Challenges of IVF

In a sermon a few of weeks ago I listed in vitro fertilization (IVF) among a handful of special ethical concerns for our time. My comments at that time were not directed toward anyone who may have used this procedure already. In this article I wish to summarize the issue so that we, as a church, may be better informed. [By the way, this article uses frank medical terminology and is intended for mature readers only.]

If a couple has had difficulty conceiving, IVF often is their last hope. The procedure usually begins with a prospective mother taking fertility drugs to produce extra eggs. These are harvested, placed in a dish, fertilized, and allowed to incubate for 48-72 hours. At this stage the embryos have four-to-eight cells. Embryos that appear to have developed normally are implanted in the uterus. Depending on the quality and quantity of embryos, and the age of the woman, several embryos are implanted at one time. The remaining healthy embryos, if any, are frozen for possible future use. In some cases, especially where triplets or more are expected, doctors may recommend “selective reduction” (i.e., abortion of one or more fetuses to give the other fetuses a better chance of survival).

So much for the basic facts. What are the ethical issues? Perhaps the most critical point is to consider whether life is being put in harm’s way. Clearly, a Christian couple would want to avoid the last step of the procedure I have just described, but the same ethical principles apply to other steps as well. What are those principles? First, according to Scripture, human life is sacred because we are created in the image of God (Gen. 1:26-27; 9:6). Second, God condemns the taking of innocent life (Exo. 20:13; Prov. 6:16-17). And third, the pre-born child has equal value in God’s sight (e.g., the same Greek word, brephos, is used by the physician Luke to describe fetus and infant alike; compare Lk. 1:41; 2:12).

Given these principles, there is no way to draw the line at some artificial point in the development of the child, which is why we insist that life begins at conception. The one-celled zygote (newly fertilized egg) and the glob of cells which make up the embryo are as much our concern as the clearly-recognizable fetus. The key problem is this: clinics must fertilize lots of eggs and implant multiple embryos to have any chance of success. According to national surveys conducted by the Centers for Disease Control (CDC), less than 30% of all embryo transfers result in live births. In some cases, all the embryos develop; in the majority of cases, some or all embryos will die. With over 50,000 procedures being performed every year, this raises deep concerns over the sheer quantity of embryos being created, and lost, by the IVF technique.

One objection is that miscarriages occur all the time in natural reproduction, so why worry about the extra embryos in IVF? There is a critical difference: In the case of natural reproduction, the survival of the zygote or young embryo is largely beyond our control. There is nothing we can do to aid life in the first few days after conception; it is “out of our hands,” so to speak. In the case of IVF, every step involves a choice: How many eggs are fertilized?, Which ones do we keep, implant now, or freeze?, and What do we do with the frozen embryos?

Speaking of which, if something should happen to the parents, such as divorce or death, the fate of frozen embryos becomes a tricky issue because the courts of our land are unwilling to grant them full human status. In one tragic case (Davis v. Davis), the husband finally obtained the frozen embryos and destroyed them so that his estranged wife could not have “his” children.

Couples seeking IVF usually have worthy motives: all they want is a child. IVF clinics have good motives, too: they want to help couples achieve their goal. But sadly, early human life is treated merely as a means to an end. This is not consistent with the inherent worth that God has accorded each human being.

Is there any way for Christian couples to avail themselves of IVF while avoiding these ethical problems? Perhaps, but only if a couple instructs the clinic to fertilize as few eggs as possible, and implant all the resulting embryos at some stage (including any that are frozen). This may not be practical. Fortunately, IVF success rates are improving all the time, so it should be possible to reduce the number of embryos per live birth. Indeed, the same CDC surveys mentioned earlier show that clinics can implant fewer eggs for about the same success rates. Also, many clinics providing IVF typically offer another program called GIFT. In this method, eggs and sperm are mixed and introduced into the fallopian tubes—there is no choosing, freezing, or disposal of embryos. This technique is not suitable for some medical conditions, but is slightly more successful than regular IVF, without its many ethical difficulties.

Some of the most challenging moral issues facing Christians today are those practices that are endorsed by laws of the land or social norms, but which the Bible does not address directly. But when it comes to medicine, we have to keep in mind one general, overriding principle: the sanctity of human life. This should be of utmost concern as we make critical decisions concerning the life of others.

© 2000 – 2010, Trevor Major. All rights reserved.

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