IVF Within a God-sanctioned Marriage
Previously, we discussed the background of in vitro fertilization as a focal point of the debate around assisted reproduction technologies. We wanted to understand what kind of ethical concerns Christians should have when it comes to using medical technology to help increase the chances of pregnancy and childbirth. In order to isolate the unique ethical issues relating to the procedures themselves, it is necessary for us to first assume a framework of biblical marriage. God created mankind as a gender binary, male and female, to live together in an exclusive covenant bond so that the two become one flesh. It is in this context that procreation is meant to occur, so that man may multiply and fill the earth to rule over it according to God’s purpose in the beginning. This excludes any and all so-called same-sex marriages, cohabiting couples, poly amorous arrangements, or even individuals seeking to raise children alone.1
Sperm collection and ovarian stimulation do have some ethical concerns. As we mentioned before, the common use of pornographic materials in sperm collection presents a problem for Christians, but clinics are usually sympathetic to these concerns and offer alternatives. Some husbands take their wife into the collection room, if possible, while others may be able to collect semen at home and deliver to the clinic. The concerns related to ovarian stimulation mostly have to do with the increased risks involved when multiple eggs are fertilized. As Dr. Megan Best notes, “it would be negligent to expose the mother and children to the risks of a multiple pregnancy unnecessarily.”2 She also notes in an aside for doctors that there has not yet been much research into the possible long-term cancer risks of medications used to stimulate egg production.3
If nothing is done, the leftover embryos will die.
Dr. Megan Best
Normally, a woman’s body produces one mature egg each month during her ovulation cycle, but with the use of medication, doctors can stimulate her ovaries to produce 10-20 eggs in a single cycle. Because of the risks of multiple pregnancy, transferring more than two embryos at a time is medically negligent, and the best clinics will only transfer one at a time. This usually involves selecting the “best-looking” of the embryos, presumably based on the experience of the doctor as to which embryo has the best chance of survival. There does seem to be a bit of “playing God” here, where a question of life and death is based on external appearance and a doctor’s best estimate.
But what does that mean for the rest of the embryos? As Best states cryptically, “If nothing is done, the leftover embryos will die.”4 Since 1983 embryos have been frozen and later defrosted as needed. Again, there are challenges at every stage of this process. First, many clinics will only freeze the embryos that appear to be the most robust, but there is really no way to tell by looking which ones have the potential to develop into a baby. Second, some insurance companies do not pay for embryos to be frozen or limit how long they may be preserved. This is something that must be considered before a couple starts down the path of IVF. And third, a significant percentage of embryos will not survive defrosting, anywhere from 50%-90% according to Dr. Best.5
Of course, the question of whether freezing embryos is ethical comes before these practical concerns. If an embryo is a human being, is it morally permissible to freeze them? As Best notes, “We don’t usually freeze people.”6 Our actions toward human embryos must be guided by the principles of love for God and for our neighbor. If the embryo is my human neighbor, then I am duty-bound to protect each one from harm. One could argue that freezing them does protect them, and embryos can still be viable after being frozen for decades. Still, we should note that freezing embryos is unnatural, and treats embryos in a way that we generally do not treat human persons. In fact, as Carl Trueman recently argued, “the very procedures [IVF and surrogacy] require society to treat that person as a thing, a commodity.”7
If the embryo is my human neighbor, then I am duty-bound to protect each one from harm.
Once embryos are frozen a couple has a considerable amount of time to decide when and whether to have any more children. This means that their relationship may change significantly. What happens if they divorce and one person wants to transfer an embryo with a new partner? Or what happens if both parents die? Are these so-called “orphan embryos” heirs of their estate? If a surrogate agreed to gestate them, would that person be able to inherit? “This is a strong argument against freezing,” says Best, “because we freeze in anticipation of good consequences but we cannot foresee what will happen in the future.”8
Even if the couple lives and stays together, they may find that there are leftover embryos once they have had the children they want. What is to be done with them? Again, this is something couples should consider before deciding to use IVF to have a family. In many cases the embryos are eventually thawed and simply allowed to die, once the storage period has expired. To avoid this, Best offers this advice: “if you do decide to freeze embryos, create no more embryos than the number of children you are prepared to have. If you don’t want more than 6 children, don’t create more than 6 embryos. Make sure they are all transferred to the womb at some stage, if they do not pass away during development in the laboratory.”9 Of course, this does not completely eliminate the ethical concerns, since no one is able to know that he will live long enough to follow through on this well-intentioned plan to use all the embryos.
One alternative that allows the embryos the opportunity to survive is to donate unused, frozen embryos to other couples for reproduction. In this case, the embryo is defrosted and transferred to the womb of a woman who is not necessarily biologically related to the couple who created it. This allows the adoptive mother to carry the child from the beginning, so the couple can together experience pregnancy, birth, breastfeeding, and all the rest. Embryo donation and adoption does not seem to add any extra ethical concerns to those previously mentioned. In a world where IVF is already being practiced, it may be the best solution to the problem of a surplus of frozen embryos.
1There are other ethical issues to discuss relating to those kinds of non-traditional family arrangements, that we will discuss later. For now, we want to look at the ethics of IVF without those additional concerns.
2Megan Best, Fearfully and Wonderfully Made (Kingsford NSW: Matthias Media, 2012), 335.
3Ibid., 339.
4Ibid., 340.
5Ibid.
6Ibid., 341.
7https://www.christianpost.com/voices/do-you-think-that-children-born-by-ivf-are-human-beings.html
8Best, 344.
9Ibid.