Roughly nine out of 100 of the reproductive-age population in the U.S. have difficulty conceiving or carrying a child to term. Medical journals say the rate of infertility has reached epidemic proportions.
Infertility affects couples on a deeply personal level, causing feelings of anxiety, disappointment, anger, guilt, jealousy, grief and despair. If such emotions are not controlled by the Spirit of God, they can create tension within a marriage. They can also compound infertility.
Causes of infertility
Infertility has many causes. Some - but certainly not all - are the result of sin. High on the list are sexually-transmitted infections (STIs), which are often the result of immorality.
Chlamydia and gonorrhea can lead to the greater complication of pelvic inflammatory disease. The leading cause of infertility, PID causes miscarriages or the tubal damage and scarring that complicate efforts to conceive. Women may be unaware they have PID until after they miscarry. As many as one million American women each year will experience a PID episode.
Abortion, especially when repeated, is a leading cause of infection and scarring in the uterus that make later conception and implantation difficult or impossible. Studies show that STIs are aggravated by oral contraceptives, intrauterine devices, and elective abortion. Both abortion and PID cause ectopic (tubal) pregnancies which lead to infertility in many women. The number of ectopic pregnancies has sky-rocketed in recent years.
It's ironic that one result of the "sexual revolution" is a rise in infertility. Other causes of infertility include pollution, alcoholism, drug abuse, marijuana use, and smoking. For the sake of the health and happiness of our young people, they need to be warned about the possible consequences of these behaviors to their future fertility.
Christians must be aware of the causes and yet not assume that everyone who experiences fertility problems is suffering the consequences of sin in his or her life. Some couples never discover a reason for their infertility, which may include:
- Exposure to certain chemicals or medications
- Environmental toxins, such as lead or certain pesticides
- Various diseases and disorders, including cancer, endometriosis, or Polycystic Ovarian Syndrome
- Stress, poor nutrition, or intense athletic training
Childless couples deserve sympathy and understanding, not constant inquiries about their parental status. They can derive comfort and encouragement from the faithful examples of Abraham and Sarah, Isaac and Rebekah, Jacob and Rachel, Elkanah and Hannah, Zachariah and Elizabeth, and others.
Where should infertile couples draw the line?
Through technology, it is now possible for a woman to give birth to her own grandchild, to have a baby after menopause, to have twins born years apart, and to have an ovary transplanted from an aborted fetus. Seemingly, there is no longer a point at which an infertile couple must abandon hope. The scope of fertility assistance is not even limited to married couples. Unmarried women can be artificially inseminated and unmarried men can hire surrogates to bear them children. But, how far should we go?
Since fertility technology offers so many new choices (see Primer), couples must determine how far they will go in pursuit of a child. It may be helpful for them to consider these questions: Should the quest for a biologically related child be unceasing, at any cost? Is parenthood a right or a privilege? Are children objects we produce and possess, or blessings from God that require our faithful stewardship?
It is up to infertile couples to rein in their desperation. In his book, Vital Signs, Mark Blocher comments: "Unmarried men and women do not have the right to procreate. Likewise, in our fallen state some bodies are incapable of bearing children. As with other abnormal physical conditions, infertility should receive medical attention. However, childlessness is not a medical condition and not amenable to medical treatment." (Moody Press, 1992)
Parenthood among single adults in the manner described above, particularly among homosexuals and lesbians, contributes to the breakdown of the biblical idea of the family. Childless singles and couples may want to consider building their families through adoption, especially the adoption of children with special needs, sibling groups, and older children who are harder to place.
As they benefit from fertility assistance, infertile couples must draw the line before violating two abiding principles: (a) the sanctity of human life and (b) the sanctity of marriage. At least five aspects of fertility assistance are problematic.
1. The problem of the perfect child
There is no such thing, but some couples have fallen under the spell of the myth of the 'perfect' child. The idea that we can select for variations in intelligence, body type, coloring, health, and so on from the catalog of available sperm or egg donors is seductive, but deceiving.
Parents may even choose their child's sex, but usually this is done by testing lives already begun. The only "cure" for "imperfection" of an already-conceived baby is abortion. The deliberate abortion of any child - "pre-implantation" or otherwise - is a violation of the sanctity of human life.
