Ethical Considerations and IVF

[Steve Curtis]

**Originally, this was posted in the "pastoral concerns" forum, but I wanted to open it up to a broader discussion**​

Most (if not all) of us would likely agree that the destruction of fertilized embryos (which often happens in IVF) would be the sinful taking of a human life. Further, most of us likely oppose preimplantation genetic diagnosis (PGD), the process of testing fertilized embryos for genetic diseases for the purpose of selectively implanting the “better” embryos (resulting in the “worse” embryos being discarded). Most also oppose donor eggs or sperm (i.e., third party participation in the pregnancy). With those caveats understood, what are your views on this scenario?

* - A married couple chooses to pursue IVF after being diagnosed with infertility issues
* - They instruct that only 2 (or 3) of the eggs extracted be fertilized
* - They further insist that both (or all 3) fertilized eggs be implanted (without conducting PGD)
* - They elect to freeze the extra eggs – but these eggs have not been fertilized – for possible use later (to avoid the costly and perhaps painful process of stimulating the production of eggs)


To begin the discussion, I found a few quotes in a cursory web search:

James Dobson: “in vitro fertilization is less problematic when the donors are husband and wife—if all the embryos are inserted into the uterus (i.e., no embryos are wasted or disposed of after fertilization and no selection process by doctors or parents occurs). As the woman’s body then accepts one or more embryos and rejects the others, the process is left in God’s hands. This seems to violate no moral principles.

Richard Land: ”It is never permissible for Christians to create more embryos than they plan to use.”

Al Mohler: “Christian couples must not embrace the new reproductive technologies without clear biblical and theological reflection. At a bare minimum, Christian couples must commit to the implantation of all embryos, and the selective reduction of none. But this does not alter the fundamentally artificial character of the technology or the moral status of the embryos, and thus IVF presents grave moral issues to the Christian conscience.

R.C. Sproul, Jr.: “Some Christians… only fertilize what they plan to implant, and carry these to term. The problem here, in my judgment, is akin to a problem with birth control- it separates what God has brought together. Though there might be still some latent gnostics in the Christian realm that see the marital act as a necessary evil allowable only when conception is possible, that is not my position. That said, there is something perverse about separating the marital act from its fruit.”

 

[jwithnell]

That's a tough question, and I think it also raises the dilemma caused by the original experimentation to create this process -- does accepting the end equate to accepting the means? Also the risk to both mother and children in a multiple-pregnancy are greatly enhanced raising sixth-commandment issues, enough to make me reject all forms of "assistance" at a time when I thought it might be needed. I'd find it hard to impose my conclusions on another couple, though.

 

[Peairtach]

I think John Jefferson Davis in his book "Evangelical Ethics" allows for this scenario. Maybe John Frame, too.

That said, there is something perverse about separating the marital act from its fruit.”

AIH is also artificial. I suppose those who allow for the type of IVF you're talking about would justify it because of the ''abnormal'' situation of the infertility.

Can something be moral which is not "natural"? Surely. Is some medicalisation of sexulality and fertility always immoral in itself? Surely not.

Jean

That's a tough question, and I think it also raises the dilemma caused by the original experimentation to create this process -- does accepting the end equate to accepting the means?

Well that opens a can of worms in itself, since how many medical breakthroughs have involved overtly immoral or unethical means? I suppose the further we are distanced from the immoral means by history, the less it can be construed that we are giving sanction to the means.

Ironically, science and technology often creates the infertility in God's providence by putting chemicals into the environment, and then seeks to correct it by some means that may be are morally legitimate, and others that are definitely not, some quite bizarre.

 

[brianeschen]

Various thoughts:

One thing to consider that has not been brought up too - the hormone treatment that the wife must undergo during this process can have harmful side effects.

I agree with all the quotes in the OP in this - anyone considering this process needs to wrestle with all the moral implications by searching Scripture. It is hard to keep this in mind because the desire for children is so great for those struggling with infertility.

If you know someone who is considering this process and would like to talk to someone who has been through just about everything, feel free to PM me.

 

[Edward]

I`d suggest that Mohler, Land and Dobson are probably on the right track. I'm not sure that Sproul junior is.

 

[JoannaV]

There is a form of IVF that only extracts 1 or 2 eggs, which some doctors will do. But of course that can end up being even more extremely expensive (and physically demanding) if you then need to do it again. And again. (Oh I guess you mentioned that in your scenario, as the reason why they were freezing unfertilised eggs. :doh )

I know some people who are opposed to IVF, yet are considering it because the pain of being childless is so great. It's a pain I can't understand, so it's not a subject I feel qualified to speak on beyond the most obvious factors. *For me* I tend to be generally against artifical type things unless necessary, with my definition of necessary being quite strong, but that's not something I have a solid argument for, it is just how I feel compelled to live.

For some couples embryo adoption might be an option, but only some

Hmm I don't know much about the mechanics of PGD but I could see it being used when placing embryos for adoption???

We all agree that there is a certain dependency on God in the creation of new life, and yet we can debate so many of the different lines that could be drawn as to what extent we are to actively do something and where it is to be "left to God". God has created us to be involved in the process - purely on a physical level our bodies are fertile at certain times. Our emotions etc can dictate when we engage in the act that may or may not lead to new life. If a couple particularly desire a child they can do various things to increase the probability of a pregnancy, for example the woman can be aware of certain bodily signs that indicate fertility, or she could even use the most artificial means of a thermometer to chart her basal temperatures. I'm not aware of anyone who would say this was wrong, though I may just not have encountered such an opinion? So then we start to ask how much intervention is too much. Is it wrong to do something to encourage the ovary to release an egg? Are such things akin to the "sweat of thy face" which accompanies gardening since the fall? (Nowadays a farmer might have an artificial tractor with a/c...)

The main consideration with IVF would then seem to be that it separates "the marital act from the fruit". This might seem obvious to some but I'm not so sure it is. In your scenario we are still considering children within the marital union. So I think there is still a connection, just not such a direct one. Also, it does not prevent the marital act from having direct fruit. I need to see some more Scripture/comments on this issue; it is not something I've thought about before.

I suppose the freezing of unfertilised eggs is not in itself a major concern. You either store your eggs in your ovaries or in a freezer. So if you've decided to use artificial means then it doesn't seem to make much difference. I know some people might say, "If the egg is in the ovary then God could choose for that egg to be released and fertilised, but if in the freezer it only has that opportunity if you decide to use it" but that seems a redundant argument to make if IVF has already been decided upon.

Like I said earlier, I really do not know anything about PGD. Like, does it have any risks to the embryos? But reading your scenario again I wonder if PGD wouldn't be so bad if used to implant a "better" embryo with one less likely to be viable.