about embryo conception and transfer,
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including the patient's right to determine the number of embryos
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or eggs to conceive and transfer, and the most recent scientific
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information on the number of embryos needed to be transferred to
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achieve a successful pregnancy.
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3. A statement that the patient retains the right to
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withhold or withdraw consent at any time before transfer of
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gametes or embryos without affecting the patient's right to
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future care or treatment.
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4. A description of the facility's practice regarding
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selecting embryos that are viable to transfer and the outcome
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for embryos that are deemed not viable for transfer, including
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whether those embryos will be destroyed or used for training or
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research.
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5. A description of the facility's practice regarding
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cryopreservation of embryos and the associated costs.
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6. The effect of the following on treatment, embryos, and
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the validity of informed consent: the health care provider's
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practice closing; divorce; separation; failure to pay storage
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fees for nontransferred embryos; failure to pay treatment fees;
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inability to agree on the fate of embryos; the death of a
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patient or others; withdrawal of consent for transfer after
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fertilization but before cryopreservation; incapacity;
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unavailability of agreed-upon disposition of embryos; or loss of
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contact with the facility.
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(b) The informed consent form must also disclose all of
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the following:
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1. Medical risks to the person undergoing treatment,
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including all of the following:
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a. Medication and ovarian response risks, including
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ovarian hyperstimulation syndrome. The form must describe signs
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and symptoms of and methods for preventing ovarian
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hyperstimulation syndrome, including the use of individualized
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ovarian stimulation, gonadotropin-releasing hormone agonist
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triggers, and freezing all embryos after a cycle to transfer in
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a separate, subsequent cycle. The form must also state that
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moderate-to-severe ovarian hyperstimulation syndrome occurs in
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approximately 1 to 5 percent of cycles, varying by individual
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risk and declining with modern prevention methods.
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b. Procedure and anesthesia risks from egg retrieval,
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including pain, bleeding, infection, injury to adjacent
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structures, and rare serious complications.
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c. Pregnancy-related risks, including ectopic pregnancy,
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miscarriage, hypertensive disorders, and diabetes, noting that
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ectopic pregnancy after in vitro fertilization has been reported
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in the range of approximately 1.4 to 3.2 percent of in vitro
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fertilization pregnancies, with patient-specific variation.
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2. Medical risks to children conceived through in vitro
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fertilization, specifically that:
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a. Multiple gestation carries increased risks of
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prematurity, low birth weight, and neonatal morbidity compared
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with singletons.
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b. Most children conceived through in vitro fertilization
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are healthy, but some adverse outcomes, including premature
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births or low birth weights among singleton pregnancies, have
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been observed in surveillance reports, and that historic
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multiple-embryo transfer practices contributed to higher
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multiple-birth rates.
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3. Risks of multiple gestation and selective reduction.
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The disclosure must:
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a. Describe maternal and neonatal complications associated
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with multiple gestation and explain that preventing multiple
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gestation is the safest strategy.
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b. Define selective reduction as provided in this section
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and include the following statement: "If two or more embryos
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implant, your physician may discuss an option that entails
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intentionally ending the life of one or more fetuses to reduce
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the total number of fetuses. You may accept or decline this
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option."
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c. Specify that, in accordance with chapter 390, any
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selective reduction must be performed before the gestational age
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of the fetus progresses beyond 6 weeks, unless an exception
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under s. 390.0111(1) applies.
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d. State that single-embryo transfer is an evidence-based
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strategy to reduce multiple gestation and that professional
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guidelines limit the number of embryos to transfer by age and
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prognosis.
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e. Identify practices available to minimize embryo loss or
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destruction. The disclosure must enumerate options and allow
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patient elections that include all of the following:
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(I) Limiting fertilization to the number intended for
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transfer in current and planned cycles.
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(II) Single-embryo transfers where clinically reasonable,
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avoiding embryo discard based solely on nonmedical traits.
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(III) Embryo cryopreservation and an embryo disposition
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plan that prioritizes future transfer to the commissioning
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couple or embryo transfer to another couple. Cryopreserved
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embryos may be used for research or discarded only if expressly
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authorized by the patients.
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(IV) Mild or natural-cycle stimulation protocols when
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clinically feasible.
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(V) Preimplantation genetic testing limitations, including
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possible no-result or mosaic findings, and the disclosure that
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results are not infallible and do not require embryo discard.
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4. Financial obligations and costs, including all of the
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following:
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a. A good faith itemized estimate of total cycle costs,
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including professional and laboratory fees; anesthesia;
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medications; preimplantation genetic testing, if elected; embryo
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storage; and anticipated additional procedures.
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b. A clear statement that ongoing storage fees will be
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assessed for cryopreserved embryos and that nonpayment will be
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handled only as set forth in the patient's embryo disposition
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agreement under subsection (4) and s. 742.17.
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5. The health care provider's transfer policy. If the
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disclosure does not state the health care provider's transfer
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policy, the default transfer policy is to perform single-embryo
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transfers when clinically reasonable.
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6. Alternatives to in vitro fertilization. The disclosure
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must include a description of reasonable alternatives, which may
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include, but need not be limited to, timed intercourse,
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lifestyle and medical optimization, natural procreative
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technology-informed diagnostics, ovulation induction,
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intrauterine insemination, use of donor gametes, adoption,
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expectant management, and counseling.
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7. Success rates and limits. The disclosure must include
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all of the following:
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a. Required national benchmarks, including present age-
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stratified independently-reported success rate data from the
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most recent finalized Society for Assisted Reproductive
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Technology National Summary Report and any companion first-
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transfer and subsequent-transfer tables provided for that year.
