Informed Consent for Assisted Reproductive Technology

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A bill to be entitled 1
An act relating to informed consent for assisted 2
reproductive technology; amending s. 742.17, F.S.; 3
revising requirements for certain written disposition 4
agreements required between a commissioning couple and 5
a treating physician; creating s. 742.175, F.S.; 6
defining terms; prohibiting health care providers from 7
performing in vitro fertilization without first 8
obtaining informed consent from the commissioning 9
couple; requiring that such informed consent be 10
obtained each time a new in vitro fertilization cycle 11
is undertaken; requiring health care providers to 12
provide the patient certain information; providing 13
construction; specifying requirements for the informed 14
consent form; requiring health care providers to enter 15
into a written disposition agreement with patients to 16
track specified elections; specifying requirements for 17
such agreements; prohibiting health care providers 18
from discarding embryos for nonpayment unless certain 19
conditions are met; providing construction; requiring 20
health care providers to disclose their policies; 21
requiring health care providers to provide certain 22
disclosures within a specified timeframe; providing an 23
exception; requiring health care providers to provide 24
informed consent in the patients' primary language or 25

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with a qualified interpreter; requiring that the 26
informed consent form state whether an interpreter was 27
used; requiring health care providers to offer 28
patients the opportunity to ask questions and withdraw 29
consent without penalty at any time before an embryo 30
transfer; requiring health care providers to retain 31
certain records for a specified timeframe; requiring 32
health care providers to provide patients a copy of 33
their records upon request within a specified 34
timeframe; providing for disciplinary action; 35
providing construction; providing severability; 36
amending s. 456.072, F.S.; conforming a provision to 37
changes made by the act; providing an effective date. 38
39
Be It Enacted by the Legislature of the State of Florida: 40
41
Section 1. Section 742.17, Florida Statutes, is amended to 42
read: 43
742.17 Disposition of eggs, sperm, or preembryos; rights 44
of inheritance.—A commissioning couple and the treating 45
physician shall enter into a written agreement that provides for 46
the future use of the embryos by the commissioning couple, 47
continued storage with payment, embryo transfer to another 48
couple, permission for or prohibition of research donation, 49
selections for contingencies under s. 742.175(4)(b), and the 50

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disposition of the commissioning couple's eggs, sperm, and 51
preembryos in the event of a divorce, the death of a spouse, or 52
any other unforeseen circumstance. 53
(1) Absent a written agreement, any remaining eggs or 54
sperm shall remain under the control of the party that provides 55
the eggs or sperm. 56
(2) Absent a written agreement, decisionmaking authority 57
regarding the disposition of preembryos shall reside jointly 58
with the commissioning couple. 59
(3) Absent a written agreement, in the case of the death 60
of one member of the commissioning couple, any eggs, sperm, or 61
preembryos shall remain under the control of the surviving 62
member of the commissioning couple. 63
(4) A child conceived from the eggs or sperm of a person 64
or persons who died before the transfer of their eggs, sperm, or 65
preembryos to a woman's body shall not be eligible for a claim 66
against the decedent's estate unless the child has been provided 67
for by the decedent's will. 68
Section 2. Section 742.175, Florida Statutes, is created 69
to read: 70
742.175 Assisted reproductive technology; informed 71
consent; required disclosures; embryo disposition.— 72
(1) DEFINITIONS.—As used in this section, the term: 73
(a) "Assisted reproductive technology" has the same 74
meaning as provided in s. 742.13 and includes in vitro 75

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fertilization, intracytoplasmic sperm injection, embryo culture, 76
cryopreservation, and embryo transfer. 77
(b) "Commissioning couple" has the same meaning as 78
provided in s. 742.13. 79
(c) "Cryopreservation" means, with respect to embryos, 80
freezing the embryos in an undisturbed environment for the 81
purpose of saving them for future procreative use. 82
(d) "Cycle" means a single procedure of in vitro 83
fertilization, zygote intrafallopian transfer, or gamete 84
intrafallopian transfer. 85
(e) "Embryo" means the product of fertilization of an egg 86
by a sperm until the appearance of the embryonic axis. 87
(f) "Health care provider" means a health care 88
practitioner as defined in s. 456.001 who is authorized to 89
provide assisted reproductive technology services under his or 90
her applicable scope of practice. 91
(g) "Independently-reported success rate data" means 92
public, audited data on assisted reproductive technology 93
outcomes, including national and clinic-level reports, 94
maintained by the United States Centers for Disease Control and 95
Prevention's National ART Surveillance System and the Society 96
for Assisted Reproductive Technology. 97
(h) "Informed consent" means a voluntary, written, and 98
signed authorization, executed after receipt of the disclosures 99
required by this section provided in plain language 100

