It's good and normal to desire children - but at any cost?
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One in six couples will experience infertility. Since we each came from large families with many siblings and nieces and nephews, my husband and I never expected to experience infertility. In fact, during our three years of dating, we discussed every potential problem we could face – how to handle joint finances, how to balance family and career, how to manage personality conflicts, how to properly load a dishwasher. You name it – we fretted about it – except what ended up being the greatest challenge of our marriage.
So, we get it. We understand what an unexpected and devastating diagnosis infertility can be.
Harvard medical researcher Alice Domar reports, "The majority of infertile women report that infertility is the most upsetting experience of their lives. Infertile women report equivalent levels of anxiety and depression as women with cancer, HIV status or heart disease."
And so, procedures such asin vitro fertilization (IVF) seemingly offer real hope for those who so desperately desire children. In that procedure, a woman takes hormones to stimulate her ovaries to produce many eggs in a single cycle. The mature eggs are then removed through transvaginal aspiration (a procedure done under sedation) or even laparoscopic surgery. Sperm are collected from a man, typically through masturbation. A clinician then places each egg in a bath of sperm, attempting to create embryos. Once fertilization has taken place, one or more embryos are then transferred into a woman’s uterus in the hopes that at least one will implant successfully and be carried to term.
By the way, what is an “embryo”? An embryo is what results when sperm and egg successfully join. It is a completely new human being at a very early stage of development. In the right environment and under the right circumstances, an embryo will keep on growing – from a fetus, to a newborn, to a toddler, to a child, through adolescence to, if she survives the turmoil of puberty and high school, adulthood. So an embryo is just a very young person.
The difficulty is that, when you learn more about IVF, it is not such a good thing. Most people find it difficult to believe that there could be a moral or ethical concern with a medical procedure that is performed in pursuit of the natural and good desire to have a child. I’ve had to explain to numerous friends and family members why we chose not to use IVF. Yes, IVF may allow couples to conceive the child that they desire and for some this will outweigh everything else. But, here are ten things I learned about IVF that might give some couples reason to reconsider:
1. IVF destroys common notions of parenthood. The old-fashioned way of making babies involves the physical union of a man and a woman. But, even the most basic version of IVF involves other people in the actual act of creation –doctors and technicians who retrieve the sperm and eggs, fertilize them in the lab and place them in the woman’s body. It can get more complicated – surrogates, donor eggs, donor sperm, children conceived from the frozen, banked sperm of deceased fathers, and some technologies involving three sets of DNA that sound like they came out of Brave New World. While this might not bother you, this can get confusing and upsetting for the children conceived through IVF, and social science data suggests that donor-conceived children report struggles with identity and origin and that they fare worse than their peers in outcomes such as depression and substance abuse.
2. IVF is a form of eugenics. Speaking of Brave New World, we have versions of the “fertilizing room” and the “bottling room.” Is the “social predestination room” next? Why do I say this? Well, to increase the chances of success, IVF involves diagnostic and screening procedures to get the “best” baby. For example, sperm are washed to isolate the healthiest and fastest among them and can be sorted to produce a desired gender. Eggs can be screened for chromosomal abnormalities. And, IVF clinics can use preimplantation genetic diagnosis (PGD) to detect genetic conditions and chromosomal mutations (or even undesired traits, like
simply being a girl). In PGD, one or more cells is removed from the developing embryo and evaluated for the “undesirable” trait. Only the “healthy” embryos are then used for transfer into the woman. This might be appealing if you are desperately trying to conceive and want to optimize your chances for a healthy baby. But recognize that in doing so, you are weeding out “unwanted” babies in the quest for the “perfect” one. We have names for that when it happens among grown-ups – whether based on disability, gender, or race.
3. We don’t know the long-term effects of IVF on children’s health. Although IVF has been used since 1978 and over 5 million children have been born through IVF, we don’t know fully the long-term effects of IVF or its screening procedures on the health of children. One study presented to the American Academy of Pediatrics suggests there is an increased risk of birth defects for children born through IVF. Other more established risks associated with IVF include higher rates of prematurity and low birth weight, especially because of the increased likelihood of multiples.