But sex selection need not involve abortion. Techniques are available that reveal whether sperm carry the X or Y chromosome before conception takes place. This is important when certain diseases or disabilities are passed along on the sex chromosomes, but similar tests may someday also yield information about a potential child's height, IQ, eye and hair color, and weight.
Parents must question their own motives in choosing one characteristic over another, and whether such foreknowledge and manipulation are at all appropriate.
One example of manipulation run amok is cloning. Scientists find an embryo with desirable traits and use his or her genetic information to make "carbon copies." In the process, the original embryo is destroyed. Their hope is to enhance the success of fertilization techniques, but ethicists caution that cloning affects the uniqueness of the individual. Pro-life people wonder, should the genetic material of a person who never saw the light of day be passed on to limitless future generations?
2. The problem of donated gametes
College women are recruited to sell their eggs for thousands of dollars. Their eggs are sold online. Sperm may be retrieved shortly after a man has died, and bereaved women have demanded the right to be inseminated with the stored sperm of their husbands and lovers. Meanwhile, as they get older, the children of anonymous donors wonder about the "parents" they never knew. Ethicists and judges struggle to make sense of the myriad new relationships and other difficulties fertility techniques create.
Several methods of fertility assistance involve donated eggs or sperm (gametes). While introducing a third (or fourth) party into the marriage relationship in this manner does not constitute adultery, it does affect the intimacy of marriage, and create confusion about the meaning of motherhood and fatherhood.
Blocher believes such a violation of the "unitive aspect" of marriage means Christians cannot endorse artificial insemination of the wife with donor sperm nor the transfer of donated eggs fertilized with the husband's sperm. "One's procreative abilities are definitely part of the 'one flesh' relationship spoken of in Genesis 2:24. Becoming one flesh means that the man and woman consent to a lifelong relationship with one another. . . . Access to one's sexual/procreative powers is to be reserved for the person to whom a lifelong commitment is made." The marriage vow "for better, or worse" thus takes on added meaning. Not only should married couples (or singles) refrain from receiving donated eggs or sperm, but, by implication, they also should not become egg or sperm donors.
One of the most egregious violations of the sanctity of human life occurs when the donor of eggs or ovaries is an aborted baby girl. Adult egg donors are in short supply and the process of donation is difficult and painful. The benefits to infertile couples, proponents say, far outweigh the "ethical conundrums." Nevertheless, this proposal . . .
- Ignores the true donor's right to informed consent,
- Would be used as an argument for abortion, and
- Creates the potential for women to be used as "fetus farms."
What about surrogate mothering arrangements? Surrogacy gains in popularity, despite numerous cases in which one party has changed his or her mind. Women have borne children for their daughters, sisters, and friends. Others contract with a couple, charging a hefty fee on top of the medical expenses associated with pregnancy.
Typically, surrogacy is the method of last resort, when other costly fertility procedures have failed, or when the wife is unable to carry a pregnancy to full term. The surrogate may be implanted with the husband's sperm and/or the wife's egg. Single men also seek surrogate mothers to bear their children. Such arrangements are not advisable for several reasons:
- They could be considered a violation of the sanctity of marriage.
- They may cause needless confusion in the parent-child relationship.
- Children are treated as objects for sale.
- These arrangements often require the surrogate mother to agree to have an abortion should prenatal tests reveal the baby has a disability.
- Surrogacy seems to borrow from Sarai's unwise exploitation of Hagar, with all its ensuing trouble (Gen. 16 and 21).
3. The problem of extra embryos
Many fertility techniques involve stimulating the woman's ovaries so they produce many eggs at a time, instead of only one a month. The eggs may be fertilized all at once, or a few at a time with the rest cryopreserved (frozen) for future use. Extra embryos may also be frozen for later implantation. It is believed that as many as 400,000 embryos now linger in frozen suspension.
When more eggs and embryos are created, a couple's chance of conceiving is greater, and the success rates of techniques such as IVF improve proportionately. But when as many as eight embryos implant, the mother risks a difficult pregnancy and the death of some or all of her babies.
The treatment of choice for multiple pregnancies is "multifetal pregnancy reduction" - abortion. Under the guidance of ultrasound, a needle inserted through the vagina locates the nearest embryo sac. Manual suction removes the embryo. Usually such pregnancies are reduced to twins or triplets.
