A Christian understanding of in vitro fertilization
Editor’s note: In an effort to address critical life issues that people face today, Ministry occasionally publishes articles such as this. The goal of such articles is to promote conversation about topics—keeping in mind that the thoughts expressed therein do not necessarily reflect those of the editors or publishers.
Research testifies that the desire to have a baby remains one of the most primal and deep-seated desires of women.1 Without the biological urge to reproduce, our God-created species would die out. Many women grow up emulating their mothers and planning for their own family: how many kids they want, what they will name them, how they will raise them. Then, once married, many couples desire to raise a family of their own and have biological children. However, now more than ever, some couples find their desires and plans thwarted by infertility. As pressure mounts to have children (from society, family, and even church members), frustrations escalate within themselves and their marriage.
Infertility and the media
Our society has spoken loud and clear about infertility, bombarding us with advertisements for solutions, setting up icons that miraculously become pregnant, and focusing a significant amount of attention on the glorification of motherhood.
The quick fix to infertility in this “fast food” nation centers around assisted reproduction technologies (ART). Just look at the cover of many magazines and you will see features of otherwise infertile women using surrogates to become pregnant or undergoing in vitro fertilization or artificial insemination. With all the attention on the end result of pregnancy by any means possible, the medical and entertainment industries have not regarded the physical, emotional, and spiritual ramifications of scientifically produced children on the everyday woman. These women are our wives, sisters, and friends. As Christians we want to support them in infertility or get straight answers if we ourselves are dealing with this problem.
The IVF procedure
The goal of in vitro fertilization (IVF) consists of a straightforward process: to take a woman’s eggs and a man’s sperm, fertilize them outside the body, and then implant them back into the woman’s womb with the goal of pregnancy;2 but the process has many complicated steps in between.
Once a couple has concluded that they want to experiment with IVF, the woman will be set up with hormone therapy—taking fertility drugs through injection.3 This can be done from home, and the purpose of injecting these hormones is to stimulate multiple eggs to be produced. Known as “hyperovulation,” a woman begins to produce the many eggs needed for multiple fertilizations. During this time she goes into the clinic for checkups to see how her fertility levels are progressing. Once the doctor is satisfied that more than one egg can be removed, a woman then goes in for minor surgery requiring anesthesia, and the eggs are removed from both ovaries by inserting a long, thin needle through the vagina. Suction on the needle allows the eggs and fluid to be removed.
Semen is obtained from the husband most often through masturbation, although aspiration of the testis with a needle or punctuation with an automatic biopsy gun4 are also methods of collecting sperm. Once this has been accomplished, the doctor combines the sperm with the newly harvested eggs in hopes of fertilization, though, in some cases, sperm is injected directly into the eggs. Once the fertilized egg divides, it becomes an embryo. Some embryos are frozen for further use or eventually discarded.5 Other “fitter” embryos will be transferred into the woman’s womb. The number of embryos to be transferred is decided between the doctor and the couple. While two to three embryos are recommended, as few as one or as many as six can be transferred. The embryos are then placed in the womb by inserting a long, thin tube through the vagina and cervix while the woman is awake.
If the embryos implant into the womb, pregnancy is achieved. At this point, the doctor will advise how many of the implanted embryos should remain and how many should be “selectively reduced” or aborted in favor of healthier embryos. The remaining embryos will then either come to term as infants or be lost in miscarriage.
The drawbacks of IVF
Medical clinics advertise IVF with the emotionally laden promises of taking home a new baby, but what they do not reveal are the long, painful procedures that lead to complete fertilization. Drug therapy, invasive and time-consuming treatments, the ethical considerations of masturbation, destroying fertilized embryos, aborting implanted embryos, and a low success rate should all be considered while making this decision.
Emotional costs are great as well. For most women, IVF is the final attempt to conceive biologically and expectations can be inflated. While a lot of pressure for this costly and unpredictable service exists, stress can occur if spouses differ on how many rounds of in vitro to pursue, how many eggs should be implanted, how many should be frozen, and how many should be brought to term. In addition to stress, which negatively impacts libido,6 the focus taken off natural conception often results in sexual relations either subsiding or ceasing altogether. There are a few reasons for this. If fertility treatments involve injection of hormones into the body, then soreness in the abdomen can make intercourse painful or uncomfortable. Drugs taken to stimulate ovulation amplify emotions, causing mood swings, outbursts, and premenstrual syndromelike symptoms. Also, if progesterone suppositories are being inserted vaginally, one must wait both before and after insertion for sex to make the hormones most efficacious. Leaking suppositories during sex might also affect romance.7
However, due to concerns over becoming pregnant “twice”— through IVF and natural sex—and thus carrying too many fetuses, doctors tell patients to avoid sex during IVF treatment.8 An interrupted sex life can destroy the much needed, and God-given, physical bond between husband and wife.