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b. Independent sources patients can check, including the
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URLs in print and electronically for:
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(I) The United States Centers for Disease Control and
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Prevention National ART Surveillance System's success rates for
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national and clinic-level data and the Centers for Disease
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Control and Prevention's guidance on interpreting cumulative
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success.
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(II) The Society for Assisted Reproductive Technology's
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Clinic Summary Report, including national and clinic-level data
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for the latest finalized year.
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c. Clinic-specific context, explaining that the data from
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the United States Centers for Disease Control and Prevention and
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the Society for Assisted Reproductive Technology is audited,
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standardized, logged, and finalized after the reporting year,
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and that individual prognosis varies by age, diagnosis, and
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treatment plan.
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d. A statement that Florida public policy favors singleton
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births when medically safe and that health care providers should
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discuss single-embryo transfer options to reduce the chance of
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twins or higher-order multiples.
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(c) The informed consent form must include initial lines
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or checkboxes for each of the following patient elections, which
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the health care provider shall honor unless such elections are
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unsafe for the patient or unlawful:
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...(Initial here)... Embryo creation limit. We
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authorize insemination or intracytoplasmic sperm
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injection of no more than ...(insert desired
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number)... eggs per cycle.
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...(Initial here)... Embryo transfer. We authorize the
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transfer of ...(insert desired number)... embryos per
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cycle.
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...(Initial here)... Selective reduction preference.
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Circle one: We decline/may consider selective
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reduction if recommended. Health care provider policy:
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...(insert health care provider's policy on selective
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reduction, specifying that all selective reduction
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procedures must be performed in accordance with
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chapter 390, Florida Statutes)....
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...(Initial here)... Preimplantation genetic testing
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election. Circle one: decline all
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testing/preimplantation genetic testing for an
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aneuploidy (PGT-A)/preimplantation genetic testing for
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a specific condition (PGT-M) (condition: ...(insert
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condition)...). We understand preimplantation genetic
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testing is not infallible and does not require embryo
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discard.
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...(Initial here)... Financial responsibility. We
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understand and accept responsibility for storage fees
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until a disposition permitted above occurs.
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(4) EMBRYO DISPOSITION; CONTINGENCIES.—
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(a) A health care provider shall enter into a disposition
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agreement pursuant to s. 742.17 which tracks the patients'
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elections under subsection (3).
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(b) The agreement must specify the patients' choices upon
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death or incapacity of one or both patients; divorce or
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separation; prolonged loss of contact; and nonpayment after a
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grace period. Options must include continued storage, transfer
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to the patient or a gestational carrier, or embryo transfer to
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another couple. Options for research donation or discarding
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embryos must be expressly selected by the patients in order to
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occur.
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(c) A health care provider may not discard embryos for
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nonpayment unless all of the following conditions are met:
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1. The agreement expressly authorizes that outcome.
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2. The health care provider has provided at least two
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written notices to the patients' last known addresses and a 90-
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day grace period has passed.
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3. Such action complies with all other applicable laws.
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(d) This section does not require a health care provider
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to offer services he or she does not provide; however, the
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health care provider shall disclose his or her policies.
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(5) FORM, TIMING, AND LANGUAGE ACCESS.—
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(a) A health care provider shall provide the disclosures
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required by subsection (3) at least 48 hours before the first
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injectable medication, unless a shorter interval is medically
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necessary and the patient affirmatively waives the time interval
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in writing.
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(b) A health care provider shall provide the informed
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consent form in the patients' primary language or with a
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qualified interpreter, and the informed consent form must state
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whether an interpreter was used.
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(c) A health care provider shall offer patients the
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opportunity to ask questions and to withdraw consent without
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penalty at any time before embryo transfer.
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(d) Electronic signatures are permitted if compliant with
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state law.
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(6) RECORDKEEPING.—
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(a) A health care provider shall retain executed informed
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consent forms, disposition agreements, and any subsequent
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modifications for at least 7 years after the final embryo is
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transferred, adopted, or otherwise lawfully disposed of, or for
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the period required by other applicable law, whichever is
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longer.
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(b) Upon written request, a health care provider shall
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provide a patient a copy of his or her records without charge
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within 10 business days after receipt of the written request.
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(7) ENFORCEMENT.—Failure to obtain informed consent as
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required by this section constitutes grounds for disciplinary
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action under s. 456.072.
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(8) CONSTRUCTION.—
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(a) This section does not alter parentage presumptions
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under s. 742.11 or donor provisions under s. 742.14 or the
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written agreement requirements of s. 742.17.
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(b) This section does not mandate selective reduction or
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embryo destruction, and patients may decline such procedures.
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(c) The provisions of this section relating to selective
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reduction operate consistent with, and do not supplant, chapter
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390. The limitations on abortions specified in s. 390.0111 apply
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to selective reduction procedures referenced in this section.
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Chapter 390 prevails in the event of any conflict with this
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section.
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(d) This section must be construed to permit patient
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elections that minimize embryo loss consistent with medical
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safety and applicable laws.
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(9) SEVERABILITY.—If any provision of this section or its
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application is held invalid, the invalidity does not affect
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other provisions or applications of this section which can be
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given effect without the invalid provision or application, and
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to this end the provisions of this section are severable.
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Section 3. Paragraph (uu) is added to subsection (1) of section 456.072, Florida Statutes, to read:
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456.072 Grounds for discipline; penalties; enforcement.—
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(1) The following acts shall constitute grounds for which
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the disciplinary actions specified in subsection (2) may be
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taken:
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(uu) Violating any provision of s. 742.175.
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Section 4. This act shall take effect July 1, 2026.