BOSTON — A court battle is set to resume Friday over the Trump administration’s drastic cuts in medical research funding that many scientists say will endanger patients and delay new lifesaving discoveries.

A federal judge in Massachusetts temporarily blocked the cuts from taking effect earlier this month in response to separate lawsuits filed by a group of 22 states plus organizations representing universities, hospitals and research institutions nationwide.

The new National Institutes of Health policy would strip research groups of hundreds of millions of dollars to cover so-called indirect expenses of studying Alzheimer’s, cancer, heart disease and a host of other illnesses — anything from clinical trials of new treatments to basic lab research that is the foundation for discoveries. Now U.S. District Judge Angel Kelley, who was appointed by Democratic President Joe Biden, must decide whether to extend the temporary restraining order blocking those cuts.

The states and research groups say such a move is illegal, pointing to bipartisan congressional action during President Donald Trump’s first term to prohibit it.

“Yet here we are again,” attorneys argued in a court motion, saying the NIH is “in open defiance” of what Congress decreed.

In its own written arguments, the Trump administration said NIH has authority to alter the terms after awarding grants and that Kelley’s courtroom isn’t the proper venue to arbitrate claims of breach of contract.

States and researchers “have failed to show that they would suffer an irreparable injury,” according to the administration motion.

The NIH, the main funder of biomedical research, awarded more than 60,000 grants last year totaling about $35 billion. The total is divided into “direct” costs – covering researchers’ salaries and laboratory supplies – and “indirect” costs, the administrative and facility costs needed to support that work.

The Trump administration had dismissed those expenses as “overhead” but universities and hospitals argue they’re far more critical. They can include such things as electricity to operate sophisticated machinery, hazardous waste disposal, staff who ensure researchers follow safety rules and janitorial workers.

Different projects require different resources. Labs that handle dangerous viruses, for example, require more expensive safety precautions than a simpler experiment. So currently each grant’s amount of indirect costs is negotiated with NIH, some of them small while others reaching 50% or more of the total grant.

If the new policy stands, indirect costs would be capped at 15% immediately, for already awarded grants and new ones. NIH calculated that would save the agency $4 billion a year.

A motion filed earlier this week cited a long list of examples of immediate harm in blue states and red states. They included the possibility of ending some clinical trials of treatments at the University of Wisconsin, Madison, that could leave “a population of patients with no viable alternative.”

Officials at Johns Hopkins University were more blunt, saying the cut would end or require significantly scaling back research projects potentially including some of the 600 NIH-funded studies open to Hopkins patients.

“The care, treatments and medical breakthroughs provided to them and their families are not ‘overhead,’” university president Ron Daniels and Hopkins Medicine CEO Theodore DeWeese wrote to employees.

Attorneys also argued the cuts would harm state economies. The University of Florida would need to cut “critical research staffing” by about 45 people, while construction of a new research facility in Detroit expected to create nearly 500 new jobs could be paused or even abandoned, they wrote.

“Implementing this 15% cap will mean the abrupt loss of hundreds of millions of dollars that are already committed to employing tens of thousands of researchers and other workers, putting a halt to countless lifesaving health research and cutting-edge technology initiatives,” the lawsuit said.

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Neergaard reported from Washington.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

President Donald Trump on Tuesday signed an executive order aiming to reduce the costs of in vitro fertilization, a medical procedure that helps people facing infertility build their families.

“Americans need reliable access to IVF and more affordable treatment options, as the cost per cycle can range from $12,000 to $25,000,” the order said. “Providing support, awareness, and access to affordable fertility treatments can help these families navigate their path to parenthood with hope and confidence.”

The order instructed the assistant to the president for domestic policy to give Trump a list of policy recommendations on protecting IVF access and “aggressively reducing out-of-pocket and health plan costs for IVF treatment” within 90 days.

IVF became a talking point during the 2024 presidential campaign when Alabama agreed to protect in vitro fertilization providers from legal liability a couple of weeks after the state Supreme Court ruled that frozen embryos can be considered children under state law.

Trump said at the time he strongly supported its availability. And a June poll from The Associated Press-NORC Center for Public Affairs Research found that about 6 in 10 U.S. adults support protecting access to IVF, with 26% neutral and about 1 in 10 opposed.

In 2018, assisted reproductive technology, including IVF, contributed to 2% of all infants born in the United States, according to a report by the U.S. Centers for Disease Control and Prevention.

Here’s what to know about this increasingly common fertility treatment.

The procedure offers a possible solution when a woman has trouble getting pregnant, and it’s normally tried after other, less expensive fertility treatments have failed.

It involves retrieving the woman’s eggs and combining them in a lab dish with a man’s sperm to create a fertilized embryo, which is then transferred into her uterus in an attempt to create a pregnancy.

IVF is done in cycles and may take more than one. The procedure can use a couple’s eggs and sperm or those from a donor.

Insurance coverage of IVF and other fertility treatments can be patchy and depends on who provides insurance for the patient.

More large employers are offering the coverage to attract and keep workers. Many businesses also are extending coverage beyond those with an infertility diagnosis, making it accessible to LGBTQ+ couples and single women.

Government-funded programs such as Medicaid largely limit fertility treatment coverage. Coverage is less common among smaller employers.

Critics have said the lack of widespread coverage creates a divide, limiting treatments mainly to people who can pay thousands of dollars out of pocket.

The first baby conceived through IVF was born in 1978 in England. But the first in the U.S. was in 1981 in Norfolk, Virginia, with the birth of Elizabeth Carr.

Her mother, Judith Carr, had had three abnormal pregnancies, forcing the removal of her fallopian tubes. She and her husband sought treatment from Howard and Georgeanna Jones, doctors who opened a fertility clinic at Eastern Virginia Medical School.