Beyond all this, however, at any step along the way, failure of IVF is possible, forcing the couple to start back at the beginning with hormone therapy. Even after six complete rounds of IVF treatments, the take-home rate of a live baby remains at only 23–70 percent, according to the New England Journal of Medicine.9 That means 30–77 percent of women who have invested months of painful and body-altering treatments will not get to hold a biological baby in their arms.
God’s temple, your body
IVF can wreak havoc on a woman’s body and reproductive organs. The body was not made to endure hyperovulation, multiple pregnancies at the same time, and hormonal drugs. In the case of twins or higher-order multiple pregnancies, the mother will more likely develop high blood pressure or anemia,10 as well as having a higher risk for miscarriage, induced high blood pressure, preeclampsia (protein in the uterus), or gestational diabetes during pregnancy. Women carrying multiple fetuses are also more likely to have hemorrhaging, anemia, or die in childbirth compared with women who are only pregnant with one child at a time.11 The Bible tells us that our “bodies are temples of the Holy Spirit” (1 Cor. 6:19, NIV), and although in this specific context Paul addresses sexual union with someone outside of your spouse, this could be relevant to IVF, especially in the case of gamete donors.12 Even without donors, the Bible gives precedence for treating the body as a place worthy of God. Second Corinthians 6:16 says, “we are the temple of the living God” (NIV), and Jesus, too, refers to His body as a temple (John 2:19). Most Christians believe that taking care of their bodies reflects the image of God, but in vitro may compromise the physical body.
Despite these concerns, women, with their amazing sacrificial instincts, are willing to go through much suffering for the sake of love, and, therefore, even painful events like hormone shots, high blood pressure, fluctuating hormones, natural or caesarean birth, and the after-recovery of childbirth may seem worth the afflictions. These considerations must be weighed by the woman, for she owns her body, but the decision for IVF is not just for the wife to make.
The Bible tells us that in marriage, our bodies are not ours alone but our spouse’s as well (1 Cor. 7:4). Through marriage God unites two different people and makes them “one flesh” (Gen. 2:24, NIV). In marriage, spouses put each other first, attend to physical, emotional, and sexual needs and always seek the best for each other. Husbands are admonished to “love their wives as their own bodies” (Eph. 5:28, NIV), ensuring that their wife honors her body. We take care of our own bodies through proper nutrition, getting enough sleep and exercise, taking time for relaxation and community, and not intentionally harming ourselves with drugs or unnecessary procedures. If the husband would not be willing to put his own body through suffering, biblically he would not want his wife to attempt the same physical suffering. IVF does not just affect the woman; husbands must also determine how in vitro fits into their obligation to care for their wives as well. But beyond the matrimonial relationship, both spouses should be aware of additional risks to babies born through in vitro.
In the IVF process, embryos may be damaged through handling and exposure. Even if the baby comes to term, a strong likelihood exists that he or she will be born prematurely, with a low birth rate and complications.13 This is especially true of multiple births. Premature babies are usually characterized by slower development, a susceptibility to illness, and a higher chance of infant mortality.14 In addition to these medical complications, girl babies may have higher rates of infertility because of the use of fertility drugs during conception.15
In the end, couples must come to a unified decision for each other, themselves, and their potential children. Both spouses need to determine if IVF and the results of the process are glorifying to God, and consider if the physical risks of IVF—for the wife and the potential children—seem appropriate and wise.
Fertility clinics are not quick to advertise the financial cost of IVF. These clinics subsist as for-profit organizations in an industry that can make a lot of money on the pain of couples wanting children. Each round of IVF treatments costs about US$15,000.16 While not uncommon to undergo several cycles of in vitro, many couples simply cannot afford to invest the US$90,000 that six rounds of in vitro demand in order to have a moderately successful chance of conceiving.
Couples may feel stress due to financial considerations. As more time and money goes into the quest for a biological baby, it is not unusual for couples to dip into savings accounts, retirement plans, or other funds to pay for treatment. Tithing, charitable giving, and support of extended family members can fall by the wayside.
Of course, one cannot put a price tag on love and family, but one can measure their spending against a biblical background. Christians might consider the biblical principle of stewardship and determine how their use of money stands up against Jesus’ own words about giving to the needy and serving God above money (Matt. 6).