4. The odds are against you. Despite the promise it holds out, IVF is not that successful. In 2012, according to statistics published by the Society for Assisted Reproduction, only 35.9% of IVF cycles (involving the transfer of one or more fresh, non-donor embryos into a woman) resulted in pregnancy and only 29.4% of cycles resulted in a live birth. The success rate differs based on woman’s age (the comparable numbers for women over 42 are 8.6% and 3.9%) and whether the embryos used are thawed or fresh.
5. Over a half million embryos are in frozen storage because of IVF. To increase the chance of success, multiple embryos (as many as a dozen) are created in each IVF cycle, but it is not safe or effective to transfer them all at once into the woman. The result is that hundreds of thousands of “unused” embryos are left over. Couples struggle with what to do with their extra embryos and, in the Unit
ed States alone, there are an estimated 500,000 embryos in cryopreservation awaiting final disposition. This might include future transfer (either to the mother or to another person seeking pregnancy through “embryo adoption”), scientific research, or destruction.
6. IVF involves a reckless disregard for human life. The number of embryos that do not survive the screening or implantation processes and the dilemma of surplus frozen embryos clearly establish that IVF involves a lot of embryonic “waste.” Given the rate of loss of life – whether you label it “embryonic” or anything else – inherent in IVF, we should pause and reflect as to whether we should knowingly destroy so many lives in order to create life.
7. IVF sometimes involves abortion. IVF involves the intentional destruction of human life. Sometimes, when multiple embryos are created and transferred into the woman, more of them successfully implant than is safe or desired. “Selective reduction” is the technique used to reduce the problems associated with multiples. That’s right – that euphemism means your doctor selects one or more healthy developing fetuses for destruction, leaving the remaining fetuses to develop (hopefully) to full term.
8. IVF is risky for the mother. The IVF process requires the mother (or the woman donating the eggs) to undergo a process of hormonal stimulation to produce multiple eggs for fertilization. There are associated risks such as ovarian hyperstimulation syndrome and complications from the egg retrieval procedure. Also, because of the higher likelihood of multiple births, using IVF means higher rates of pregnancy complications too.
9. IVF isn’t a cure for infertility. A healthy woman ought to be able to conceive and bear a child. If she can’t, something is likely to be wrong with her medically or physically. While she may have any number of conditions that can be diagnosed and treated, IVF won’t help since it is solely focused on making babies. It won’t restore fertility, lead to healthy future pregnancies, prevent miscarriages or help a woman realize long-term health benefits (whether or not she becomes pregnant).
10. IVF objectifies women and children. IVF objectifies women because it treats them as a means to a child, rather than as a whole person. The attitude behind IVF is to get the woman a product – the “baby” – rather than to approach her with integrity and holistically as a person entitled to good health care. The multi-billion dollar IVF industry combines the worst aspects of technological proficiency and a consumerist mentality and preys on the very natural (and good) desire for children. It also objectifies the women who are exploited to donate their “healthy” eggs or who are enticed to become surrogates. And the child “produced” through IVF is objectified, treated from her conception as an interchangeable, fungible and ultimately disposable commodity, rather than as a unique and beloved human person.
If you have concerns about IVF, like we did, what are your options? Couples facing infertility have better alternatives. NaproTechnology, for example, approaches infertility from a holistic perspective and focuses on diagnosing and treating a woman’s (and man’s) underlying health issues that may be causing infertility. Bonus: it also has a higher success rate than IVF. And of course, there are other ways to build a family, such as adoption, which do not involve the reckless or intentional disregard for human life.
But, what if you have exhausted medical treatments and don’t think adoption is for you? What if IVF holds out your last hope to conceive and bear a child? In the end, it may be difficult to accept that this might never happen. But, in seeking to do so through IVF, one must wonder at what cost.
Elizabeth Kirk, J.D., is a Resident Fellow at the Stein Center for Social Research at Ave Maria University and former Associate Director of the Notre Dame Center for Ethics & Culture. She lives in Ave Maria, Florida with her husband and three children.