Before reading any further on Assisted Reproductive Technologies and In vitro Fertilization (IVF), it is important to state that all human beings are willed by and loved by God regardless of how they came into this world. Children who come into being through IVF or other morally problematic Fertility Treatments are beloved children of God. Each human life is sacred. We are all loved by God who created us.
Are fertility treatments immoral?
The short answer is, “it depends”. New technologies are emerging all of the time and it is impossible to review each fertility treatment in-depth on this page. Because each treatment cannot easily be given a “yes” or “no”, it is important that Catholics learn to evaluate the moral permissibility of such treatments on their own.
The first, and easiest, way to evaluate a fertility treatment is to ask the question “does this treatment separate the unitive end from the marital act?” If the answer is “yes”, then it is immoral. The act of marital intercourse is both procreative and unitive. Any fertility treatment that separates (or attempts to separate) the act of intercourse from its unitive end is immoral. One example of a fertility treatment that falls into this category is artificial insemination. In this case the husband does not inseminate his wife, a doctor does using either the husband’s sperm or a donor’s sperm. This type of treatment is immoral.
The second, and more nuanced, way to evaluate a treatment is to ask the question “does this treatment assist the natural act of intercourse or bypass it?” An example of something that assists the couple would be vitamins that improve the woman’s cervical mucus quality and make it easier for a couple to achieve pregnancy. This type of treatment does not bypass the natural act of intercourse and could be considered morally acceptable. An example of a treatment that bypasses the natural act of intercourse would be Gamete intrafallopian transfer, known as GIFT. This fertility treatment injects the wife’s eggs and the husband’s sperm into the wife’s fallopian tubes to allow fertilization to occur naturally; however, the natural act of intercourse is bypassed. This would be an immoral fertility treatment. Another way to assess this is by asking the question, "can conception and/or implantation occur without natural sexual intercourse?" If a baby can be conceived and/or implanted without having sex, then it is immoral.
It can be tricky to assess fertility treatments. In fact, some doctors will tell Catholic’s that they can use GIFT fertility treatments because “fertilization does not happen outside the body”. The problem is that these doctors do not understand what Catholics actually believe about procreation when they give bad moral advice like this. The moral permissibility of the various fertility treatments is widely misunderstood. If you ever face infertility in your marriage and want to ensure that the treatments you receive are not opposed to God’s good design, then you have options using NaPRO Technology. It is always recommend that you contact the National Bioethics Center for a free consultation.
What are Assisted Reproductive Technologies (ART)
Assisted Reproductive Technologies are a type of fertility treatment. They are a series of technologies that are used to help infertile or subfertile couples achieve pregnancy. In their definition of ART, the Center for Disease Control includes all fertility treatments in which either eggs or embryos are handled. ART does not include all types of fertility treatments. Each of the treatments that fall under the category of Assisted Reproductive Technologies separates the unitive end from the act of intercourse and are immoral.
In vitro Fertilization (IVF)
Of significant concern is a type of Assisted Reproductive Technology called In vitro Fertilization or IVF for short. IVF is an increasingly popular industry that is projected to make almost 34 billion dollars annually by the year 2028. More than 8 million babies have been born of IVF since the first IVF baby, Louise Brown, was born, interestingly, on July 25, 1978 which is 10 years to the day from the release of Humanae vitae. Over 1.5% of all babies born in the United States are born of IVF. Over 35% of all twins and 75% of all higher-order multiple births are directly attributable to ART and IVF. It is not known exactly how many frozen embryos there are in the world, but it is known for sure that there are over 400,000 embryos currently frozen worldwide with some estimates reaching 1.5 million frozen embryos. Needless to say, IVF is incredibly commonplace and it seems that very few people question if we ought to be doing it.
Fortunately, the Catholic Church has assessed IVF and is very clear that it is not permissible. IVF is morally problematic for a number of reasons; however, before going into those reasons, it is important to recognize that the desire for children is a good desire and that couples who face infertility should be helped with treatments that are morally permissible. It is also important to restate that babies born of IVF are beloved children of God and that their lives are sacred.
