On May 22, 2026, Tennessee Governor Bill Lee signed legislation requiring fertility clinics in the state to join SART — the Society for Assisted Reproductive Technology — as a prerequisite for state certification to perform assisted reproductive technology (ART) procedures. The law describes SART membership as the “gold standard” for clinical quality, laboratory practices, data reporting, and patient care.

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It is the first law of its kind in the United States.

For patients seeking IVF treatment in Tennessee, this is a meaningful development. But it is not the reassurance it may appear to be. And for patients in every state, it is a reminder that legislation alone cannot protect you. Asking the right questions still can.

How This Law Came to Be

The Tennessee legislation did not emerge from a commitment to expanding fertility care. It emerged from a crisis.

In April 2024, the Center for Reproductive Health in Nashville abruptly closed, leaving patients without answers about the status of their frozen eggs, sperm, and embryos. As confusion spread, the threat emerged that the state might assert guardianship over reproductive tissue. The American Society for Reproductive Medicine (ASRM) recognized the danger immediately — not just for the affected patients, but for the legislative response that might follow.

At the start of the 2025 legislative session, two personhood bills were introduced in Tennessee, defining life and “unborn child” as beginning at fertilization. A separate bill sought sweeping new restrictions on fertility clinics, including a prohibition on genetic testing for embryo selection, a limit on the number of embryos that could be fertilized, and government oversight of unused embryos.

Had that bill passed, it would have devastated access to IVF in Tennessee.

ASRM worked with the Tennessee Medical Society and clinic representatives to offer an alternative — a bill that required SART membership rather than imposing direct government restrictions on clinical practice. That alternative became law when Governor Lee signed it in May 2026.

It is important to understand what this law is: a compromise reached in a hostile legislative environment, designed to head off something far worse.

What SART Membership Actually Means

SART is a professional organization affiliated with ASRM. Its member clinics are required to meet certain structural standards — accredited embryology laboratories, qualified staff, and submission of outcome data to the Centers for Disease Control and Prevention (CDC).

These are real requirements. SART membership is not meaningless. But patients should understand what it does not guarantee.

SART’s most visible function is publishing IVF success rates by clinic. Those rates — the numbers patients rely on when choosing a fertility clinic — are self-reported. Clinics submit their own data. SART does not independently audit or verify the numbers before publication. There is no external body checking the math.

This is not a secret, but it is not well understood by patients. The same organization that Tennessee has enshrined as the gold standard for clinic quality relies on an honor system for the statistics that matter most to the families walking through clinic doors.

As researchers Trolice, Madeira, and Lindheim noted in Fertility and Sterility, attorneys specializing in reproductive medicine malpractice have described the ART industry as “the Wild West of medicine — a realm where almost anything goes and almost no one knows what has gone on.” The absence of mandatory, independent error reporting in the United States remains a fundamental gap.

By contrast, the United Kingdom’s Human Fertilization and Embryology Authority (HFEA) requires fertility clinics to report laboratory incidents, near misses, and errors. According to HFEA data, 517 incidents were reported in 2022/23, 581 in 2023/24, and 792 in 2024/25 — with more than 99% of treatment cycles completed without incident. That is what genuine transparency looks like. The United States has no comparable system.

SART membership is a floor. It is not a ceiling. And it is not independent oversight.

The Political Reality in Tennessee

Patients in Tennessee should not mistake this law for the state legislature’s endorsement of IVF.

Tennessee is a state where personhood bills — legislation that would define life as beginning at fertilization — were introduced in the same session that produced this law. The legislators who supported those bills have not changed their position on when life begins or on the legal status of embryos. The law that passed was a negotiated outcome, not a philosophical shift.

The political environment for reproductive medicine in Tennessee, and in many states across the country, remains fragile. What the legislature has given, a future legislature can take away — or restrict further.

The Utah embryo personhood lawsuit, filed in 2026 by an anti-abortion organization arguing that embryos created through IVF should have the same legal protections as unborn children, signals where this conversation may be heading nationally. The Alabama Supreme Court’s 2024 ruling that frozen embryos can legally be considered children in certain situations created disruption that temporarily halted IVF services in that state.

Tennessee’s new law does nothing to address these legal questions. It regulates clinic quality standards. It does not protect IVF access if the legal or political landscape shifts.

What This Means for Patients — In Tennessee and Everywhere

Whether you are seeking fertility treatment in Tennessee or any other state, this law is a reminder that external protections are incomplete and that informed patients are their own best advocates. The questions that matter most are not answered by SART membership status alone. As a third-party specialist and industry leader, Karen Synesiou recently wrote for INCIID that patients should be asking their clinics directly:

• How are eggs, sperm, and embryos identified throughout the IVF process?
• Does the laboratory use an electronic witnessing system?
• Are barcodes, RFID technology, or other automated verification tools used?
• How are frozen embryos tracked and monitored?
• What safeguards are in place to prevent mix-ups?
• What happens if an error occurs?
• How old are the cryogenic storage tanks, and what alarm systems are in place?

These questions go beyond what SART membership requires of clinics. They get at the daily reality of laboratory safety — the thing that matters most when your embryos are in someone else’s hands.

Read Karen Synesiou’s full article: A Day in the Life of an Embryologist — The Questions You Should Be Asking About the Laboratory Process.

Advocate — Your Voice Matters

The Tennessee law was passed because patients and clinicians showed up. Clinic representatives opened their doors to state senators and explained the realities of fertility care. ASRM members provided testimony. Advocacy worked.

It needs to keep working.

If you live in a state with active fertility legislation, your voice matters. Contact your state legislators. Share your story. Support organizations that are tracking and responding to fertility legislation at the state and federal levels.

INCIID’s Fertility Legislation Tracker monitors active, enacted, and failed fertility legislation across all 50 states. Check your state. Know what is happening. Stay engaged.

The families who will benefit from stronger protections are the ones being created right now — in laboratories none of them will ever see, by professionals whose names they may never know, through processes most of them have never been asked to question.

They deserve better than self-reported statistics and negotiated compromises.

They deserve the same transparency that patients in the United Kingdom already have.

Until transparency is a reality, your most powerful protection as a fertility patient is to keep asking tough questions—and to refuse anything less than clear, honest answers.

References

1. American Society for Reproductive Medicine, Office of Public Affairs. SART Membership Now Mandatory in Tennessee. May 2026. https://www.asrm.org
2. Trolice MP, Madeira JL, Lindheim SR. IVF errors: Is this only the tip of the iceberg? Fertility and Sterility.https://www.fertstert.org/news-do/ivf-errors-only-tip-iceberg
3. Human Fertilization and Embryology Authority (HFEA). Incident reporting data 2022/23, 2023/24, 2024/25. https://www.hfea.gov.uk
4. Synesiou K. A Day in the Life of an Embryologist — The Questions You Should Be Asking About the Laboratory Process. INCIID. June 1, 2026. https://inciid.org/a-day-in-the-life-of-an-embryologist-by-karen-synesiou/
5. Society for Assisted Reproductive Technology (SART). https://www.sart.org
6. American Society for Reproductive Medicine (ASRM). https://www.asrm.org
7. Fertility Clinic Success Rate and Certification Act of 1992. Public Law 102-493. https://www.govinfo.gov/content/pkg/STATUTE-106/pdf/STATUTE-106-Pg3146.pdf

Nancy Hemenway is the Executive Director of INCIID (InterNational Council on Infertility Information Dissemination), a 501(c)(3) nonprofit serving the infertility, pregnancy loss, and family-building community since 1995. INCIID.org