IVF and the Catholic Couple
More and more frequently I am meeting Catholic women who have undergone in vitro fertilization (IVF). Just as I am gushing with congratulations for the pregnancy, I choke to discover that IVF was involved. Moreover, these are church-going Catholics. On one occasion, when I informed a friend that the Catholic Church condemns IVF, I was met with disbelief. "How can that be? Doesn't the Church encourage having children?" she asked. As she didn't believe me, my friend investigated it herself, not by asking her pastor, but by searching the Internet. With that confirmation she explained, "I have never heard that there was anything wrong with IVF."
I wasn't surprised. After all, I have never heard a homily on the subject. Yet it is a growing phenomenon among Catholics. Endemic rates of infertility are part of the reason, but more importantly, the libertarian notion among Catholics that every man is the arbiter of his own truth: "I think God would want me to have a baby, otherwise he wouldn't have put this desire within me. This is the only way to have a baby. I don't need to seek counsel on this."
Among well-educated Catholics this is perhaps a more common attitude. As IVF is such a common procedure, it does not seem to demand any fresh moral analysis. As with contraception, the moral authority of the Church on this subject is frequently neglected: "I don't need the Church telling me what to do, I know what is right for me." When it comes to IVF, if one has the funds to afford the procedure, that is analysis enough. In fact, infertile couples represent a particularly lucrative market. They are more likely to be older, better educated, better off financially, and desperate to have a child. They can be easily exploited.
IVF is not only a means to have children, it is also a means to have better children. Part of the moral analysis of IVF would have to deal with the eugenic measures that are an inevitable part of the process. Part of every IVF procedure entails the screening of embryos to determine their fitness prior to implantation. The process excludes those embryos with undesirable characteristics ranging from genetic diseases to the wrong sex. Unused embryos are either destroyed or placed in frozen storage for later use. For hundreds of thousands of these embryos, "later" never comes. They languish in storage for years and are eventually forgotten or abandoned.
Couples who begin the IVF procedure do not start off intending to abandon their embryos. Many times they are not aware that "extra" embryos are going to be created. Excess embryos have become the standard of practice in the United States. Fertility clinics are highly competitive, and in order to produce higher rates of pregnancy they must create and implant more embryos. "Wastage" of embryos is the price to pay for a greater number of successful pregnancies. If a couple is investing an enormous amount of money in the procedure, they are going to choose the clinic with the best statistics. While in some countries legislation allows the creation of only that number of embryos that will be implanted, the U.S. has no such restrictions, and therefore abandoned embryos become a problem. Most couples who have embryos in storage consider them saved for future use. Unfortunately for the embryos, once a couple has gotten pregnant and delivered a child, going through the procedure a second time becomes unlikely. They are happy with their baby and that's enough. The procedure is unpleasant and humiliating and the results so often disappointing that most couples are not willing to endure it more than once.
A typical example may be illustrative. I met a woman who had undergone IVF and delivered twin daughters. They were premature and one was beginning to show signs of progressive hearing loss. The woman was in her early forties. The pregnancy with the twins was horrible, and she was always sick. But now she was left with eight frozen embryos. She hadn't been aware that they were being created, believing that only the eggs and sperm would be frozen for future use. At the time of our conversation she was particularly anxious because she had to decide whether to pay for another year of storage for these embryos. She struggled terribly with this decision, as she had no alternative plans for them. She didn't think she could survive another pregnancy. She had even asked her sister to take some of them, but her sister's children were older and she was enjoying her freedom. She looked upon the lifestyle of this woman with her little twins and didn't want that again for herself.
The most telling part of her struggle came from her husband, the father of these embryos. "He doesn't understand what the big deal is," she said. It seems he had watched her go through a dangerous pregnancy and said, "Never again." He dismissed her indecision regarding the eight embryos with contempt. "Forget them! We have our daughters, and I have my wife back, that's enough," he said. She explained away his attitude with, "After all, all that he did was squirt in a cup. He just doesn't get it." She was not surprised with his detachment.
