Infertility and In Vitro
Fertilization (IVF)
FR. JAMES McTAVISH, FMVD
Infertility is a growing problem and at times in our pastoral ministry we
encounter couples who desire to undergo In Vitro Fertilization (IVF) to obtain
a child. They may even ask the ethical advice of a priest or remain perplexed at
why the Church says no to IVF. This short article gives the reader the essential
medical details of the process and provides a moral evaluation of the various steps
of the technique. The Church has to say no to IVF because it involves a massive
destruction of human life. The technique violates the dignity of the married act
and the child to be conceived is considered as a product and not a gift. In our
catechetical ministry it helps to emphasize that behind the Church’s “no” to IVF
is actually a bigger “yes” to life. Pastoral accompaniment should be provided to
those couples who have to carry the cross of infertility.
Keywords: Infertility, In Vitro Fertilization (IVF), embryo destruction, gift.
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A
t times in our pastoral ministry we encounter married couples
who are infertile. They would like to have children but
cannot. If the couple are socioeconomically well off it is not
uncommon for them to consider In Vitro Fertilization (IVF).
In the past they would have to go to neighbouring countries to have this
specialized procedure but now it is actually available in the Philippines.
Sometimes these couples will ask a priest friend for his opinion or ask
him to explain why the Church says no. This short article provides the
necessary background information to assist us in our catechetical task of
explaining why IVF is inherently wrong. The couple need pastoral support
and should seek other alternatives.
Let us begin by looking more closely at infertility.
1. Infertility
If 100 just married couples begin having sexual relations (with no
previous use of contraceptives) then within one year, 80 % of the women
would be pregnant. Of the remainder, 10 % would be classified as subfertile
but 10 % would be infertile.
Problems in the male account for 25% of cases of infertility, in the
female 40 % and combined male/female problems in the remaining 35%.
Infertility is a growing problem. Some probable causes include;
1. Delayed marriages and later childbearing
2. Sexually transmitted diseases
3. Pollution
4. Diet
5. Lack of exercise
6. Previous contraceptive use leading to sterility
7. Sterility from previous abortion
8. Falling sperm count in males (medicines, alcohol etc)
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It should be remembered that subfertile (not infertile) couples can use
Natural Family Planning in reverse i.e. to have sexual relations at the time
of ovulation when fertility is at its peak.
2. Data regarding IVF
The first IVF baby (sometimes known as a test-tube baby) was born in
England in 1978. Her name is Louise Brown. Since then the technique has
been increasingly used and by 1994 it was estimated that over 250,000 IVF
babies had been conceived and successfully born. By 2000, this number
had risen to over 1 million. By 2008 the number of IVF babies had reached
3.5 million worldwide.
Success rates vary between different clinics and hospitals and depend
on various factors most especially the age of the mother (as younger
women have a higher success rate). Overall IVF is probably around 15 30% successful.
The treatment is expensive. The average cost of total treatment is
$25,000 - $60,000 US dollars depending on which country the procedure
is carried out in.1
3. The technique of IVF
There are generally four major steps in the process of IVF:
i) Collect eggs from the woman
ii) Obtain sperm from the man
iii)In the laboratory, place eggs and sperm together to allow for
fertilization, to create embryos. Intra-cytoplasmic sperm injection
(ICSI) has been used since the 1990’s.
iv) Transfer embryos into uterus of woman
1
The Asian Hospital and Medical Center in Metro Manila quotes a price between
P200,000 - P400,000 per cycle of IVF. Accessed http://www.asianhospital.com/
healthdigestitem.aspx?qy=134 on 5 January 2012.
FEATURES: Infertility and In Vitro Fertilization (IVF)
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4. Moral issues involved in IVF
I) Collect eggs from the woman
The woman is given drugs to hyper-ovulate (produce many eggs). The
drugs can cause side effects such as abdominal pain, nausea etc.
II) Obtain sperm from the man
Obtaining sperm by masturbation may be morally objectionable.2
Sometimes donor sperm may be used which is not from the husband.
III) In the laboratory eggs and sperm are placed together to
allow for fertilization, to create embryos.
Embryos are then created in the laboratory (the test tube) thus the
human fertilization occurs apart from sexual intercourse and outside the
human body. The unitive-procreative dimension of the conjugal act is lost.3
The conjugal act, while most closely uniting husband and wife (unitive
aspect), capacitates them for the generation of new lives (procreative
aspect). We remember that the child has the right “to be the fruit of the
specific act of the conjugal love of his parents.”4
Usually, many embryos are created in excess of what is required.
The healthy ones are kept but defective embryos are destroyed. Healthy
embryos can then be transferred to the woman or they can be frozen for
use at later date. Sometimes they are experimented on.
In the USA alone there are more than 500,000 frozen embryonic
persons, a kind of “hell of ice.” In thawing them 50 % will die.
2
Is masturbation to provide a medical sample a different act from masturbation for
pleasure? Some moralists believe the two are not the same and their moral evaluation is
different.
3
The conjugal act, while most closely uniting husband and wife (unitive aspect),
capacitates them for the generation of new lives (procreative aspect) – see Humanae Vitae,
no. 12.
4
Catechism of the Catholic Church, no. 2378
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IV) Transfer embryos into uterus of woman
Many embryos are implanted in the mother’s womb (usually 2-4)
to increase the chance of pregnancy. Many of these implanted embryos
will spontaneously abort so many embryos are lost for every child born.
Despite this, multiple pregnancies are common which may affect the
mother’s health.
