Two years ago, the Heritage Foundation analyzed the Centers for Disease Control’s (CDC) in vitro fertilization (IVF) data and found that approximately 4.1 million embryos are created via IVF each year, while the CDC reports that only 97,000 babies are born as a result of IVF annually. What’s even more shocking is that, although the CDC publishes data on the number of IVF cycles per year and live births as a result of those cycles, it does not publish or even track the fates of over four million unaccounted-for embryos each year.

This is unacceptable. Life begins at the moment of fertilization, and each embryo — whether formed in a womb or created in a lab — is priceless, unique, and deserves to be valued.

It’s long past time for the CDC to require better reporting on outcomes, not just of IVF cycles, but of the individual embryos created in those cycles. In the absence of decisive action from the CDC, states have the opportunity to take the lead — and they should. State-level reporting requirements for IVF would bring transparency where the CDC has failed to do so, acting on a simple truth: the fate of approximately four million embryos each year should not be a mystery.

Unfortunately, the pro-life majority in the South Dakota House just passed up the opportunity to lead on this, voting down HB 1182, which would have required an annual report on the fate of IVF embryos. Other states shouldn’t make the same mistake. Every legislator who recognizes that life begins at conception ought to understand the state’s vested interest in knowing what is happening to millions of lost human lives each year.

The Massachusetts Institute of Technology reports that between one and 10 million embryos are currently frozen in cryogenic storage in the United States. That is an astounding range, highlighting the profound lack of transparency and accountability in the IVF industry. The fact that we cannot even produce an accurate estimate of how many embryos are in storage, much less how many have been abandoned or simply lost, demonstrates a disregard for the lives being created in glass. Considering the tragic and preventable loss of life that has occurred due to storage tank failures and lab mix-ups, it also demonstrates a lack of concern for parents who are hoping to give their embryonic children a chance at life.

When pro-lifers have questioned why only 2.3% of IVF embryos result in a live birth, the industry has balked, insisting that loss of embryos is inherent to the process. It’s important to keep in mind that there’s a difference between the intentional destruction of an embryo and an embryo losing its life because it failed to continue to develop. If most or all of the embryos losing their lives in IVF are simply failing to develop and dying naturally, then the industry ought to be transparent with families about the level of risk for their embryos. However, given the growing number of add-ons like preimplantation genetic testing (PGT) promising parents the opportunity to ensure they are not transferring embryos with potential genetic abnormalities, and even the chance to select traits like sex, height, and eye color, it seems unlikely that the only embryos that don’t make it are the ones that simply didn’t survive the process — a tragedy in and of itself.

The add-ons and dubious promises of U.S.-based fertility clinics have made the U.S. an international destination for IVF and surrogacy. While other nations prohibit sex selection and limit the use of PGT testing, the United States fertility industry has embraced both — and even used them as marketing tools. Dr. Jeffrey Steinberg, a Los Angeles-based IVF provider, has cavalierly dismissed concerns about sex selection, arguing that it will essentially all come out even as his clients from India want boys and his clients from China are now starting to request more girls, while U.S. and U.K. clients are roughly 50-50 split, with a slight lean toward daughters. But how often do those preferences result in embryos abandoned indefinitely in frozen storage or discarded as medical waste? How often does the possibility of a genetic condition result in embryos being passed over? Without reporting, we simply don’t know.

Every life created through IVF is precious and deserves to be protected. Right now, we don’t even know what happens to the vast majority of those lives. That’s unacceptable. If the CDC will not lead on this issue, then it’s time for states to step up and require reporting on the fate of IVF embryos.

Patience Sunne serves as the director of Engagement at Them Before Us, a nonprofit dedicated to protecting children’s rights.