Editor’s Note: In recent months, there has been a renewed national conversation around in vitro fertilization (IVF), as politicians debate insurance coverages for the procedure on a national level. Many have pushed back against this, advocating for other methods of infertility care that do not come with the moral questions of IVF. Amid all this conversation, Lutherans may well wonder what we ought to think about IVF.
In this article, Dr. Donna Harrison, M.D., retired board-certified OBGYN, Director of Research (and former CEO) of The American Association of Pro-Life Obstetricians and Gynecologists, and LCMS Lutheran, unpacks the ethics of IVF from a medical perspective.
Stay tuned for an article on the theological implications of IVF, to be posted later this week.
As Lutherans, we receive and understand the second greatest commandment: to love our neighbor as ourselves (Matt. 22:39). The logical response to this commandment is, “Who is our neighbor?” Christ’s parable of the Good Samaritan shows us that our neighbor is any human being in need that God puts in our path. Is the human embryo a human being? If so, how should we treat our youngest and most vulnerable neighbor?
Is the embryo conceived through in vitro fertilization (IVF) a human being?
The term “human” refers to cells which have the genetic makeup of human beings. In scientific terms, a “being” is called an “organism.” An organism is defined as an entity whose structures and actions are directed toward the life and health of the organism as a whole. That is what makes an “organism” different from an “organ” like the liver, or from a cancer. Neither the organ nor the cancer coordinate their actions toward the life and health of the organ or cancer.
So, is the human embryo an organism? The answer is quite clear and well articulated by embryologist Dr. Maureen Condic:
Based on universally accepted scientific criteria, a new cell, the human zygote, comes into existence at the moment of sperm-egg fusion, an event that occurs in less than a second. Upon formation, the zygote immediately initiates a complex sequence of events that establish the molecular conditions required for continued embryonic development. The behavior of the zygote is radically unlike that of either sperm or egg separately and is characteristic of a human organism. Thus, the scientific evidence supports the conclusion that a zygote is a human organism and that the life of a new human being commences at a scientifically well defined “moment of conception.” This conclusion is objective, consistent with the factual evidence, and independent of any specific ethical, moral, political, or religious view of human life or of human embryos.
Elsewhere, Condic states:
The embryo acts in a coordinated, organismal manner to produce and to regulate its own development. All of the actions of the embryo are directed toward producing the structures and relationships required for the ongoing life and health of the embryo as a whole. At no time does the embryo even remotely resemble a mere human cell or collection of human cells.
So, scientifically, it is clear that a human being begins life at the moment the sperm fuses with the egg, forming a zygote, which is a one-celled embryo. That same human being continues through the different stages of zygote, embryo, fetus, newborn, toddler, child, adolescent, adult and aged adult until that human being dies.
In the process of IVF, when sperm and eggs are mixed in the petri dish and embryos are formed, roughly half of those embryos will die before they develop to the stage where they could possibly be implanted in the womb. But the amount of time we live does not determine our value as human beings. A human being that lives for only a few minutes or a few years is not less valuable than a human being with a longer life. Our requirement to love our neighbor as ourselves isn’t limited by the neighbor’s age.
The IVF industry and loving our embryonic neighbor
An embryo is the youngest and most vulnerable neighbor we will ever encounter. God has a fabulous design for caring for the physical needs of our embryonic children, including creating the embryonic child as a gift in the context of a loving bodily union of husband and wife. The egg comes from the mother, the sperm from the father. Both mother and father have a clear, God-ordained vocation to care for the children that God gives them from their union. Furthermore, beginning at fertilization, embryonic children are surrounded with optimal nourishment and protection designed to provide for their every need. Bonding with their mother begins in utero.
The context of the creation of human beings in IVF is fundamentally physically and emotionally different than with natural procreation, and this leads to one of the biggest ethical problems in the IVF industry: With IVF, there is not necessarily an intrinsic God-given vocational context. In the IVF industry, the legal “mother” and “father” are the ones who contract and pay for the IVF process in exchange for the production of a product, which is the child. Legally, the child formed using IVF is the property which is being bought and sold.
It is possible for any combination of human beings to contract for the purchase of a child via donor sperm, donor egg and gestational surrogacy and be considered the legal “parents.” In the IVF industry, the relationship of father, mother and child is just a social construct — a contract. The egg can come from any woman. That woman, as the “egg donor,” is not intrinsically considered the child’s mother. The child may be carried in a womb that was hired for the duration of pregnancy, i.e., a “gestational surrogate.” In other words, the womb in which the child grows and the woman that he or she bonds to in utero may or may not belong to the woman that the egg was taken from. And in fact, neither of these women may be the person who is the legal mother of that child. Similarly, in IVF, the sperm can come from any man, who is called the “sperm donor.” There is no requirement that the “sperm donor” have any previous, current, or ongoing relationship to, or even knowledge of, the child formed from his sperm, or to the egg donor, gestational surrogate or eventual legal parent. The child created under these circumstances may never know the love and belonging of their biological mother, father or siblings.