What is the fate of those extra embryos lingering in frozen limbo? If they are never used by the couple, should they be destroyed? Released for adoption by other childless couples? Donated to research? Courts are forced to decide these issues when couples divorce and one party no longer wishes to become a parent. Sadly, the embryos in question always seem to lose.
What happens to embryos diagnosed as diseased or handicapped? And, what are the implications of freezing embryos anyway? Might forgotten embryos be stock-piled for future generations? Who controls this treasure? Does storing embryos separate fertilization from the rest of pregnancy, lending credence to the idea that an embryo is not a person unless he or she is implanted in the womb? The answers have direct bearing on the sanctity of human life.
4. The problem of embryo research
Aside from the possibility that extra embryos may be used in research, much of fertility assistance technology rests upon a foundation of past embryo research. The pro-life movement objects to experimentation using human embryos because, at the very least, it violates the basic requirement for most research: informed consent of the one experimented on. The very nature of the experiments, and the often cavalier attitude of researchers toward embryo "wastage," further violates the sanctity of human life.
5. The problem of compromise
In 2 Corinthians, the apostle Paul admonishes believers not to "yoke" themselves to unbelievers. The principle is typically applied to marital or business partnerships, but could also relate to agreements between Christian couples and fertility clinics.
In the course of some fertility treatments, clinic personnel are invited into the most deeply personal aspects of a couple's life. Furthermore, they are joining the couple in a project that has long-term, far-reaching, and cosmically significant effects: bringing new life into the world - a thought that should give anyone pause.
In addition, a presumption is reasonably made by the clinic that the Christian couple accepts its standards, while no demand is made on the clinic to adopt the couple's standards. In light of 2 Corinthians 6:14, it seems very odd that believers so willingly and thoughtlessly mesh their efforts with an industry that lacks the conviction about life that forms the core of the Christian worldview.
Fertility clinics serve many couples who are desperate for a baby and willing to do whatever it takes to get one. It is unlikely clinic staff are able to differentiate between the average couple and the Christian couple who lives within biblical boundaries and ultimately accepts God's sovereign will as final. Nor should they be expected to make this distinction and adjust their operating standards accordingly. It's up to believers to take responsibility for their own lives.
Christian couples can compromise themselves at fertility clinics even though they firmly hold to the principles of the sanctity of marriage and of human life. And the temptations grow once they've invested thousands of dollars. No matter how articulately they may express these dearly held beliefs to clinic personnel, it is too much to expect that doctors, nurses, and lab technicians will understand and embrace them. Therefore, even though they may assent to the idea of only fertilizing a minimum number of eggs and assurances that all embryos will be implanted, once control is relinquished in the front office, who knows what may happen to a Christian couple's sperm, eggs, or embryos in the lab? The record has shown that the fertility industry is populated with unscrupulous doctors who will pass their own sperm off as that of donors, and careless technicians who will mix up embryos or misplace them.
Even clinics with the highest standards have a cavalier attitude toward embryos. If, for the sake of argument, they do agree to one couple's stipulations, they may still be mistreating the offspring of other people.Fertility clinics willingly create more embryos than can be implanted at one time. In the normal course of treatment, they perform pre-implantation genetic testing on embryos and have no qualm about discarding ones deemed unfit. They commonly advocate "pregnancy reductions" when more than two embryos implant in a woman's uterus. They freeze "surplus" embryos for years on end, or sell them to researchers who then put them under a microscope and disassemble them for spare parts.
Christians go to great lengths to find doctors who won't perform or refer for abortions. They also need to exercise caution in choosing their fertility clinics.
Conclusion
Possibly the only treatments that pass muster are fertility drugs, corrective surgery, and techniques that do not manipulate the embryo, such as artificial insemination with the husband's sperm. It may be possible to honor the sanctity of human life and marriage by modifying other methods, but if Christian testimony is to extend into all spheres of life, immoral procedures are not an option. The end never justifies the means.
Children are the Lord's heritage.There's nothing wrong with desiring to conceive and bear one's own children, but adoption remains a worthy means of building families. It focuses less on the passing on of genetic heritage and more on being a parent. It mirrors the love that God has for His children. The adoption of infants can be costly, but so is fertility technology. Parents who adopt, especially children with special needs, depend on the loving support of their church families.