by John M. Haas, Ph.D., S.T.L.
In IVF, children are engendered through a technical process, subjected
to "quality control," and eliminated if found "defective."
Infertility is a growing problem in the United States. And in true
American fashion, there has been a corresponding growth in a
"reproductive technologies industry" to provide a solution.
It is quite legitimate, indeed praiseworthy, to try to find ways to
overcome infertility. The problem causes great pain and anguish for many
married couples. Since children are a wonderful gift of marriage, it is
a good thing to try to overcome the obstacles which prevent children
from being conceived and born.
Scripture is filled with accounts of women who suffered from
infertility. The sorrow they felt at not being able to have a child
could not be diminished even by a husband's love. In the Old Testament
Elkanah says to his wife who was unable to conceive, "Hannah, why do you
weep? And why do you not eat? And why is your heart so sad? Am I not
more to you than ten sons?" Of course Elkanah's wife loved him, but she
wanted to bear their child. Such stories in the Bible are told to show
the power of God; most end happily as the women become pregnant even in
their old age. There is Sarah, the wife of Abraham and the mother of
Isaac; Hannah, wife of Elkanah, who becomes the mother of the prophet
Samuel; and Elizabeth, the mother of John the Baptist.
But the Bible tells us there are limits to acceptable methods for
conceiving a child. Recall the story of Noah's unmarried daughters who
tried to get their father drunk so that they might have children by him!
Obviously not any means can be used to achieve pregnancy.
In our day many techniques and therapies have been developed to overcome
infertility. In the United States an entire "industry" has emerged with
little or no governmental or professional regulations to protect the
inter-ests of the men, women or children who become involved. Women
receive fertility drugs which can result in their conceiving four, five
or six children at once, risking their own health and the health of
their children. Some have several eggs fertilized in vitro (in a glass
dish) without realizing that this may lead to the destruction of these
embryos or their being frozen for later experimental use.
The many techniques now used to overcome infertility also have profound
moral implications, and couples should be aware of these before making
decisions about their use. Each technique should be assessed to see if
it is truly moral, that is, whether or not it promotes human good and
human flourishing. All these technologies touch in some way on innocent
In 1987 the Sacred Congregation for the Doctrine of the Faith issued a
document known as Donum Vitae ("The Gift of Life"), which addressed the
morality of many modern fertility procedures. The document did not judge
the use of technology to overcome infertility as wrong in itself. It
concluded that some methods are moral, while others—because they do
violence to the dignity of the human person and the institution of
marriage—are immoral. Donum Vitae reaffirmed an obligation to protect
all human life when married couples use various technologies to try to
have children. Without questioning the motives of those using these
techniques, Donum Vitae pointed out that people can do harm to
themselves and others even as they try to do what is good, that is,
overcome infertility. The fundamental principle which the Church used to
assess the morality of various means of overcoming infertility was a
rather simple one, even if its application is sometimes difficult.
Donum Vitae teaches that if a given medical intervention helps or
assists the marriage act to achieve pregnancy, it may be considered
moral; if the intervention replaces the marriage act in order to
engender life, it is not moral.
In Vitro Fertilization
One reproductive technology which the Church has clearly and
unequivocally judged to be immoral is in vitro fertilization or IVF.
Unfortunately, most Catholics are not aware of the Church's teaching, do
not know that IVF is immoral, and some have used it in attempting to
have children. If a couple is unaware that the procedure is immoral,
they are not subjectively guilty of sin. Children conceived through this
procedure are children of God and are loved by their parents, as they
should be. Like all children, regardless of the circumstances of their
conception and birth, they should be loved, cherished and cared for.
The immorality of conceiving children through IVF can be difficult to
understand and accept because the man and woman involved are usually
married and trying to overcome a "medical" problem (infertility) in
their marriage. Yet the procedure does violence to human dignity and to
the marriage act and should be avoided. But why, exactly, is IVF
In vitro fertilization brings about new life in a petri dish. Children
engendered through IVF are sometimes known as "test tube babies."
Several eggs are aspirated from the woman's ovary after she has taken a
fertility drug which causes a number of eggs to mature at the same time.
Semen is collected from the man, usually through masturbation. The egg
and sperm are ultimately joined in a glass dish, where conception takes
place and the new life is allowed to develop for several days. In the
simplest case, embryos are then transferred to the mother's womb in the
hope that one will survive to term.
