So if IVF isn’t an option - or doesn’t work - then what?
My recent article on IVF provoked strong reactions and the response to it was remarkable. Why? I believe part of the reason that it resonated so deeply is that infertility, which gives rise to the demand for IVF, is a profound, yet lonely, burden to bear.
No one would guess it from looking at you – especially in a time and in a culture when so many are childless by choice. In an age of “oversharing” the most intimate details of one’s life, infertility is an unspoken ordeal. And yet it is not the sort of thing one can ignore. A woman is reminded monthly of her body’s failure to cooperate with nature. The pain of infertility is different from other forms of physical suffering or disease. Because our bodies carry within them the potential for motherhood and fatherhood, infertility damages one’s self-conception of femininity or masculinity. A woman has a womb – but no child to nestle in it and grow. She has breasts – but no little one to suckle and nourish. A man’s sterility may cause him to feel insecure in his masculinity and suffer deeply – not because of his inability to provide for a family, but his inability literally to provide a family. And because children are the visible sign of marital love (the two made one literally), infertility strikes at the very heart of what it means to be a married couple. On top of all of this, men and women simply don’t communicate the same way, and their different ways of handling suffering can strain a marriage to the breaking point.
Although nothing completely heals the pain of infertility, IVF seemingly holds out hope for couples who suffer from it. But the deep pain of infertility and the good and natural desire for a child do not legitimate any means to cease that suffering or obtain that end. This was the painful truth of my first article: some things, and IVF is one of them, simply cost too much.
Although the article struck a deep chord with many, the reactions were varied. Many readers wrote in appreciation for a primer on the moral challenges involved in IVF procedures. Others wrote in surprise, as they were not aware of some of the more problematic aspects of IVF, and wondered whether it would be acceptable to use if a couple avoided aspects like pre-implantation genetic diagnosis, selective reduction or the creation of excess embryos. While this would eliminate some of the gravest objections, others remain and they are serious. In the end, it still involves participation in a multi-billion dollar industry that uses abortion and eugenic screenings, and which results in hundreds of thousands of little lives in freezers.
Some readers wrote in frustration and even anger at a critique of a procedure that gave them real hope and, in some cases, had resulted in the birth of a long awaited and much loved child. Of course, it seems impossible to accuse oneself of wrongdoing in the creation of a deeply desired child. But, critiquing IVF in no way suggests that the children so conceived are not “children of God” or that they lack human dignity. They are clearly desired and wanted beyond measure – as all children should be. Human history is replete with such complicated and broken circumstances of conception. The dignity of the child is not diminished, but the broken circumstances remain and must be acknowledged as such.
Full disclosure: I am a Catholic, and the theological and philosophical underpinnings of the Church’s clear condemnation of IVF persuade me. I would encourage anyone with a sincere desire to understand these matters more deeply to read the Church’s explanation of its opposition to IVF. Good places to start include
Dignitas Personae and “Life-Giving Love in an Age of Technology.” In these documents, the Catholic Church clearly teaches that IVF is morally impermissible: there are no circumstances under which it is allowed. But rather than rely on those arguments, I chose to focus on ten points that I hoped would be accessible and compelling to any person, regardless of their belief. In the end, if your conscience is not troubled by the Church’s clear teaching or any of the ten points I raised, and you firmly cling to the belief that the good end of a child justifies any scientifically available means, then you will likely pursue IVF or justify your use of it no matter what argument I or others make.
Where does this leave those who suffer from infertility but are unwilling to participate in IVF? Where does that leave the many people who seek to conceive through IVF but because of its low success rate remain childless? While I am not a doctor or a counselor, I have walked this path and humbly offer some of the concrete things that have helped my husband and me.
1) Get good medical care. A healthy man and woman should be able to conceive, and a healthy woman should be able to bear a child. It is important to remember that the reproductive system is not an independent component in our bodies – oftentimes infertility can be indicative of a systemic issue. It is always worthwhile to pursue holistic medical care, especially as it could reveal underlying health concerns that may or may not be identified in a typical IVF workup. Be willing to take an active role in your health care. I had difficulty in finding a doctor who was willing to be creative once IVF was off the table, and eventually I sought treatment through NaproTechnology and reproductive immunology. I am grateful to have identified underlying conditions which affect my general health, not simply my fertility, and which are treatable and manageable. Ask your doctor, “how can you help me to be a healthy person, whether or not I conceive and give birth to a baby?” If your doctor is not interested in providing this kind of care, find another one.
2) Take good care of yourself. It’s easy to get caught up in the medical approach to infertility, but to neglect healthy living. Eat nourishing food. Take wholesome supplements. Exercise. Sleep well.