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understandable to a layperson. 101
(i) "In vitro fertilization" means a form of assisted 102
reproductive technology in which an egg retrieved from a woman's 103
ovaries is fertilized with sperm in a culture medium in a 104
laboratory and then transferred to the uterus for the purpose of 105
producing a pregnancy. 106
(j) "Selective reduction" means an abortion as defined in 107
s. 390.011 which reduces the number of fetuses in a multifetal 108
pregnancy by one or more to lower maternal and neonatal risks 109
and results in the intentional death of one or more fetuses with 110
the goal of continuing the pregnancy with fewer fetuses. 111
(k) "Single-embryo transfer" means transferring one embryo 112
in a given transfer procedure to reduce the risk of multiple 113
gestation, consistent with professional guidelines that limit 114
the number of embryos transferred by age and prognosis. 115
(l) "Transfer" means the process by which a health care 116
provider places a fresh or frozen embryo within the uterus, 117
fallopian tubes, or other part of a patient's body for the 118
purpose of initiating a pregnancy. 119
(2) INFORMED CONSENT REQUIRED.— 120
(a) A health care provider may not perform in vitro 121
fertilization, including ovarian stimulation, egg retrieval, 122
fertilization, embryo biopsy, embryo storage, and embryo 123
transfer, until each adult patient and, if applicable, both 124
members of the commissioning couple have executed the informed 125

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consent form required under subsection (3). 126
(b) A health care provider must obtain informed consent 127
each time a new cycle is undertaken and must provide updated 128
information to the patient with the latest statistics and 129
findings concerning the patient's status with each new cycle. 130
(c) This section supplements ss. 742.11–742.17 and does 131
not diminish requirements for written agreements regarding 132
gamete and embryo disposition under s. 742.17. 133
(d) This section does not prohibit a physician from 134
providing any additional information the physician deems 135
material to the patient's informed decision to undergo in vitro 136
fertilization. 137
(3) INFORMED CONSENT FORM.— 138
(a) The informed consent form must include all of the 139
following: 140
1. A description of the in vitro fertilization procedure. 141
2. Information about embryo conception and transfer, 142
including the patient's right to determine the number of embryos 143
or eggs to conceive and transfer, and the most recent scientific 144
information on the number of embryos needed to be transferred to 145
achieve a successful pregnancy. 146
3. A statement that the patient retains the right to 147
withhold or withdraw consent at any time before transfer of 148
gametes or embryos without affecting the patient's right to 149
future care or treatment. 150

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4. A description of the facility's practice regarding 151
selecting embryos that are viable to transfer and the outcome 152
for embryos that are deemed not viable for transfer, including 153
whether those embryos will be destroyed or used for training or 154
research. 155
5. A description of the facility's practice regarding 156
cryopreservation of embryos and the associated costs. 157
6. The effect of the following on treatment, embryos, and 158
the validity of informed consent: the health care provider's 159
practice closing; divorce; separation; failure to pay storage 160
fees for nontransferred embryos; failure to pay treatment fees; 161
inability to agree on the fate of embryos; the death of a 162
patient or others; withdrawal of consent for transfer after 163
fertilization but before cryopreservation; incapacity; 164
unavailability of agreed-upon disposition of embryos; or loss of 165
contact with the facility. 166
(b) The informed consent form must also disclose all of 167
the following: 168
1. Medical risks to the person undergoing treatment, 169
including all of the following: 170
a. Medication and ovarian response risks, including 171
ovarian hyperstimulation syndrome. The form must describe signs 172
and symptoms of and methods for preventing ovarian 173
hyperstimulation syndrome, including the use of individualized 174
ovarian stimulation, gonadotropin-releasing hormone agonist 175

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triggers, and freezing all embryos after a cycle to transfer in 176
a separate, subsequent cycle. The form must also state that 177
moderate-to-severe ovarian hyperstimulation syndrome occurs in 178
approximately 1 to 5 percent of cycles, varying by individual 179
risk and declining with modern prevention methods. 180
b. Procedure and anesthesia risks from egg retrieval, 181
including pain, bleeding, infection, injury to adjacent 182
structures, and rare serious complications. 183
c. Pregnancy-related risks, including ectopic pregnancy, 184
miscarriage, hypertensive disorders, and diabetes, noting that 185
ectopic pregnancy after in vitro fertilization has been reported 186
in the range of approximately 1.4 to 3.2 percent of in vitro 187
fertilization pregnancies, with patient-specific variation. 188
2. Medical risks to children conceived through in vitro 189
fertilization, specifically that: 190
a. Multiple gestation carries increased risks of 191
prematurity, low birth weight, and neonatal morbidity compared 192
with singletons. 193
b. Most children conceived through in vitro fertilization 194
are healthy, but some adverse outcomes, including premature 195
births or low birth weights among singleton pregnancies, have 196
been observed in surveillance reports, and that historic 197
multiple-embryo transfer practices contributed to higher 198
multiple-birth rates. 199
3. Risks of multiple gestation and selective reduction. 200

