Moral Implications of Fertility Issues

We recently asked a physician expert to answer an email question we received that was way out of my league. Dr. Jessica Farnsworth gave such an excellent reply that we got her permission to use it as a guest blog. Thanks, Jessica!

couple walkingThe question: What things should we consider about intra-uterine inception (the precursor to in vitro fertilization)?

My wife and I have been trying to have children for about two years now, to no avail. What things should we consider about intra-uterine inception (the precursor to IVF)? It seems to be in a different category as IVF since it isn't creating life.  In actuality, it doesn't really seem to even increase your odds of conceiving all that much.

Answer by EPM volunteer, Dr. Jessica Farnsworth, MD, Nebraska

My husband and I have dealt with difficulty conceiving and we've also been through a miscarriage, so I am very compassionate regarding this desire you and your wife have for children. 

I'm also very passionate regarding the right and wrong ways we can go about trying to have children, and am glad you are seeking to honor God in this.  So many Christians seem to believe they can pursue unethical reproductive methods on the basis of "we want it bad enough" or "we deserve happiness."  These selfish mindsets do not allow God to direct our plans and often lead us to do things that are not honoring to Him.

Regarding in vitro fertilization, it sounds like you have ruled that out already.  I would affirm your decision on this.  There are several moral issues with in vitro. 

First of all, the child is created outside the womb by human devices as a sperm and a harvested egg are combined. Second, many children (embryos) are created and some are frozen for later use while several are placed in the mother's womb. The survival for these embryos is low, sometimes quoted around 25%. So in essence, multiple children are created, knowing that most of them will not live. Some physicians only place 2-3 embryos in the mother, hoping that one or all of them will survive. Other physicians place more embryos in the mother, and if too many live, they then abort the "extras" and leave a more "manageable" number of embryos in the womb. 

The frozen embryos have an uncertain fate. Some of them remain frozen for an inestimable period of time, children that have been created and then frozen! Does it seem right to create life and then leave it? Some of the frozen embryos may be thawed later for a repeat cycle of IVF, and most do not survive. In some cases embryos are donated to other couples or some may be donated for research (i.e.: killing them in the name of scientific study). 

The overall problem with IVF is that it destroys life as it creates life. Meaning, the chance of one child surviving carries with it the necessity of many other children (embryos) having been created and then dying. So for the one surviving child, many other children have been given life (combining sperm and egg) with the knowledge that most of them won't make it. 

Regarding intra-uterine insemination (IUI), I don't believe it carries the moral issues that I mentioned above with IVF, as you are not creating multiple babies with the knowledge that most of them will die. You are also not creating life outside the womb. Basically the man's sperm is injected into the uterus through the cervix at a key time in the woman's cycle. Often the woman's cycle has been assisted with medication to try to manipulate the time of ovulation to make it more successful and predictable for an egg to be available at the time of insemination. 

The problem that I see with IUI is not a moral one, but more of a logistics one. The success rates are not excellent, likely in the 25% range. The chances of success may be hampered by the fact that only one insemination is done, when it would make more sense to do at least 2-3 attempts over a 2-3 day period.

The problem that I see with mainstream “reproductive health” is that there is often a very shoddy evaluation of the woman’s or man’s health, and kind of a cookbook method. For example: try medication followed by another medication followed by IUI followed by IVF. 

In our struggle to conceive and our desire to do it in a God-honoring way and also in a logical way, we have been pursuing the Creighton Model and I highly recommend it. I don't know where you live but it would be something worth researching. I believe many couples have medical issues behind their fertility problems and sometimes they are subtle. For example, maybe the man has a slightly low sperm count and the woman has low progesterone. Those two issues combined could reduce the chance for conception. There are multiple medical problems that can be helped in an ethical way. 

The Creighton Model (www.creightonmodel.com) is a system of natural family planning that would require you and your wife to learn during sessions with a teacher. This system has been developed and studied extensively by Dr. Hilgers, a devout Catholic, in Omaha, NE at Creighton University. He has, through years of studies, shown how the charting of cycles can assist in discovering fertility problems. The system can also be used to avoid pregnancy. I don't know where you are located but I would recommend you look for a teacher in your area (www.fertilitycare.org) and ask them if they are connected with a physician who could help you with your desire for children. 

I believe God values and cherishes children, and I believe He initiates each soul, which is a mysterious and amazing thing. Zechariah 12:1 “The Lord…who forms the spirit of man within him…” He cares deeply about your yearning for children, and will direct your paths. Cry out to him in your frustration and disappointment and ask for His provision and His guidance.

Randy Alcorn, founder of EPM

Randy Alcorn (@randyalcorn) is the author of over fifty books and the founder and director of Eternal Perspective Ministries