As we saw in part one of this series, couples who have learned to chart effectively have a 76 percent chance of conceiving during their first cycle of use and a 98 percent pregnancy rate by their sixth cycle. Still, even if natural family planning (NFP) does not work for everyone (us included), artificial reproductive technologies (ART), such as intrauterine insemination (IUI) and in vitro fertilization (IVF), are contrary to the Church's teaching on human sexuality. Not only do IUI and IVF frustrate the unitive aspect of lovemaking, they violate the baby's right to be conceived through a person-to-person, body-to-body communion of husband and wife.
Person to (Doctor to) Person
Just as the person is an integration of the physical and the spiritual, every act of lovemaking should be ordered to the physical and spiritual good of each spouse. The physical goods of intercourse — pleasure and reproduction — need little explanation. The spiritual goods — primarily joy and gratitude — are derived from knowing that your spouse accepts and embraces all that you are. In this acceptance, the person is treated as an end in himself rather than a means to an end.
Couples struggling with infertility often experience an intense bond that comes from enduring the crisis of infertility together. Such intimacy, however, is distinct from the personal communion that only occurs in the conjugal act. Perhaps more than others, infertile couples can appreciate the spiritual benefits of lovemaking. When you are infertile, every act of intercourse is pregnant with the hope that God will work a miracle.
By contrast, techniques such as IUI and IVF entail an intentional decision to bypass the unitive aspect of the marital act. The use of these procedures transforms what is supposed to be a spiritual union between two persons into a merely biological process. Unlike intercourse between animals, though, the marital act requires that husband and wife surrender their entire selves to each other and to God.
This total gift of self, from which the spiritual goods of the conjugal act are derived, is inseparable from the act itself. For this reason, techniques such as IUI and IVF cannot bring about the spiritual goods unique to marital intercourse. Donum Vitae (The Gift of Life) explains: "The origin of the human being thus follows from a procreation that is 'linked to the union, not only biological but also spiritual, of the parents, made one by the bond of marriage.' Fertilization achieved outside of the bodies of the couple remains by this very fact deprived of the meanings and the values which are expressed in the language of the body and in the union of human persons" (II, 4).
The "meanings and values" inherent to the conjugal act are uniquely personal. That is to say, man and wife can only give themselves person to person, not person to catheter to person, or person to petri dish to person. By definition, this union is exclusive. Hence, nothing should come between the person-to-person, body-to-body communion of husband and wife. IUI and IVF are not conjugal acts because they are not extrinsically exclusive. The very possibility that these procedures can produce a baby between two people who have never even met one another indicates that IUI and IVF are not exclusive, and hence, not personal. To claim that they are is to redefine the conjugal act, much as homosexuals want to redefine marriage as a union between any two people who subjectively love one another. The wisdom of the Church's instruction is derived from the recognition that the marital act is designed by God to adhere to certain objective standards.
What About the Baby?
Most people believe that intercourse should be something more than a physical process aimed at making a baby — that the baby himself has a right to be created through the loving union of two persons. This intuition, at least, helps to explain why couples who use IUI and other reproductive technologies continue making love even after the procedure in the hope that their child might be the result of a natural conception — a conception achieved without the intervention of a third party. It also permits the couple to believe that their baby is the product of their conjugal love for one another in spite of their use of a procedure aimed at conceiving a child outside of a specific conjugal act. In effect, these couples presume IUI and IVF are personal acts because they occur within the context of ongoing marital relations. But not every sexual act that may occur within marriage — sodomy, for example — is a personal act.
As suggested above, a personal act harmonizes the spiritual and physical welfare of each spouse. This integration is what distinguishes mere reproduction from procreation — creation that seeks to imitate God in his own generosity and fecundity (cf. CCC 2335). In doing so, the couple extends God an invitation to enter into and bless their sexual union in whatever way He desires. This idea, that a child has the right to be created by God through a specific personal act, is especially stressed in Donum Vitae: "Conception in vitro is the result of the technical action which presides over fertilization. … In homologous IVF and ET [embryo transfer], therefore, even if it is considered in the context of 'de facto' existing sexual relations, the generation of the human person is objectively deprived of its proper perfection: namely, that of being the result and fruit of a conjugal act in which the spouses can become 'cooperators with God for giving life to a new person.' These reasons enable us to understand why the act of conjugal love is … the only setting worthy of human procreation" (II, 5).
To conceive a child through a technological process that replaces the conjugal act is to subject him to the "standards of control and dominion" inherent to the scientific method (II, 4). As such, the baby becomes an object of micromanipulation, rather than the fruit of a personal union sanctified by God.
Christians who approve of IUI and IVF maintain that these "artificial means merely assist the natural process." The Church, however, teaches that these procedures replace the conjugal act. Clarifies Donum Vitae: "A medical intervention respects the dignity of persons when it seeks to assist the conjugal act either in order to facilitate its performance or in order to enable it to achieve its objective once it has been normally performed" (II, 7). In the case of IUI, IVF, and other techniques, "The medical act is not, as it should be, at the service of conjugal union but rather appropriates to itself the procreative function and thus contradicts the dignity and the inalienable rights of the spouses and of the child to be born" (II, 7).
Divine Grace and Human Nature
What is primarily at issue here are the differing views of human nature held by Catholics and Protestants. Catholic doctrine maintains that grace builds on nature. God — and man's — action in the world must thus respect the natural order, which itself is part of the eternal order. Protestant theology believes nature is something low, something to be overcome by grace. For the Catholic, IUI and IVF are immoral because they replace the natural means by which a child should be conceived and, in so doing, subvert the natural ends of marital sexuality. For the Protestant, these natural means (and ends) are much less important than the good intentions and faithful heart that accompany the use of these techniques. As the authors of Empty Arms put it, "One can use 'unnatural' treatments and still demonstrate trust in God." What is important for the Protestant is the belief that God is working through these procedures, apart from whether or not the procedures are performed according to nature.
United in prayer and hope in God's generosity, couples who use IUI and IVF naturally feel as if their struggle with infertility has brought them closer to each other and to God. Yet these couples, albeit inadvertently, are impeding their union as man and wife by enabling a third party to intervene. The Catechism counsels: "These techniques … betray the spouses' 'right to become a father and mother only through each other'" (CCC 2376). Some couples intuit this fact by acknowledging that masturbation is embarrassing or that choosing IVF was an extremely difficult decision. Nevertheless, these same people will maintain that they don't feel alienated from each other or God. The case is similar to those who justify their use of contraception by saying: "If God wants us to have a baby, we'll still have one." Yet, as the author of life, God "fearfully and wonderfully" begets each one of us "in secret" (Ps. 139:13-16). According to Scripture, this is His right alone (cf. Eccl. 11:5). Sure, God is acting when a man and a woman conceive a child outside of the natural order, but His hand is being forced. In such cases, God is present only permissively, rather than actively. Every baby, however, has the right to be given as a gift, a blessing bestowed according to the natural means established by God in accord with His perfect timing.
This is not to deny that babies produced through IUI and IVF are just as cute, wonderful and loved as any other children. The joy they bring to their parents is also just as real, if not more intense. This happiness, though, comes at the expense of the babies who have been denied the right to be conceived through a personal act. Needless to say, children created through artificial techniques are persons; they have immortal souls. Once conceived they also have a right to be loved and protected by their parents and society. Still, no one would admit that every act that results in the conception of a child is morally licit. Rape, for instance, may also result in the conception of a child.
Likewise, as we will see in part three of this series, not every act that creates life is "pro-life" — or even promotes the dignity of life.