Walz family fertility journey was not run through I.V.F.

As Gov. Tim Walz of Minnesota has introduced himself to Americans through stump speeches across the country in recent weeks, he has alluded to a journey through infertility for his family while warning that conservatives want to restrict in vitro fertilization.

“Even if we wouldn’t make the same choice for ourselves, there’s a golden rule: Mind your own damn business,” Walz said on the night that Vice President Kamala Harris introduced him in their first joint rally in Philadelphia. “Look, that includes IVF. And this gets personal for me and my family.”

Many have assumed that his family relied on IVF to conceive their two children. Several news outlets, including The New York Times, The Associated Press and The Minnesota Star Tribune, have reported that the family relied on in vitro fertilization. Fertility advocates concluded as much after hearing Walz talk. In April, the Tim Walz for Governor campaign office mailed out a fundraising letter in an envelope that read: “My wife and I used IVF to start a family.’’

But when asked if the Walzes wanted to share more details about their effort to conceive, the Harris-Walz campaign recently clarified that the couple did not rely on IVF but rather another common fertility procedure called intrauterine insemination, or IUI.

The treatments have a key distinction: Unlike IVF, IUI does not involve creating or discarding embryos. And so anti-abortion leaders are not trying to restrict the treatment.

But for people having trouble getting pregnant, the procedures are often linked. Some patients say they are “doing IVF” as a catchall phrase for a wide range of fertility treatments. Walz has said that he and his wife spent seven years trying to have children.

IVF has a much higher success rate than IUI. But reproductive endocrinologists, or fertility doctors, may suggest that people struggling with infertility start with IUI, which is much less expensive and less invasive. In both cases, patients often take hormone medication to induce or augment ovulation. And individuals and couples going through the two procedures often walk through similar emotional journeys, where success can bring elation but each failed attempt can be devastating.

Those who begin such treatments can also find themselves entering a world of dizzying and occasionally awkward medical terminology.

IUI works by taking a sample of highly concentrated sperm and inserting it into a woman’s uterus with a catheter — effectively trying to mimic natural conception. The IVF process often involves creating and freezing multiple embryos in a laboratory, and transferring those most likely to result in a healthy pregnancy.

Since Walz began sharing his story, he has typically referred to his family as having undergone “treatments like” IVF. “Governor Walz talks how normal people talk,’’ said Mia Ehrenberg, a campaign spokesperson. “He was using commonly understood shorthand for fertility treatments.”

By tying IVF to his family’s experience, Walz has become a powerful messenger for the Democratic Party on a difficult issue for Republican leaders, who have tried to distance themselves from efforts by influential conservative Christians to restrict a popular procedure.

Infertility struggles are common. About 1 in 7 women in this country have trouble getting pregnant or sustaining a pregnancy, according to federal data, and some 12% of women have used fertility services, which can include testing for themselves or their partners, ovulation medications, IUI, surgeries to reverse blockages and IVF.

IVF accounted for close to 100,000 infants born in the United States in 2022, and a Pew Research Center poll from this year showed that it was viewed positively by a large majority of Americans.

The issue of IVF entered the national spotlight in February when the Alabama Supreme Court ruled that frozen embryos in test tubes should be considered children. The ruling prompted fertility clinics in Alabama to pause IVF services for fear that patients or providers could be legally liable if embryos were destroyed. Republican leaders like former President Donald Trump scrambled to reassure voters that they supported IVF.

In the ensuing backlash, Democrats saw that IVF could become a potent campaign issue in a consequential election year. It was also then that Walz and his wife, Gwen Walz, agreed that the governor should speak more openly about their own experience, Gwen Walz said in a statement provided to the Times by the Harris-Walz campaign.

“Gwen and I have two beautiful children because of reproductive health care like IVF,’’ he posted on Facebook after the ruling. “Don’t let these guys get away with this by telling you they support IVF when their handpicked judges oppose it.’’

In Tim Walz’s State of the State address a few weeks after the Alabama ruling, he characterized the decision as a “direct attack on my children.’’ On July 25, as Harris, newly seeking the presidency, considered running mates, Walz criticized Sen. JD Vance, the Republican vice-presidential nominee, for “opposing the miracle of IVF’’ by voting against legislation that would have protected access to the procedure.

Barbara Collura, the president of the infertility advocacy group Resolve, said that she recalled Walz addressing her organization’s annual event in 2017.

At the time, Walz was the ranking Democrat on the House Veterans Affairs Committee, and Collura’s organization was pressing for veterans to have broader health insurance coverage for IVF services. She recalled coming away from the speech with an understanding that Walz was “an IVF dad.” Collura said she was surprised but not bothered to learn that the Walzes had undergone a different fertility treatment.

People have approached Collura in recent days about Walz, she said, saying, “somebody is actually telling their fertility story, and that is meaningful to me.”

Conversations about infertility have long been held largely in private, and so there is a lack of common public language and knowledge.

“I think every reproductive endocrinologist would agree on this: These are very delicate issues for our patients,’’ said Dr. Gerard Letterie, a reproductive endocrinologist at Seattle Reproductive Medicine. “Guys don’t want to step forward and say, ‘I have low sperm count.’ Women don’t want to say, ‘I need technology to help me get pregnant.’’’

But since the overturning of Roe v. Wade, discussions of reproductive health care have grown more frank, with more women sharing stories about harrowing pregnancies, miscarriages and efforts to conceive. And Walz appears to be breaking ground as a vice-presidential candidate by discussing his family’s experience with infertility.

In a statement, Gwen Walz, who was working as a high school English teacher as the couple was undergoing fertility treatments in the mid-1990s and early 2000s, said that the only person who knew in detail what they were going through was a next-door neighbor. “She was a nurse and helped me with the shots I needed as part of the IUI process,’’ Walz said. “I’d rush home from school and she would give me the shots to ensure we stayed on track.’’

Gwen Walz described “the journey that is infertility” as a “desperation that can eat away at your soul.’’

In interviews, some advocates for people dealing with infertility said they were unconcerned about precisely which treatments the Walzes had undergone, and found the family to be an important voice for a large group of Americans who have often struggled in private, with little understanding from the broader public.

“That’s what politicians try to do,” said Briana Helgestad, of Lakeville, Minnesota, who, with her husband, Bill Helgestad, has undergone several years of infertility treatments, including IUI and IVF, “connect with people who are voting.”

This article originally appeared in The New York Times.