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The disclosure must: 201
a. Describe maternal and neonatal complications associated 202
with multiple gestation and explain that preventing multiple 203
gestation is the safest strategy. 204
b. Define selective reduction as provided in this section 205
and include the following statement: "If two or more embryos 206
implant, your physician may discuss an option that entails 207
intentionally ending the life of one or more fetuses to reduce 208
the total number of fetuses. You may accept or decline this 209
option." 210
c. Specify that, in accordance with chapter 390, any 211
selective reduction must be performed before the gestational age 212
of the fetus progresses beyond 6 weeks, unless an exception 213
under s. 390.0111(1) applies. 214
d. State that single-embryo transfer is an evidence-based 215
strategy to reduce multiple gestation and that professional 216
guidelines limit the number of embryos to transfer by age and 217
prognosis. 218
e. Identify practices available to minimize embryo loss or 219
destruction. The disclosure must enumerate options and allow 220
patient elections that include all of the following: 221
(I) Limiting fertilization to the number intended for 222
transfer in current and planned cycles. 223
(II) Single-embryo transfers where clinically reasonable, 224
avoiding embryo discard based solely on nonmedical traits. 225

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(III) Embryo cryopreservation and an embryo disposition 226
plan that prioritizes future transfer to the commissioning 227
couple or embryo transfer to another couple. Cryopreserved 228
embryos may be used for research or discarded only if expressly 229
authorized by the patients. 230
(IV) Mild or natural-cycle stimulation protocols when 231
clinically feasible. 232
(V) Preimplantation genetic testing limitations, including 233
possible no-result or mosaic findings, and the disclosure that 234
results are not infallible and do not require embryo discard. 235
4. Financial obligations and costs, including all of the 236
following: 237
a. A good faith itemized estimate of total cycle costs, 238
including professional and laboratory fees; anesthesia; 239
medications; preimplantation genetic testing, if elected; embryo 240
storage; and anticipated additional procedures. 241
b. A clear statement that ongoing storage fees will be 242
assessed for cryopreserved embryos and that nonpayment will be 243
handled only as set forth in the patient's embryo disposition 244
agreement under subsection (4) and s. 742.17. 245
5. The health care provider's transfer policy. If the 246
disclosure does not state the health care provider's transfer 247
policy, the default transfer policy is to perform single-embryo 248
transfers when clinically reasonable. 249
6. Alternatives to in vitro fertilization. The disclosure 250

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must include a description of reasonable alternatives, which may 251
include, but need not be limited to, timed intercourse, 252
lifestyle and medical optimization, natural procreative 253
technology-informed diagnostics, ovulation induction, 254
intrauterine insemination, use of donor gametes, adoption, 255
expectant management, and counseling. 256
7. Success rates and limits. The disclosure must include 257
all of the following: 258
a. Required national benchmarks, including present age-259
stratified independently-reported success rate data from the 260
most recent finalized Society for Assisted Reproductive 261
Technology National Summary Report and any companion first-262
transfer and subsequent-transfer tables provided for that year. 263
b. Independent sources patients can check, including the 264
URLs in print and electronically for: 265
(I) The United States Centers for Disease Control and 266
Prevention National ART Surveillance System's success rates for 267
national and clinic-level data and the Centers for Disease 268
Control and Prevention's guidance on interpreting cumulative 269
success. 270
(II) The Society for Assisted Reproductive Technology's 271
Clinic Summary Report, including national and clinic-level data 272
for the latest finalized year. 273
c. Clinic-specific context, explaining that the data from 274
the United States Centers for Disease Control and Prevention and 275

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the Society for Assisted Reproductive Technology is audited, 276
standardized, logged, and finalized after the reporting year, 277
and that individual prognosis varies by age, diagnosis, and 278
treatment plan. 279
d. A statement that Florida public policy favors singleton 280
births when medically safe and that health care providers should 281
discuss single-embryo transfer options to reduce the chance of 282
twins or higher-order multiples. 283
(c) The informed consent form must include initial lines 284
or checkboxes for each of the following patient elections, which 285
the health care provider shall honor unless such elections are 286
unsafe for the patient or unlawful: 287
288
...(Initial here)... Embryo creation limit. We 289
authorize insemination or intracytoplasmic sperm 290
injection of no more than ...(insert desired 291
number)... eggs per cycle. 292
293
...(Initial here)... Embryo transfer. We authorize the 294
transfer of ...(insert desired number)... embryos per 295
cycle. 296
297
...(Initial here)... Selective reduction preference. 298
Circle one: We decline/may consider selective 299
reduction if recommended. Health care provider policy: 300