Obviously, IVF eliminates the marriage act as the means of achieving
pregnancy, instead of helping it achieve this natural end. The new life
is not engendered through an act of love between husband and wife, but
by a laboratory procedure performed by doctors or technicians. Husband
and wife are merely sources for the "raw materials" of egg and sperm,
which are later manipulated by a technician to cause the sperm to
fertilize the egg. Not infrequently, "donor" eggs or sperm are used.
This means that the genetic father or mother of the child could well be
someone from outside the marriage. This can create a confusing situation
for the child later, when he or she learns that one parent raising him
or her is not actually the biological parent.
In fact, the identity of the "donor," whether of egg or sperm, may never
be known, depriving the child of an awareness of his or her own
lineage. This can mean a lack of knowledge of health problems or
dispositions toward health problems which could be inherited. It could
lead to half brothers and sisters marrying one another, because neither
knew that the sperm which engendered their lives came from the same
But even if the egg and sperm come from husband and wife, serious moral
problems arise. Invariably several embryos are brought into existence;
only those which show the greatest promise of growing to term are
implanted in the womb. The others are simply discarded or used for
experiments. This is a terrible offense against human life. While a
little baby may ultimately be born because of this procedure, other
lives are usually snuffed out in the process.
IVF is also expensive, costing at least $10,000 per attempt. Over 90% of
the embryos created perish at some point in the process. In a desire to
hold down costs and enhance the odds of success, doctors sometimes
implant five or more embryos in the mother's womb. This may result in
more babies than a couple wants. In Canada, one woman gave birth to five
children engendered by IVF. She had wanted only one, so she sued her
doctor for "wrongful life," demanding that he pay for the cost of
raising the four children she did not want.
To avoid the problems of carrying and rearing "too many" babies after
several have been implanted, doctors sometimes engage in something
euphemistically called "fetal reduction" or "selective reduction." Here
they monitor the babies in utero to see if any have defects or are
judged to be not as healthy as the others. Then they eliminate those
"less desirable" babies by filling a syringe with potassium chloride,
maneuvering the needle toward the "selected" baby in the womb with the
aid of ultrasound, and then thrusting the needle into the baby's heart.
The potassium chloride kills the baby within minutes, and he or she is
expelled as a "miscarriage." If it cannot be determined that one baby is
less healthy than the others, some doctors simply eliminate the baby or
babies who are easiest to reach. Again we see the unspeakable
diminishing of the value of human life which can arise from this
Not everyone who has had a child through IVF has used donor eggs or
sperm, collected the sperm through masturbation, or killed "extra"
unwanted babies in the course of the pregnancy. Yet there is still a
moral problem with the procedure itself. Why?
Why IVF is Wrong
Human beings bear the image and likeness of God. They are to be
reverenced as sacred. Never are they to be used as a means to an end,
not even to satisfy the deepest wishes of an infertile couple. Husbands
and wives "make love," they do not "make babies." They give expression
to their love for one another, and a child may or may not be engendered
by that act of love. The marital act is not a manufacturing process, and
children are not products. Like the Son of God himself, we are the kind
of beings who are "begotten, not made" and, therefore, of equal status
and dignity with our parents.
In IVF, children are engendered through a technical process, subjected
to "quality control," and eliminated if found "defective." In their very
coming into being, these children are thoroughly subjected to the
arbitrary choices of those bringing them into being. In the words of
Donum Vitae: "The connection between in vitro fertilization and the
voluntary destruction of human embryos occurs too often. This is
significant: through these procedures, with apparently contrary
purposes, life and death are subjected to the decision of man, who thus
sets himself up as the giver of life and death by decree." The document
speaks of "the right of every person to be conceived and to be born
within marriage and from marriage." To be within and from marriage,
conception should occur from the marriage act which by its nature is
ordered toward loving openness to life, not from the manipulations of
The dehumanizing aspects of some of these procedures is evident in the
very language associated with them. There is the "reproductive
technology industry." Children are called the "products" of conception.
Inherent in IVF is the treatment of children, in their very coming into
being, as less than human beings.
Following reports of the cloning of "Dolly" the sheep in Scotland, there
is increasing speculation about cloning human beings. Cloning is a
complex procedure by which scientists take a body cell such as a skin
cell (somatic cell) and render the cell's nucleus into a primitive state
so it is capable of guiding the development of another human being
under the right conditions. The nucleus of an egg is removed and
replaced by the nucleus of the somatic cell. The egg is then given an
electrical charge, and new life begins to grow.