To understand why IVF is not a morally permissible fertility treatment, it is necessary to understand how it works. In IVF, a woman is given pharmaceutical drugs that force her ovaries to produce an unnatural amount of mature follicles, which will result in mature eggs, roughly 10-20. These eggs are then harvested prior to release from the follicle via needle aspiration. Some women will develop Ovarian Hyperstimulation Syndrome as a result of this procedure which can cause serious complications that can include death.
After collection, the eggs are then fertilized in a laboratory by sperm which are collected from the husband (or a donor) via masturbation. Approximately three to five days after the eggs are fertilized, the newly developing babies, called embryos, are analyzed and are given the grade of either A, B, or C with A being the best (or most viable) and C being the worst (or least viable). The embryos are then biopsied for genetic testing if the couple so desires. After grading and testing the babies they are discarded (if given a poor grade or if genetic testing showed an undesirable trait or condition) or they are frozen for later use. It should be noted that embryos who receive a “C” are often viable people who, if given the chance to be implanted, gestated and birthed, would grow into a healthy adults.
The woman is then administered another pharmaceutical drug that forces her uterus to grow a lining that will allow the embryos to implant and continue growing. Depending on how many embryos were produced and are going to be implanted, some are then thawed and transferred into the woman’s uterus while the others remain frozen for later use. Typically one to four embryos are transferred. Because every embryo transfer is very costly and because embryo transfers are often unsuccessful, more than one embryo is usually transferred at a time in hopes that at least one will “take.”
Depending on the age and health of the woman and the “grade” of the embryos, 20-60% of embryo transfers successfully result in implantation. Often times, more than one embryo will implant. In fact, over 40% of all IVF births are twins or higher order multiples. If too many embryos are implanted, then the woman will undergo a selective abortion to reduce the number of babies she will give birth to. This type of abortion is conducted in either the first or second trimester of pregnancy and is euphemistically referred to as “embryo reduction surgery” or “multifetal reduction surgery."
Women who undergo IVF have a higher rate of miscarriage than the general population at 20-50% depending on several factors. They also have higher rates of serious pregnancy complications such as ectopic pregnancy, preterm labor, low birth weight, preeclampsia and placenta Previa. IVF is also associated with a higher risk of developing certain types of cancer later in life. Children born of IVF are more likely to have birth defects. And as these children grow into adulthood, research is beginning to show that people born of IVF are more likely to have heart disease, hypertension, and certain cancers.
While there is not enough time to go into great detail in this post, it is important to highlight areas of IVF that make this procedure immoral: First, it separates the unitive end of martial intercourse from the act which violates the nature of human sexual intercourse and violates the dignity of the spouses. Second, masturbation (which is gravely immoral) is used to collect sperm. Third, it creates a system by which the embryos (who are human babies) are graded and tested which violates the dignity of those persons. Ultimately this system is used to classify these humans to determine who should live and who should die. Fourth, human babies who are not implanted are frozen, sometimes indefinitely. They are suspended somewhere between life and death with no ability to be baptized. They are neither permitted to live nor are they permitted to die which violates their dignity as human persons. Fifth, babies are aborted when too many embryos are intentionally transferred and then successfully implant. Sixth, IVF turns a procreative act of self-gift between spouses into a transaction in which a human being (the baby) becomes a product to be created, destroyed and sold. This is contrary to the dignity of the human person made in the image and likeness of God.
Given these reasons, it is easy to see why IVF is not a morally permissible fertility treatment. Other fertility treatments are definitely immoral as well and should not be done while still some treatments could be morally permissible in certain circumstances.
In conclusion, children are a gift from God. It is right and good for a married couple to desire children and seek to have children. But children are not a right that we can demand by any means necessary. Infertility is a true cross that some couples have to carry. As Christians we are called to assist people in carrying that cross. But the ways by which we do that must be in line with God’s laws and precepts. We can use morally permissible fertility treatments, adoption, grief counseling or other such means, but we cannot use Assisted Reproductive Technologies and In vitro Fertilization.