So far we have covered some basic background on reproductive technologies, surrogacy, and donor eggs/sperm. I believe that there are serious ethical concerns with each of these technologies, and my recommendation to anyone who embraces pro-life ideology would be to avoid them.
The second-to-last topic in this series is in vitro fertilization. This is typically shortened to "IVF." So, what is IVF? "In vitro" means "outside the body" and fertilization is the creation of a brand new human being. So, IVF is the creation of a brand new human being outside of the female body. Typically, parents that decide to try IVF have tried many other medications and therapies with no success. They desperately want a child, and science offers them hope.
Now realize that I am not saying that scientists are becoming God. They can't create life, only God can do that. What they can do is extract the sperm and the egg from a man and a woman and put them together to create a new human being. Once the embryo "takes" it can be implanted inside the mother and will hopefully attach and grow properly.
For the purposes of this post, let's assume that the mother (that is, the woman providing the egg) is planning to carry the child to term and parent him/her, and that the man providing the sperm is planning to walk through the pregnancy with the mother and parent the child in a loving and monogamous marriage. Since we have already covered the many ethical issues with surrogacy and donor material, this seems like a good place to start.
Let's take a moment and reflect on when human life begins. While many pro-choice people claim this is a thorny question that is impossible to answer, the fact of the matter is that life begins at conception. I'm not a scientist and I have very little interest in researching and explaining cell fusion and other science-y things, so go google it. You'll be fine. Maybe someday I will blog more extensively about why I believe life begins at conception, but today is not that day (neither is tomorrow, so simmer down).
If we believe, and I think most pro-life people do, that life begins at conception then we must be troubled by the fact that during the IVF process a very small, very fragile, person is created. This person can't speak for themselves, can't breathe, can't defend themselves, and can't live on their own. Arguably, these tiny embryos are the most vulnerable people on the planet.
Also, if we believe that life begins at conception, we must take a very hard look at any reproductive technology that manages or handles a zygote (fertilized egg) outside the human body. Because, that zygote is no longer just an egg or some sperm, a zygote is a very small human person. Some faith traditions also object to taking sperm outside of the human body (as far as I know there is no reason to extract eggs from a woman other than to begin the IVF process) but my belief is that the true issues don't come in until we're handling a zygote - a human.
I believe we all need to do the research and determine where we think the line is. For me, the bright ethical line with reproductive technology is drawn at any action that endangers or harms a human being. Since I believe that human life begins at conception, then any action that harms or endangers a zygote is unacceptable.
Let's take a closer look at IVF.
To start the process the egg and sperm need to be extracted from the human body. As discussed in the last post, this is somewhat dangerous for the mother but not as big of a deal for the father. When donating eggs, the goal is to extract as many as possible. This is still true for women who are hoping to keep their eggs, but there is not as much pressure on the mother. After the eggs have been extracted they are placed in a Petri dish and then exposed to the father's sperm.
Honestly, that kind of surprised me, I thought it was more scientific than just sticking them together. But, there you are.
The next day they're checked to see if fertilization happened. If it did, they're left alone until they start to divide. This is when they become embryos (a developmental term, not meant to dehumanize). If you believe that life begins at conception we're now dealing with very small humans.
After several days, one or more embryos are placed inside the mother in hopes that they will implant and grow. Any leftover embryos are destroyed or stored (cryopreservation is used, in layman's terms they are frozen) in case they are wanted in the future. The embryologists will discard any embryos that aren't considered viable.
I'm referencing a document from the Cleveland Clinic but my research shows that this is very similar to the procedures at other clinics. I am sure there are differences depending on where you go, but the overall process seems to be pretty standard.
Embryos can be screened very early on for genetic disorders or unwanted characteristics. Any embryo possessing a disorder (such as Down Syndrome) can be discarded in favor of a typical (often referred to as "normal") embryo.
There are a lot of problems here, let's look at them one at a time.
First of all, there is some risk to the embryo outside the womb. No matter how careful the embryologists are and how advanced the lab is, their natural home is inside the mother - not hanging out in a Petri dish. The risk to them increases when they have been frozen and thawed.
Second, unwanted or less viable embryos are discarded. I have talked to many women who say this doesn't happen, but it's part of the process. Not every embryo is going to make the cut. If they aren't progressing properly, they're not going to implant them. If life begins at conception they're already human even if they don't divide properly or they die early on inside the Petri dish.
What if they only take one egg? There is an option called "Natural IVF" where the only eggs retrieved are the ones (usually one or two) a woman produces naturally each month. This is done without all of the drugs to stimulate the ovaries and would produce fewer embryos. It seems like this is a very unpopular option, though, because the chance of failure is very high, and most of the other costs are the same. Even if only one or two eggs are retrieved, there are still greater than normal risks to the embryo.
A quick review of some fertility groups show that most women see dozens of eggs fertilized, but most don't "make it" long enough to be implanted. If we believe that each fertilized egg is a human, then this is extremely problematic.