No one has yet engendered a human being through cloning, but many scientists believe that this is only a question of time.
There are a number of reasons why someone would try to engender a new
human life through cloning. None would be morally legitimate. For
example, a couple may want to use a cell from a dying child to clone
another baby as a way of perpetuating the life of the first child.
Obviously, this would not be a continuation of the dying child, but the
bringing into being of a new child. The dying child would become the
"progenitor" of a new life without having agreed to it; the new child
would not be treated as a unique individual with his or her own
identity, but as an extension of another person.
A man or woman might also want to have a baby without getting married or
involving a parent of the opposite sex. Some homosexual people have
said that cloning would be a perfect way to have children, because they
would not have to marry someone of the opposite sex. This would be
terribly unfair to the child, depriving him or her of a natural father
Some may want to clone themselves, thinking that they are so intelligent
and successful that a child with their attributes would be a great gift
to society. This would be an act of supreme selfishness that would also
deprive a child of a mother and a father. Anticipating that one day the
cloning of a human being might be attempted, Donum Vitae said this:
"[A]ttempts or hypotheses for obtaining a human being without any
connection with sexuality through 'twin fission,' cloning or
parthenogenesis are to be considered contrary to the moral law, since
they are in opposition to the dignity both of human procreation and of
the conjugal union."
Most disturbing of all, some researchers want to use cloning to create
human beings solely for experimentation and destruction. They propose to
supply genetically matched tissues for treating various diseases by
making human embryos from patients' body cells, then dissecting these
developing embryos for their "spare parts." Some even speak of growing
genetically altered "headless" or "brainless" human clones as organ
farms, arguing that such creatures could be exploited for any needed
organs because they would not have the status of "persons."
Moral Interventions to Overcome Infertility
Any number of morally acceptable interventions may be used to overcome
infertility. For example, surgery can overcome tubal blockages in the
male or female reproductive system which prevent fertilization from
taking place. Fertility drugs may also be used, with the caution that
large multiple pregnancies may put mother and infants at risk. There are
also many ways of tracking natural reproductive rhythms to enhance the
chances for achieving pregnancy. The Pope Paul VI Institute at Creighton
University in Omaha, Nebraska has been successful in helping couples
overcome infertility using natural methods.
Most theologians consider the procedure known as LTOT, or Lower Tubal
Ovum Transfer, to be morally acceptable. This involves transferring the
wife's egg beyond a blockage in the fallopian tube so that marital
relations can result in pregnancy. Another method, more morally
controversial, is called GIFT, or Gamete Intra-Fallopian Transfer. It
involves obtaining a husband's sperm following marital relations and
aspirating an egg from the wife's ovary. Egg and sperm are placed in a
tiny tube separated by an air bubble, and the contents of the tube are
then injected into the wife's fallopian tube with the hope that
fertilization will occur. Some theologians consider this to be a
replacement of the marital act, and therefore immoral. Other theologians
see it as assisting the marital act, and therefore permissible. Because
the teaching authorities of the Church—the Pope and bishops—have not
made a judgment about GIFT, Catholic couples are free to choose it or
reject it depending on the guidance of their own conscience. If the
teaching authority of the Church should judge the procedure to be
immoral, however, GIFT should no longer be used.
The Church has great compassion for those who suffer from infertility.
Out of love for all human life and respect for the integrity of marital
relations, however, the Church teaches that some means of trying to
achieve pregnancy are not licit. Some of these means actually involve
the taking of innocent human life, or treating human life as a means
toward an end or a "manufactured product." They do violence to the
dignity of the human person.
In America we have a tendency to think that we can solve all problems
with the right "technology." But children are not engendered by
technology or produced by an industry. Children should arise from an act
of love between a husband and wife, in cooperation with God. No human
being can "create" the image of God. That is why we say that human
beings "procreate" with God. Engendering children is a cooperative act
among husband, wife, and God himself. Children, in the final analysis,
should be begotten not made.
Dr. Haas is President of the National Catholic Bioethics
Center, Boston, Massachusetts and a consultant to the NCCB Committee for
Copyright © 1998, United States Catholic Conference, Inc., Washington,
D.C. All rights reserved.