God designed human beings to be created and nurtured within a family to whom they are biologically related. While in some cases, such as adoption, the family does not look like this, we should approach intentional attempts to unravel or dismiss that design with great trepidation, especially because we do not know what the consequences of such unravelling may be for the child. Adoption does not intentionally unravel God’s design, but rather mirrors the love that God shows us when adopting us as His sons and daughters.
Some faithful Lutheran medical professionals would not recommend IVF at all because it takes the creation of a new human being out of the natural context of fertilization, which God designed specifically to be within the mother’s fallopian tube. Since the embryo in the tube generates hormones that alert the mother’s body to the embryo’s presence, there may well be some additional care and nurture that takes place even in the fallopian tube, which the embryo in the petri dish will miss because we cannot artificially replicate it. However, some faithful Lutheran medical professionals could possibly accept a form of IVF if it was done in a way that respected each embryo created as a human being, meant to belong in the womb of their mother and raised by their biological parents. This would preclude freezing embryos, which is inherently disordered and a mistreatment of embryonic children.
Lutherans should also be tremendously concerned that the IVF industry treats our tiniest neighbor as property, to be used or destroyed at will. We must reject the prevailing idea that these tiny human beings are property to be used or disposed of. We are responsible for protecting all of our neighbors, including the youngest and most vulnerable. In order to do this, we must have a serious understanding not just of the concept of IVF, but also of the facts about IVF.
The facts about IVF
IVF is often recommended to couples who have been unable to naturally conceive as a quick and sure way to end up with a baby. But IVF does not cure the underlying problem causing infertility. IVF simply sidesteps the problem with a technical workaround for God’s design.
IVF is done by removing eggs (an average of 12 eggs per retrieval) from a woman who has been hyper-stimulated with hormones to produce more than the natural one egg per cycle. (It should also be noted that this hyperstimulation carries some real medical risks for women.) Then, sperm is retrieved from a man and mixed with the eggs. The results are then incubated until visually recognizable embryos are formed. How many embryonic human beings form depends on the mother’s age and other factors.
The “best” human beings in the embryo stage are then identified visually, and the rest are discarded. (It has been demonstrated that many of these “poor quality” human beings in the embryonic stage can grow into completely normal children if they were transferred into a womb.) Once identified, one or two of the “best” human beings in the embryo stage are transferred to the womb of a woman. Since there is a choice of which human beings to transfer, the process is inherently eugenic. Human beings in the embryonic stage are selected for transfer based on the wishes of the people who have purchased them, according to what they want in a child: the right sex, the right physical features, etc. The rest of the embryos are generally frozen.
About one out of every ten human beings in the embryonic stage dies in the process of freezing. It is currently estimated that 90–98% of the human beings created in IVF are discarded, frozen or sent to a lab to be subjects of research. It is estimated that currently over 1.5 million embryonic human beings are frozen. Only about five out of a hundred human beings formed in IVF ever come to birth. In the IVF industry, there is little concern with the “excess” embryonic human beings who are not implanted. To end up with a living baby from IVF can cost hundreds of thousands of dollars. IVF “success” is measured only in whether or not the buyers walk away with the desired living child. To maximize “success” requires many embryos to be formed who are never implanted.
Options for infertile couples
It is time to step back and reevaluate the IVF industry, questioning whether or not this industry acts in the best interests of either the infertile couple or the human beings formed during the IVF process. There are alternative approaches to helping infertile couples.
One approach is called Restorative Reproductive Medicine (RRM), which is now gaining momentum. RRM focuses on fixing the underlying physical problems preventing the natural creation of human beings so that couples can procreate naturally. The success rate of RRM is equal to or exceeds the success rate of IVF, and works to enhance the relationship between husband and wife, rather than intruding into that one-flesh relationship.
Another alternative for the couple who cannot naturally conceive is embryo adoption, which mirrors born child adoption. In embryo adoption, the adopted embryo who already exists in a frozen state is rescued from certain death and brought into a family. Adoption is a relationship of love and compassion mirroring our adoption as God’s sons and daughters.
In conclusion
Many Lutherans have formed their families with IVF. Many Lutherans face the difficult reality that they have embryonic children still frozen. Many Lutherans were also given minimal information about the process of IVF, and most were not given information about the ethical difficulties, before being drawn into the IVF process.
The discussion surrounding IVF is close to home, difficult and emotionally painful. We can love and celebrate the lives of the children we have now no matter the circumstances of their conception and still take a hard look at whether or not the IVF industry is operating according to biblical principles. Lutherans look backwards in repentance, and forward in faith in Christ, who forgives us and leads us into newness of life.
