While natural family planning (NFP) is not always effective for couples (like us) who are trying to conceive naturally (see part one of this series), the Church has good reasons for its teaching on human sexuality (see part two and our "Response to Readers"). Nevertheless, many couples believe they can use intrauterine insemination (IUI) and in vitro fertilization (IVF) without violating their consciences or their faith, because, after all, such techniques create life, not destroy it.
Flirting with Danger
Proponents of artificial reproductive technologies (ART) often argue that IUI and IVF are actually "pro-life." The thinking behind this assertion is that every endeavor aimed at bringing forth new life promotes the dignity of life. Of course, all orthodox Christians, both Catholic and Protestant, agree life begins at conception. For this reason, Dr. Dobson recommends that couples using IVF fertilize and insert only as many eggs as they are willing to keep, and no more than three. "To fertilize and implant more than three," reckons Dobson, "would unacceptably increase the risk of pregnancies of quadruplets or more, pregnancies which carry high risk for both mother and babies."
These dangers are significant. According to the CDC, even twins, who comprise 30 percent of ART births, "are still at substantially greater risk for illness and death than singletons." Dr. Eric Surrey, president of the Society for Assisted Reproductive Technology, cautions: "Twin pregnancies are at a three- to five-fold greater risk for pregnancy complications and perinatal mortality compared to carrying one fetus. With triplets, there is at least a seven-fold greater risk." Low-birth weights and neurological diseases, such as cerebral palsy, are also far more common in twins and other multiple-infant births. In addition, women using ART, especially when combined with drugs that cause ovarian hyperstimulation, are putting their "health and lives in jeopardy," warn Drs. Marie Anderson and John Bruchalski. "Since there is no regulatory agency to oversee the industry, women are treated as research subjects, given drugs that pose an unknown risk."
While pro-life Christians who resort to IUI or IVF would never consider having an abortion, they should keep in mind that the reproductive technology industry is institutionally dependent upon the destruction of human life. On average, women 35 and younger are impregnated with three to five embryos per cycle. Most IVF specialists discourage couples from transferring just one embryo, but approximately 66 percent of all ART births are singletons. At the same time, the overall live-birth success rate for ART is 29 percent. Hence, well over 70 percent of all embryos created through ART do not survive. Thousands more children that reach the fetal stage are killed via selective or "multifetal pregnancy" reduction, a euphemism used to refer to a first trimester abortion. Although the CDC does not disclose the exact number of multifetal reductions each year, the number of multifetal pregnancies accounting for miscarriages and induced abortions exceeds the number of multiple births by approximately 10 percent. A 1993 study found that 31 percent of multifetal pregnancies ended with miscarriage while 27 percent ended with selective reduction.
With experts complaining about an "epidemic of multiple births," physicians feel pressure to keep their multibirth rate low. As reported by the San Francisco Chronicle, "The creation and destruction of human embryos is part and parcel of modern infertility treatments, reflecting both the inherent inefficiency of human reproduction and efforts by fertility clinics to keep costs down and success rates as high as possible" (Aug. 20, 2001, A-1).
It is estimated that as many as one million embryos have been destroyed since IVF was introduced in the United States in 1981. Over 500 embryos alone lost their lives to produce the first "test tube baby," Louise Brown, in 1978. Currently, more than 400,000 embryos are frozen.
Even if a couple follows Dr. Dobson's advice and transfers only as many embryos as they are willing to carry to term, they are still unintentionally cooperating with the murder of nascent human life. To begin with, these couples are benefiting from technologies that would not exist without embryonic research, research many of these same couples oppose. Additionally, they are lending financial and social support to a system that dishonors life by encouraging such practices as selective reduction (i.e., abortion), cryopreservation and genetic selection. Finally, couples who use ART tacitly buy into the abortion-driven myth that life begins upon implantation, rather than conception. After all, no one sends out pregnancy announcements when their baby is still "in vitro." Yet the debate over when life begins — at conception or implantation — is one of the great divides that separate the culture of life from the culture of death.
I've Got the Power
Ironically, many of the couples using IUI and IVF in their late twenties and mid-thirties were contracepting earlier in their marriage. This is because IUI and IVF are the logical counterparts of the contraceptive mentality, whose fundamental tenet is that women enjoy total control over their fertility. The following comment from one infertile woman perfectly epitomizes this view: "I'm not a control freak, but it's one area of my life that I thought I'd always have control over. You know, I was on the pill for five years before we started trying to have a baby. … Five years I thought I was in control of my fertility. When I didn't get pregnant, it came as quite a shock" (Handbook of Families & Health, SAGE Publications, 103).
Predictably, the Catholic Church is criticized from both sides: When it's convenient, couples tell the Church that they should be allowed to contracept; when they change their mind, they tell the Church that she should permit them to use IUI and IVF. Either way, the Church is accused of being archaic and narrow. Rather, it is the view that separates the procreative and unitive aspects of marital intercourse that is truly "narrow." Such a view reduces the sexual act to being either primarily for the sake of unity or primarily for the sake of reproduction. The Church alone, in her wisdom, refuses to divide the two.
The Church refuses to divide what God has joined because she does not have the power to do so (cf. Mt. 19:6). The possession of such power would enable man to become like God (cf. Gn. 3:5). In fact, this premise underlies the scientific revolution, which promises man total control over nature, even human nature and human sexuality. Some might argue that the power science gives man comes from God, but not every thing invented by man is for his own good. This does not mean that technology cannot be used to assist the reproductive process, but that such assistance must never be divorced from the recognition that all life is a gift.
In accepting the gift of life, man agrees to respect the means by which life should be transmitted. A man who gave his wife a diamond ring, for instance, would be horrified if she used it as a drill bit. Likewise, a gift should not be opened before its time; rather the gift-giver chooses when and how to give the gift. As Donum Vitae reminds us: "The child is not an object to which one has a right, nor can he be considered as an object of ownership: rather, a child is a gift, 'the supreme gift' and the most gratuitous gift of marriage" (II, 8).
If children are "the supreme gift of marriage," how are couples to understand their infertility as a gift? The fourth and final part of this series will discuss the heart of the mystery of infertility and provide additional resources for those who want more information.