"I just look at my beautiful daughters, and I realize: I have other children out there!" she said. "I just know that my daughters are going to ask me one day, 'Were there others?' By then it will be common knowledge how this was done. I don't know what I'm going to say to them. I love my daughters, but I regret how they came to be." Her suffering was real.
So why does the Church condemn IVF? The first principle explains all the others: a child has a right to be conceived within the loving embrace of his or her parents. To be conceived outside of this holy embrace is an injustice to the child. With IVF the child is "conceived" through the manipulations of a third party: a laboratory technician. Does this nullify the infinite value of the life so conceived? Certainly not! But it exposes the child to all kinds of evils, not only of freezing but also abandonment, or "exposure."
In ancient Rome a newborn infant was allowed to live or die according to the decision of its father. If a father acknowledged the infant as his own he or she would live. Otherwise the child could be "exposed" literally left in the gutter or sold into slavery. The bastard child was destined for this. It was a terrible injustice to the child: the bastard son would never be king, nor educated, nor enjoy the privileges of the legitimate son. Now, no one today would deny the child conceived out of wedlock the same dignity as his legitimate siblings. He or she does not belong in the gutter regardless of his father's irresponsibility. We have progressed this far at least as a civilization. However, with IVF we can see the dramatic return to this ancient practice of exposure. This is what then-Cardinal Ratzinger, the present Pope Benedict XVI, called the "absurd fate" of the abandoned frozen embryo. It is absurd because nothing morally legitimate can be done to secure its survival.
Some would argue that Cardinal Ratzinger never considered the option of embryo adoption when writing Donum vitae. This could hardly be the case. At the time of its writing surrogacy was already a well-known practice. In Donum vitae he condemns surrogacy under the same terms as heterologous IVF: that is, obtaining either the egg or sperm from someone other than the married couple desiring a child. Heterologous IVF would be employed in the case of aspermia of the husband, or anovulation of the wife, or if one or the other partner carried an undesirable genetic trait. The child so conceived would not be the biological child of this couple, but of another pairing of biological/genetic matter. Surrogacy implies the possibility of gestating an embryo in the womb of a woman who is not the biological mother, i.e. an "adoptive" mother. Surrogacy is making oneself pregnant with a child who is biologically unrelated to oneself, and doing so apart from the conjugal act. It is similar to heterologous IVF inasmuch as there is a third party involved apart from the married couple themselves.
Many argue that embryo adoption should be available for an embryo who has been abandoned and whose own mother's womb is not available. The argument is compelling as it offers a chance of survival for an embryo, rescuing it from a fate of becoming fodder for experimentation. Such "rescue" adoption should be a morally acceptable option, shouldn't it? While the intention of a couple to offer themselves as "rescue" parents is laudable, intention alone does not suffice in judging moral actions. The act itself must be good, or at least morally neutral, in order for the act to be morally acceptable. In this case the woman "makes herself (1) to be pregnant with a child who is biologically unrelated, and (2) apart from the conjugal act." It is surrogacy. We are left, therefore, to examine exactly why surrogacy is unacceptable.
When a woman and a man exchange marriage vows, thereby becoming sacramentally one, they commit themselves to each other body and soul, exclusively, until death. The properties of Christian marriage are permanence and exclusivity. When we consider embryo adoption, the woman turns herself over bodily to a very different kind of relationship in which her husband takes no part. It is not analogous to traditional adoption for this reason. Hers is an intimate bodily union, quite apart from her relationship with her own husband. They are not equally partners in welcoming this child as they would be in traditional adoption. The husband is merely a bystander contributing nothing to this arrangement. She, in the meantime, is a surrogate mother until the child is born, and only then do they become adoptive parents together.
In the real-life practice of so-called "rescue" adoption, embryos are donated for adoption. Oftentimes the biological parents choose the adopting parents who apply for the process. Embryos do not come to be available for adoption except by the intention of the biological parents. Embryos who have, instead, been offered by the biological parents for research purposes are not involved. Their fate is sealed. They cannot be "rescued."