All this comes down to a fundamental question: Do I believe that God’s plan and purpose for my life can include infertility? I think many times we try to force God’s hand into a different path for ourselves by altering circumstances beyond our control. Our feeling of entitlement—to better health, a different personality, a certain lifestyle—blocks the potential that God has for us to utilize whatever He has given us, even if this potential goes beyond our understanding.
The Bible reassures us that God does have a plan for our lives. Romans 8:28 says, “we know that in all things God works for the good of those who love him” (NIV). This does not mean that we will get everything we want, but it does mean that we are secure in the plans of God. When the pain and isolation involved in infertility comes into the lives of a Christian couple, an appropriate response can be found in the Scriptures.
The Bible tells many stories of infertile couples: Abraham and Sarah (Gen. 16; 18; 21), Rachel and Jacob (Gen. 29:31–30:24; 35:16–25), Hannah and Elkanah (1 Sam. 1), and Elizabeth and Zechariah (Luke 1), but the Bible also has beautiful promises for those who could not have children. The Lord will not shame women for being unable to produce biologically but will treat them as equals (see Isa. 54:4). At a time when a husband could divorce a woman for not giving him children, this passage demonstrates that God’s love and acceptance transcends worldly values. Later in Isaiah, God says that it is better to receive an eternal heavenly status than have a worldly legacy that will pass away (Isa. 56:3b–5). For this reason, God promises those who cannot have children an eternal legacy in the Lord. God knows that the desire to leave a “name” after one dies is a goal for many people, and we are reassured that in heaven, we will have that legacy; the Lord magnificently provides for us in His eternal plan.
Yet we live on earth right now, and even an eternal promise may not dull the yearning for children. So some couples choose to bypass the frustration of IVF and seek more reliable routes to satisfy the desire for raising children, such as adoption, fostering, acting as a sponsor parent to children in need, or a change in their vocation so they are around children more. Others decide to live child-free and invest their time and money in spiritual progeny through contributions to the church and missions.
In whatever paths Christians choose to take on the emotional road of infertility, they are not alone. Not only should the couple sort out the issues and options surrounding the desire to have a family, but all people—couples and singles, male and female—in the congregation and church body at large need to support the mission of Christ by not reducing a person’s worth to if or how many children they can have biologically, but by supporting couples in producing many children spiritually. We are all called to make new disciples for Christ.
1 John F. Kilner, Paige C. Cunningham, and W. David Harger, The Reproductive Revolution: A Christian Appraisal of Sexuality, Reproductive Technologies, and the Family (Grand Rapids, MI: Eerdmans, 2000), 40.
2 Teresa Iglesias, IVF and Moral Justice: Moral, Social, and Legal Issues Related to Human In vitro Fertilization (London: The Linacre Centre, 1990), 30.
3 Edwin C. Hui, At the Beginning of Life: Dilemmas in Theological Bioethics (Downers Grove, IL: InterVarsity Press, 2002), 190.
4 “Masturbation,” World In Vitro Fertilization Units, www.ivf-worldwide.com/Education/sperm-collection.html.
5 Kilner, 108.
6 “Low Sex Drive in Women,” Mayo Clinic, at www .mayoclinic.com/health/low-sex-drive-in-women/DS01043 /DSECTION=causes.
7 Ernest H. Y. Ng, Benyu Miao, Wai Cheung, and Pak-Chung Ho, “A Randomised Comparison of Side Effects and Patient Inconvenience of Two Vaginal Progesterone Formulations Used for Luteal Support in In Vitro Fertilisation Cycles,” Abstract, European Journal of Obstetrics & Gynecology and Reproductive Biology 111, no. 1 (November 10, 2003).
8 “Sex Warning for IVF Couples,” BBC News, October 26, 2001.
9 Beth A. Malizia, MD, Michele R. Hacker, ScD, MSPH, and Alan S. Penzias, MD “Cumulative Live-Birth Rates after In vitro Fertilization,” New England Journal of Medicine, 2009, 236–43.
10 “Pregnancy: Frequently Asked Questions,” American Congress of Obstetricians and Gynecologists, August 2011.
11 “Risks to the mother,” One at a Time: Better Outcomes for Fertility, http://www.oneatatime.org.uk/37.htm.
12 See statement number three in the General Conference of Seventh-day Adventists Administrative Committee, “Considerations on Assisted Human Reproduction” (ADCOM), 1996.
13 Stephanie Saul, “The Gift of Life, and Its Price,” New York Times, October 10, 2009.
14 Kilner, 45.
15 Hui, 198.
16 Iva Skoch, “Should IVF Be Affordable to All?” Newsweek, July 21, 2010.
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