If an IVF child makes it to birth they are twice as likely to have a birth
defect or handicap, three times as likely to have a neurological defect and
up to seven times more likely to have a urological defect.
Three reasons why the Church says “No” to IVF
1. Massive destruction of human life
Many embryos are created in the procedure. The healthy ones are
kept but defective embryos are destroyed. The healthy embryos can then
be transferred to the woman or they can be frozen for use at later date.
What to do with the frozen embryos? Many embryos are implanted in
mother’s womb (usually 2-4) to increase chance of pregnancy. Should too
large a number of embryos start to grow, the “excess” embryos are usually
aborted (called “pregnancy reduction.”)
Currently the number of embryos sacrificed, even in the most
technically advanced centres of artificial fertilization, hovers above 80%.5
2. Separation of the unitive-procreative dimension of the
conjugal act
The Church’s teaching on marriage and human procreation affirms
the inseparable connection, willed by God and unable to be broken by
man on his own initiative, between the two meanings of the conjugal act:
the unitive meaning and the procreative meaning. By safeguarding both
these essential aspects, the unitive and the procreative, the conjugal act
preserves in its fullness the sense of true mutual love and its ordination
toward man’s exalted vocation to parenthood.6
5
Congregation for the Doctrine of the Faith, Instruction Dignitas Personae on Certain
Bioethical Questions (2008), footnote 27
6
See Humanae Vitae, no.12
FEATURES: Infertility and In Vitro Fertilization (IVF)
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In IVF the fertilization occurs in a scientific laboratory outside the
human body. This means that the unitive and procreative dimensions of
the marriage act are separated.
3. The child must be a gift not a product
A child “cannot be desired or conceived as the product of an intervention
of medical or biological techniques; that would be equivalent to reducing
him to an object of scientific technology. No one may subject the coming
of a child into the world to conditions of technical efficiency which are to
be evaluated according to standards of control and dominion.”7
How to react in front of an existing IVF child?
In front of an existing IVF child or in relating to their parents once the
child is already born, Donum Vitae teaches: “although the manner in which
human conception is achieved with IVF and Embryo Transfer cannot be
approved, every child which comes into the world must in any case be
accepted as a living gift of the divine Goodness and must be brought up
with love.”8
Need for a pastoral approach to infertility
Many infertile couples suffer tremendously – from their aching desire
to have their own child to the challenge of having to accept their condition.
Sometimes even the tests for infertility can be a little humiliating. It should
be remembered that the child is a gift from God and no one has a “right”
to a child. The one who has the rights is the child to be born. The reasons
for infertility are not always known. Neither should it always be explained
away as “the will of God.” If the infertility is the result of previous sexual
promiscuity with subsequent infection then it would be imprudent to
label this as God’s will. Neither should every couple who is infertile be
counselled with insensitive advice such as: “Well as a priest I can’t have
children either.” If a celibate has no children it is because of free choice
7
Congregation for the Doctrine of the Faith, Instruction Donum Vitae on Respect for
Human Life in its origin and on the Dignity of Procreation (1987). Part II, B, 4c
8
Donum Vitae II, B5
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not infertility. The Catechism of the Catholic Church gives the following
advice:
The community of believers is called to shed light upon and
support the suffering of infertile couples…Spouses are called
to find in it an opportunity for sharing in a particular way in
the Lord’s Cross, the source of spiritual fruitfulness…Physical
sterility can be the occasion for other important services to the
life of the human person, for example, adoption, various forms of
educational work, and assistance to other families and to poor or
handicapped children.9
As Church we note the increasing cases of infertility, we caution
against seeking recourse to IVF and commit ourselves to accompany
couples to help carry this cross. It may be with medical intervention the
couple may discover that the cause of infertility is treatable. In the whole
process the couple should be encouraged to pray and not lose faith in their
loving God - “Early the next morning they worshiped before the LORD,
and then returned to their home. When Elkanah had relations with his wife
Hannah, the Lord remembered her. She conceived, and at the end of her
term bore a son whom she called Samuel, since she had asked the Lord for
him” (1 Samuel 1:19-20).
The Church announces a “no” to IVF and a big “yes”
to life!
The Church must courageously oppose anything that threatens human
life like IVF. In saying “no” to IVF she is announcing a big “yes” to life.
As she teaches in Dignitas Personae the Church’s mission to protect the
poor “implies courageous opposition to all those practices which result in
grave and unjust discrimination against unborn human beings, who have
the dignity of a person, created like others in the image of God. Behind
every ‘no’ in the difficult task of discerning between good and evil, there
shines a great ‘yes’ to the recognition of the dignity and inalienable value
of every single and unique human being called into existence.”10
9
See Donum Vitae, Part II, B, 8,d
See Dignitas Personae, Conclusions
10
FEATURES: Infertility and In Vitro Fertilization (IVF)
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Questions
If you are asked “On what basis does the Church say no to IVF?” can
you now explain it?
How do you understand the inseparability of the unitive and procreative
dimensions of the conjugal act?
What is your ethical opinion about embryo destruction and freezing?n
Fr. James McTavish is a Scottish missionary priest with
the Verbum Dei community based in 39 Nicanor Reyes,
Varsity Hills, Loyola Heights, QC 1108. He worked as
a surgeon before hearing the call of the Lord to heal the
Body of Christ through evangelization − “Give me life by
your Word” (Ps. 119, 105). He teaches Moral Theology
and Bioethics at the Loyola School of Theology and
also gives courses in the University of Santo Tomas. He completed his Licence
in Moral Theology (Alphonsianum, 2008) and Masters in Bioethics (Regina
Apostolorum).
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