3) Love your spouse. Infertility puts a great deal of stress on marriage and especially on intimacy. Just as contraception and pornography risk reducing one’s spouse to an object of pleasure, a hyper-focus on fertility can reduce one’s spouse to a means to have children. Don’t neglect your marriage in your desire for children. Instead, let infertility be the occasion to accept your spouse with all his or her frailties and weaknesses. Love one another. Focus on your common interests and your friendship. Be attentive to ways that you can protect your intimacy.
4) Share your burden. Because infertility is silent and lonely, and because it may place different burdens on men and women, I often desired and sought the advice, prayers and encouragement of others – especially other women dealing with the same issue. Whether a professional counselor, a spiritual director, support groups, or close friends, don’t be afraid to seek outside support. In turn, give support to others who will appreciate your companionship and who may benefit from the lessons you have learned along the way.
5) Protect your heart. There can be many hurtful reminders of the pain of infertility. I think, for example, of how difficult it can be to hear people complain that they are pregnant, reminding us of an experience we may never have. Or how painful it is to hear a friend confidently plan the timing of her next child as if it was so easy for everyone, or declaring that she is “finished” when you haven’t even been given the chance to begin. It is difficult for some to attend baby showers, or even to be around young children. Know your limits and protect your heart by being prepared in advance. It may be necessary for you to avoid certain people or situations, especially at particularly difficult points in your journey.
6) Educate others. If you are emotionally able to do so, it can be helpful to share with others your situation and gently instruct them about ways they can be sensitive to this suffering and support those who struggle with it. For example, can you share with your doctor information about IVF? Can you ask your pastor to be sensitive to those who struggle with infertility? Can you talk to your priest to make sure that couples who desire to have children are remembered in prayer intentions in liturgy? Can you start a support group in your parish or in your community?
7) Pray. Although we greatly desired the gift of a child, deep down I was reluctant to beg God for a child. I felt so blessed in so many other areas of my life – my marriage, my family, my vocation – that it seemed (to me) greedy to ask for additional gifts. And, at times, our infertility caused me to fear that God didn’t want us to have a baby – so, best not to ask Him. At a certain critical point in our infertility journey, I had the great fortune to speak to a wise bishop about our struggle. In the gentlest, most fatherly manner, he reprimanded me, warning me against despair, and counseled, “Do not fail to ask God for what you need. He will not refuse you.” And, the bishop was right. God has not refused me those gifts I needed most – acceptance, peace and joy. I have also found solace in meditating on Scripture, especially on those passages that involve the barren women of Bible and the witness of their own perseverance in prayer and the fruit that it bore for the Kingdom. Reading the lives of certain saints has been also been helpful to me, as well as the spiritual memoir, My Sisters the Saints, which recounts a woman’s journey to motherhood with the companionship and guidance of six women saints.
8) Deepen your appreciation of the role of suffering. It’s very easy to let infertility make you a sad, bitter person, to let it come between you and your husband, and to let it come between you and God. At one point, I made the decision that I did not want to be miserable – and was given the grace to realize that God didn’t want this for me either. I wanted a good marriage. I wanted to look at other children with joy – not with resentment or envy. It helped me to think about and meditate on the role of suffering in our lives, and how I ought to handle it, whether it was infertility or something else (it’s always something!). I recognized that rather than trying to avoid suffering or letting it define my life, I needed to practice gratitude and selfless love. In his encyclical on hope, Spe Salvi, Pope Benedict summed it up like this: “It is not by sidestepping or fleeing from suffering that we are healed, but rather by our capacity for accepting it, maturing through it and finding meaning through union with Christ, who suffered with infinite love.”
9) Hope. One particular challenge I had with infertility was how to simultaneously accept my cross and yet remain hopeful. A woman’s cycle only reinforces these seemingly inconsistent states of mind – hopes are raised and dashed each month anew. I will admit that after much reflection on this paradox, I still do not understand it fully. One source that I have found enlightening is Josef Pieper’s essay, “On Hope,” in which he reminds us that hope is not the “presumptuous anticipation of fulfillment,” but rather “the power to wait patiently for a ‘not yet’ that is the more immeasurably distant from us the more closely we approach it.” Or as Pope Benedict XVI put it in Spe Salvi, “It is, however, hope—not yet fulfillment; hope that gives us the courage to place ourselves on the side of good even in seemingly hopeless situations . . . .” I also learned that in hoping for a good that might not come, I let myself be open to goods that I could never have imagined. Let yourself be surprised by hope.
10) Be open to other ways to be “fertile.” Those who suffer from infertility must remember that all marriages are called to be fruitful, even if it is not possible in the biological sense. Infertility is an occasion for trusting that there are other avenues to realize your desire to care for others. There is not one path for everyone. Some might choose to parent children through foster care or adoption; others will choose to pursue other vocations, such as carrying for the elderly or poor, missionary work, or vocations that might be incompatible with raising children. For our marriage, we chose adoption. That’s the topic of another article, but in discovering our vocation to adoption, my husband and I are grateful – beyond words – for our infertility.
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.