What about after the embryos "pass muster" and are ready to be implanted? Implanting high numbers of embryos is no longer common, so any embryos that are left over need to be destroyed or preserved. A woman under 35 will typically have one or two embryos implanted. A woman 35 or over could have five to eight implanted because their chances of successful implantation are lower.
By the time they're ready to be implanted, the embryos are typically 3 to 5 days old. In a natural pregnancy, the mother hasn't missed a period yet and is unaware she is pregnant. Is there a certain amount of selection that happens in a natural pregnancy? Certainly. There is, however, a difference between allowing things to happen normally and interfering in the process.
One fertility website boasts of a 90% implantation rate with a high quaility blastocyst (3-5 day old embryo). Realize that when they're sorting for "high quality" embryos they're discarding "low quality" embryos. So, if a mother implants two or three embryos, she may end up with a twin or triplet pregnancy - if three embryos survive the selection process the clinic may be unwilling to implant all three because it could cause a high risk pregnancy.
Another potential cause of multiples is "twinning." This is when the blastocyst/embryo splits on his/her own after being inserted into the mother's uterus. So, if a mother is implanted with two or more embryos she could end up carrying triplets, quadruplets, or more. She may then be pressured to selectively reduce (abort) one or more of the babies, especially if one or more of them has a chromosomal or other abnormality.
If the parents have too many high quality embryos, they may choose to freeze them to use later. This could mean one or more babies are "stuck" in limbo waiting to see if they can be implanted. Typically, there are thought to be lower levels of success with frozen embryos than with fresh ones. There are pros and cons to each type of transfer (many of them cost-related).
So, what happens after they're frozen? What if mom and dad don't want any more kids? What if another pregnancy is too risky or mom can't do another IVF cycle? What if mom and dad split up, who gets the embryos?
There are a couple of options. First, mom and dad can just implant as many embryos as they can and hope for the best. As mentioned above, this could mean they have multiples in one pregnancy. It could also mean doing more than one or two IVF cycles. This is very expensive and can have physical side effects for the mother. There are also the emotional side effects for the whole family. Further, there is the very real question of how many children the family can manage. What if several embryos survive and some of them end up twinning? That could make for a LOT of babies.
A second option is to store the embryos indefinitely. However, if the parents aren't planning to use them, this is a no-win situation. The embryo lives in frozen limbo and mom and dad have to keep paying for storage.
Third, there is embryo adoption (sometimes called snowflake adoption). This is where the biological parents release their embryos to another couple. This gives the babies a chance to live and grow, and hopefully a decent shot at life.
IVF has a lot of ethical problems. Embryos (children) are created and managed outside the womb. The typical process involves sorting and discarding children that are less than ideal. Once that process is over, there is a chance that too many embryos will be high quality. This means that some of them have to be frozen - which may reduce their chances of being successfully implanted later. If mom implants too many embryos, she could end up with a high-risk pregnancy and decide to selectively reduce (abort) the "extra" babies.
IVF is a very risky procedure for babies, and I am going to go ahead and say this is not a pro-life option. Even if you only end up with one high quality or viable embryo there is a very good chance others were discarded. The implantation process is also not 100%. While the one website claimed a 90% success rates, the national statistics are much different. The most recent data is from 2016 and the success rate ranges from 15% (for older mothers) to 56%. That means that 85% to 44% won't make it.
It isn't enough to say "just don't do it." Many couples have already begun the process and have embryos in storage or in the process of maturing in hopes of implanting them. What do they do? Others have children conceived through IVF. Still others have friends and family considering IVF. Finally, we have approximately one million embryos in storage in the United States. What do we do with them?
If you have already started the process, do your best to complete it with minimal risk to your children. If you have to freeze them to save them, then perhaps that's what you need to do. If you're unable to implant the rest of the embryos, consider releasing them for adoption or allowing them to pass on. I'm not sure what the spiritual implications are for frozen embryos, but your family needs closure and they need to be allowed to find their way to heaven. I believe that you will see them again one day.
If you have children through IVF, be honest with them but realize that they're still just as human as anyone else. It is OK to question or even regret the process of their conception without loving them any less. Allow them to struggle if they need to, but don't push your emotions on them. If you haven't, take time to mourn the babies that were lost. It's OK to grieve for them. Think of IVF as similar to conceiving a child outside of marriage. The process of conception may not have been the right thing, but that doesn't make the child any less wonderful or valuable.
Do you have friends or family considering IVF? Talk about it. Don't stay quiet. Desperate couples do desperate things, and they may be willing to close their eyes to the problems and risks. Lovingly and gently talk to them about it.
Finally, we have the problem of frozen embryos. What do we do with one million frozen children? Well, either we allow them to pass on or we implant them. Those are really the only options. Which do you think is a better choice? Personally, I think implantation is the best option, but it would be a challenge to find enough willing mothers. If you're struggling with infertility I would encourage you to look into embryo adoption. These children need homes and their biological families are unwilling or unable to care for them. Are there still issues and risks with transferring these children? Yes, but I believe it could be the best choice in a bad situation.
Next time, and the final post in this series, we'll talk about pro-life options for growing our families. Stay tuned!