Walz has conflated IVF and IUI when discussing his family. What’s the difference?

Minnesota Gov. Tim Walz speaks often about his family’s struggle with fertility. He’s also accused his vice presidential opponent, Sen. JD Vance, R-Ohio, and other Republicans, of wanting to end in vitro fertilization treatments, commonly known as IVF.

Vance, who opposes abortion, has said he supports continued access to IVF treatments.

IVF was thrust into the political spotlight in February after the Alabama Supreme Court ruled that frozen embryos are people, and that someone could be held liable for destroying them. Amid the already heated debate about abortion rights, reproductive rights advocates worried that Republican states would also move to limit access to the treatments.

Walz has tied the IVF discussion to his family’s fertility challenges.

But in speaking about IVF — a treatment that involves collecting mature eggs from ovaries and fertilizing them with sperm in a lab — Walz has at times made statements that have given the impression that he and his wife started their family using IVF, including in his inaugural remarks as Vice President Kamala Harris’ running mate. But the Walzes used another fertility treatment called IUI, or intrauterine insemination, which is often a precursor to IVF for patients.

• "Today’s IVF day. Thank God for IVF, my wife and I have two beautiful children," Walz said in a July interview on MSNBC’s "Inside with Jen Psaki."

• "If it was up to him (J.D. Vance) I wouldn’t have a family because of IVF," Walz said in a video clip shared online Aug. 9 by the Harris-Walz campaign. "My kids were born through that way," said Walz, who was speaking in an interview on the "Pod Save America" podcast in July before Harris chose him as her running mate.

• The New York Times reported that in April, the Tim Walz for Governor campaign office sent out a fundraising letter in an envelope that said, "My wife and I used I.V.F. to start a family."

• In Walz’s March State of the State speech in Minnesota, Walz called the Alabama Supreme Court’s IVF ruling that frozen embryos can be considered children "a direct attack on our family. It was a direct attack on my children."

In speeches after Harris chose him as her running mate, Walz made comments that could be read either as the couple having IVF treatments, or that they had nonspecific fertility treatments.

• In Walz’s first speech after Harris chose him as her running mate, Aug. 6 in Philadelphia, he said Republicans should mind their own business when it comes to people’s personal choices. "Look, that includes IVF, and this gets personal for me and my family," he said. "When my wife and I decided to have children, we spent years going through infertility treatments."

• Walz made similar comments in speeches in Glendale, Arizona, Detroit and Eau Clarie, Wisconsin, saying IVF was personal to him and describing the couple’s experience with fertility treatments. 

Other times, Walz has referred only to his family having fertility treatments or treatments "like IVF."

• In a Feb. 25 Facebook post, Walz wrote, "Gwen and I have two beautiful children because of reproductive health care like IVF. This issue is deeply personal to our family and so many others."

• In a March 13 X post, Walz wrote, "My wife and I went through fertility treatments for seven years. It's no coincidence that we named our daughter Hope. Reproductive care like IVF is personal — to our family and so many others. We’re going to make sure it stays protected in Minnesota."

• At an Aug. 10 Las Vegas rally, Walz said IVF and reproductive care are personal to him, and he spoke about a nurse coming over to give fertility shots to his wife. Both IVF and IUI treatments can require a patient to receive injectable medication.

• At an Aug. 17 speech in Omaha, Nebraska, Walz said, "When my wife and I decided we wanted to have kids, we spent years in fertility treatments."

• In two separate news interviews in  March and August, Walz referred to the couple receiving fertility treatments at the Mayo Clinic, but didn’t specify what kind of treatments.

In an Aug. 19 Glamour article, Gwen Walz, his wife, described the couple’s fertility issues and said they used IUI treatments.

In this 2018 file photo, a container with frozen embryos and sperm stored in liquid nitrogen is removed at a fertility clinic in Fort Myers, Fla. (AP)

IUI is another common fertility treatment that increases the chance of pregnancy by injecting sperm directly into the uterus at the time of ovulation. Oftentimes, doctors will start patients on IUI treatments before escalating to IVF, as it’s less invasive and less expensive.

IUI does not involve frozen embryos, as do IVF treatments. Some abortion opponents are opposed to IVF treatments because frozen embryos not used can be destroyed. 

Gwen Walz said in a statement shared with PolitiFact that she and her husband had kept their fertility treatments to themselves, but decided to discuss them publicly after seeing "extreme attacks on reproductive health care across the country," particularly in Alabama.

After the Glamour article was published, Vance accused Walz of lying about using IVF. "Who lies about something like that," he wrote in an Aug. 20 X post, sharing a video the Harris-Walz campaign had shared of Tim Walz speaking on the "Pod Save America" podcast.

Harris campaign spokesperson Mia Ehrenberg told PolitiFact in a statement that "Governor Walz talks how normal people talk. He was using commonly understood shorthand for fertility treatments."

Ehrenberg said, "Infertility is a deeply personal journey, but the Governor and Mrs. Walz came forward to share their story because they know that MAGA attacks on reproductive rights are putting all fertility treatments at risk."

Fertility doctors PolitiFact interviewed said patients often  conflate the terms IVF and IUI.

It's "incredibly common," said Dr. Eve Feinberg, a Northwestern Medical Group Reproductive Endocrinology and Infertility specialist. "And I would say especially for the male partner. Their role is the same in both, they provide sperm. So I often find that male partners use the terms interchangeably."

Dr. Leah Roberts, a reproductive specialist at Boca Fertility in Florida, also said her patients often use the term "IVF" to mean other fertility treatments.

"Most people who are not OBGYNs even, most people who are even physicians, or people in the general United States will often conflate the two," Roberts said. 

Roberts said most people undergoing IVF treatments today are actually undergoing intracytoplasmic sperm injection, a type of IVF treatment.

"A lot of this does come down to semantics, where the general population will use IVF to mean anything done in a reproductive endocrinologist's office for infertility care," Roberts said.

Roberts said once patients are done with their treatments, it’s easier to just tell people they had IVF rather than explain IUI to others.

"If you say IVF, people generally will understand that you went through infertility treatments without getting into the nitty-gritty of exactly how, when and where your children were conceived," Roberts said.

Ryan Stitzlein, vice president of political and government relations for Reproductive Freedom for All, an abortions rights group that supports the Harris-Walz campaign, said if IVF clinics were forced to close, access to IUI treatments could be limited.

"They’re the same clinics; they're the same doctors they're going after," Stitzlein said, noting that some Alabama fertility clinics shut down after the court ruling.

Feinberg agreed with Stitzlein, saying that an IVF ban would limit access for IUI treatments because fertility specialists perform the majority of treatments.

"So, if IVF becomes illegal and the clinics shut down, then it's going to severely restrict access for all," Feinberg said.

Roberts said fewer fertility clinics would mean less access to IUI treatments. Whether a law banning IVF would affect IUI directly, would depend on how the law was written, she said, but warned that laws can often have broader ramifications than lawmakers intend.

Roberts added it wasn’t common for people in Walz’s generation to discuss fertility treatments, and credited them for speaking out now.

"We should just encourage everybody to talk about it and address it and realize that 1 in 6 couples have infertility, and so it's more common than people may realize," Roberts said.