The Norfolk clinic faced resistance before it even opened. When it sought a required state certificate in 1979, more than 600 people jammed into a public hearing. Several women voiced support for IVF and testified about wanting to start a family, while anti-abortion groups raised concerns about doctors interfering with human conception and embryos being discarded.

Despite proposed state legislation to stop the clinic, it opened in 1980, with others following soon afterward in California, Tennessee and Texas. By 1988, at least 169 in vitro centers were operating in 41 states.

The use of IVF continued to grow, but sentiments against it never really went away in the American anti-abortion movement, said Margaret Marsh, a history professor at Rutgers University in New Jersey.

Many abortion opponents had made an uneasy peace with the technology as a treatment for infertility, Marsh said. But opposition to IVF has gained momentum since the overturn of Roe v. Wade in 2022.

“Not everyone in the anti-abortion movement opposes these reproductive technologies, but many do,” she said.

The treatment often uses hormones to trigger ovulation so multiple eggs are produced and a needle is used to remove them from the ovaries.

Eggs can be fertilized by adding the sperm to the eggs in a lab, or a single sperm can be injected into each egg.

The fertilized egg is cultured over about five to six days to create the blastocyst — the early stage of an embryo — and is either transferred or stored for future use, said Dr. Jason Griffith, a reproductive endocrinologist in Houston.

Griffith said that on day three after fertilization, an embryo is anywhere from six to 10 cells. By day six, it’s between 100 and 300 cells. In comparison, he said, a person contains more than 1 trillion cells.

Frozen embryos can be used for future pregnancies, and the vast majority survive the thawing process.

The freezing process involves replacing the water in embryo cells with a protectant fluid and flash-freezing with liquid nitrogen, according to Johns Hopkins Medicine.

Frozen embryos are stored in tanks containing liquid nitrogen at hospital labs or reproductive medicine centers. Griffith said they can also be kept in storage facilities contracted by health care facilities, especially when they are stored for many years. Frozen embryos can be safely preserved for a decade or more.

Griffith said conditions are monitored in these facilities and there are physical security mechanisms to safeguard the tanks and backup generators in case of power outages.

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Ungar reported from Louisville, Kentucky. Associated Press writers Tom Murphy in Indianapolis and Ben Finley in Norfolk, Virginia contributed reporting.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

MADISON, Wis. — Wisconsin Democratic Gov. Tony Evers used his seventh State of the State speech Wednesday to urge the Republican-controlled Legislature to enact a wide range of proposals they have rejected in the past, including numerous gun control measures just a month after there was a school shooting not far from the state Capitol.

Here’s what to know about the speech from Evers, a Democrat who may run for a third term next year in the battleground state:

Evers, without mentioning President Donald Trump by name, said “there is a lot of angst about what may happen in the days, months, and years ahead.”

“I have always been willing to work with anyone who is willing to do the right thing for the people of Wisconsin,” Evers said. “And that has not changed. But I will not compromise on our Wisconsin values of treating people with kindness, dignity, empathy, and respect.”

Evers called for bipartisan efforts to address immigration and promised to fight any attempt to repeal the Affordable Care Act. He also repeated his pledge to veto any bill that limits access to abortion, birth control, infertility treatments, or any other part of reproductive care.

Wisconsin is one of 22 states suing the federal government over Trump’s attempt to end birthright citizenship.

Wisconsin is one of the “blue wall” states that Trump won in 2016 but lost in 2020. Trump carried Wisconsin in 2024 on his way back to the White House.

Evers called for a series of gun control measures five weeks after school shooting just six miles (9.66 kilometers) from the Capitol that left a teacher and 14-year-old student dead. The 15-year-old shooter shot and killed herself.

Evers called for universal background checks for gun purchases and restoring a 48-hour waiting period for gun purchases, a law that Republicans repealed in 2015.

He also called for banning the purchase of “ghost guns” and closing a loophole that allows for domestic abusers to own firearms.

Evers also called for incentives and new requirements to safely secure firearms and a “red flag” law that would allow judges to take guns away from people determined to be a risk to themselves or others.

Republicans have repeatedly rejected the proposals in the past.

“We cannot let common sense get lost in debates over whether basic policies could have prevented the most recent shooting, or the one before it, or the one before that,” Evers said. “We aren’t here in Madison to quibble about the semantics of the last shooting; we are here to do everything we can to prevent the next one.”

The governor last week created a state office for violence prevention, which Republicans vowed not to fund after federal funding runs out in two years.

Evers, a former teacher and state superintendent of schools, also called for spending $300 million to provide comprehensive mental health services in schools statewide. That would be 10 times the amount the Legislature approved for school mental health services in the last budget.

Declaring 2025 as “The Year of the Kid,” Evers called on Republicans to approve $500 million to lower the cost of child care. The bulk of that would go toward funding the Child Care Counts program, for the next two years. Without more funding, the program — which was created during the COVID-19 pandemic — is slated to end in June.

Evers also called for creating new programs designed to set price ceilings for prescription drugs and improve oversight of drug companies, removing the state sales tax on over-the-counter medications and capping the copay on insulin at $35.

He also repeated his previous call for them to allow for voters to place proposed law changes on the ballot themselves through referendums, something that Republican Assembly Speaker Robin Vos declared “dead on arrival.”

In an emotional moment, Evers welcomed the widow and parents of former state Rep. Jonathan Brostoff, who died by suicide in November. Evers, his voice cracking with emotion, talked about Brostoff’s death when introducing a new program that would allow people to temporarily and voluntarily register to prevent themselves from purchasing a firearm.