Adopting parents make arrangements with their own fertility clinic, and the frozen embryos are delivered by overnight courier. The practice is much less costly for the adopting parents than if they were to go through IVF for themselves. It is a promoted not only for its cost effectiveness, but also for the control that embryo adoption provides as compared with traditional adoption. Adopting parents can see the children already born to the biological parents. They control the gestational period and don't run the risk of prenatal exposure to such things as drugs and alcohol. With the exception of the hormonal stimulation and retrieving of eggs and sperm, the adopting parents endure the same procedure as the biological parents. They work with the same kind of clinic and the same kind of team of physicians and technicians. The embryos are screened with the same selective process.
From a "pro-life" point of view these may seem like hair-splitting details of little import when a human life is at stake. However, and this deserves some pause: the fragility of the marital relationship has been all too easily compromised in our current culture. We, as Catholics, have become somewhat jaded about permanence in marriage, as divorce and "serial monogamy" are as endemic among Catholics as other Christians and non-Christians. Marriage is one of those things that "can take it"; in this case "it" is a challenge of enormous proportions. In the case of embryo "rescue" we may be all too ready to put sacramental marriage at risk for the sake of "saving a baby." But are we really talking about "rescue"?
In the case of truly abandoned embryos for whom biological parents are not available, we can look at the experience of Spain, which made abandoned embryos available for adoption a few years ago. Most couples coming forward for adoption were from outside Spain. Many were homosexual couples for whom adoption was illegal their home country. Now, American fertility clinics have started recruiting surrogate mothers for homosexual couples that desire children. This is a way to get around the difficult traditional adoption process for some, but is it a solution to the problem of abandoned embryos?
One can hardly expect that the practice of embryo donation and adoption will not become commercialized. Already one Texas businesswoman, frustrated with her own struggles to adopt a child, started a business in "designer embryos." Customers choose from a variety of "pairings" depending on the price they are willing to pay. Eggs and sperm from college-educated donors cost a bit less than those from master's and doctoral degreed donors. Ivy-league donors are in a category of their own. She recruits donors, has a fertility team make up "batches" of embryos, and markets them online. She explains that she was tired of having to be at the mercy of biological mothers who could change their minds at the last minute. She was "sick of begging." She wanted a "quality product" to be available for those who could afford the price. She found a ready number of donors among university students seeking to fund their education. And she found a market share in the competitive reproductive technology arena.
As long as embryos can be frozen and shipped they will be treated like any other commodity. The freezing process itself must be considered morally illicit. No being should be submitted to freezing, regardless of its stage of development. Storage of embryos by cryopreservation should be considered extraordinary and disproportionate care. It is not done for the good of the human being so treated, but for the convenience of others, and only in others' good time will it be suspended. It is sheer will to power of one human being over another. While cryopreservation is the means by which hundreds of thousands of human embryos are maintained, it is not for that reason any less deplorable a treatment.
Before a group of evangelical Christians, I was asked how we got to the point of having to deal with hundreds of thousands of abandoned embryos. My answer was simple: contraception. As long as we could separate the unitive and procreative aspects of conjugal love we were destined for this situation. At one time contraception offered the promise that one could have as much sex as he or she wanted, and with anyone he or she wanted, and never fear a pregnancy. Now we don't even have to have sex and we can be made pregnant. Ours has not become an overly sexualized culture, but an asexual culture. This same group of evangelicals asked where they could find the Catholic explanation of contraception. I told them about Humanae Vitae, but said, "Don't bother to ask your Catholic friends about it, because they've never read it."
Sheila Diamond is a master's prepared registered nurse and is currently a doctoral candidate at the John Paul II Institute for Studies in Marriage and the Family in Rome, Italy. She has studied in the bioethics program in Rome and wrote her thesis with Msgr. Livio Melina on whether or not it could be morally licit for a Catholic couple to adopt an abandoned frozen embryo. This article, her first in HPR, offers a condensed synthesis of that paper.
This item 7985 digitally provided courtesy of CatholicCulture.org