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...(insert health care provider's policy on selective 301
reduction, specifying that all selective reduction 302
procedures must be performed in accordance with 303
chapter 390, Florida Statutes).... 304
305
...(Initial here)... Preimplantation genetic testing 306
election. Circle one: decline all 307
testing/preimplantation genetic testing for an 308
aneuploidy (PGT-A)/preimplantation genetic testing for 309
a specific condition (PGT-M) (condition: ...(insert 310
condition)...). We understand preimplantation genetic 311
testing is not infallible and does not require embryo 312
discard. 313
314
...(Initial here)... Financial responsibility. We 315
understand and accept responsibility for storage fees 316
until a disposition permitted above occurs. 317
318
(4) EMBRYO DISPOSITION; CONTINGENCIES.— 319
(a) A health care provider shall enter into a disposition 320
agreement pursuant to s. 742.17 which tracks the patients' 321
elections under subsection (3). 322
(b) The agreement must specify the patients' choices upon 323
death or incapacity of one or both patients; divorce or 324
separation; prolonged loss of contact; and nonpayment after a 325

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grace period. Options must include continued storage, transfer 326
to the patient or a gestational carrier, or embryo transfer to 327
another couple. Options for research donation or discarding 328
embryos must be expressly selected by the patients in order to 329
occur. 330
(c) A health care provider may not discard embryos for 331
nonpayment unless all of the following conditions are met: 332
1. The agreement expressly authorizes that outcome. 333
2. The health care provider has provided at least two 334
written notices to the patients' last known addresses and a 90-335
day grace period has passed. 336
3. Such action complies with all other applicable laws. 337
(d) This section does not require a health care provider 338
to offer services he or she does not provide; however, the 339
health care provider shall disclose his or her policies. 340
(5) FORM, TIMING, AND LANGUAGE ACCESS.— 341
(a) A health care provider shall provide the disclosures 342
required by subsection (3) at least 48 hours before the first 343
injectable medication, unless a shorter interval is medically 344
necessary and the patient affirmatively waives the time interval 345
in writing. 346
(b) A health care provider shall provide the informed 347
consent form in the patients' primary language or with a 348
qualified interpreter, and the informed consent form must state 349
whether an interpreter was used. 350

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(c) A health care provider shall offer patients the 351
opportunity to ask questions and to withdraw consent without 352
penalty at any time before embryo transfer. 353
(d) Electronic signatures are permitted if compliant with 354
state law. 355
(6) RECORDKEEPING.— 356
(a) A health care provider shall retain executed informed 357
consent forms, disposition agreements, and any subsequent 358
modifications for at least 7 years after the final embryo is 359
transferred, adopted, or otherwise lawfully disposed of, or for 360
the period required by other applicable law, whichever is 361
longer. 362
(b) Upon written request, a health care provider shall 363
provide a patient a copy of his or her records without charge 364
within 10 business days after receipt of the written request. 365
(7) ENFORCEMENT.—Failure to obtain informed consent as 366
required by this section constitutes grounds for disciplinary 367
action under s. 456.072. 368
(8) CONSTRUCTION.— 369
(a) This section does not alter parentage presumptions 370
under s. 742.11 or donor provisions under s. 742.14 or the 371
written agreement requirements of s. 742.17. 372
(b) This section does not mandate selective reduction or 373
embryo destruction, and patients may decline such procedures. 374
(c) The provisions of this section relating to selective 375

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reduction operate consistent with, and do not supplant, chapter 376
390. The limitations on abortions specified in s. 390.0111 apply 377
to selective reduction procedures referenced in this section. 378
Chapter 390 prevails in the event of any conflict with this 379
section. 380
(d) This section must be construed to permit patient 381
elections that minimize embryo loss consistent with medical 382
safety and applicable laws. 383
(9) SEVERABILITY.—If any provision of this section or its 384
application is held invalid, the invalidity does not affect 385
other provisions or applications of this section which can be 386
given effect without the invalid provision or application, and 387
to this end the provisions of this section are severable. 388
Section 3. Paragraph (uu) is added to subsection (1) of 389
section 456.072, Florida Statutes, to read: 390
456.072 Grounds for discipline; penalties; enforcement.— 391
(1) The following acts shall constitute grounds for which 392
the disciplinary actions specified in subsection (2) may be 393
taken: 394
(uu) Violating any provision of s. 742.175. 395
Section 4. This act shall take effect July 1, 2026. 396