What's Wrong with In Vitro Fertilization?

by Natalie Hudson, Executive Director of Right-to-Life of Toronto

Infertility, an untold anguish suffered by thousands of couples, is on the rise with approximately 600,000
infertile individuals in Canada today. The ongoing cycle of hope and despair a couple experiences as they await
the outcome of pregnancy tests can be emotionally grueling. Studies have shown that women experiencing
infertility can suffer emotional distress and anxiety levels as high as patients who suffer with cancer and heart
disease.

There are several methods, natural and unnatural, employed in the attempt to conceive, one of them being In
Vitro Fertilization (IVF). Many of those unfamiliar with the rigors of the IVF process, laud it as a solution to the
problem of infertility. Madame Justice Prowse in the recent BC Court of Appeal endorsement of same-sex
marriages stated that access to reproductive technologies makes procreation available to gay couples - but does
it really. What are the implications of this technique, both ethically and practically speaking?

An article from the New York Time. reprinted in The Canadian Journal of Infertility Awareness wrote about the
tremendous emotional stresses a woman has to undergo in the IVF process. Quoting Dianne Clapp, the Medical
Information Director for Resolve, a national infertility support organization, it reported,

Women have numerous pelvic exams and often take ovary-stimulating drugs via painful injections. Some drugs
tend to cause emotional swings. On an almost daily basis, women have blood drawn to monitor hormone levels.
Ultrasound examinations are performed to examine their eggs. The patients can become consumed by the
details of their hormone levels or the status of their eggs and embryos.

"There are patients who simply do not have the emotional stamina to cope with this process," says Dr. Linda D.
Applegarth, Director of Psychological Services for the Center for Reproductive Medicine and Infertility at the
Weil Medical College of Cornwell University in New York.

The physiological dangers involved in harvesting eggs for IVF treatments were reported in a Washington Post
article in December of 2001. Drugs taken to stimulate ovulation commonly cause "PMS-like symptoms such as
bloating, abdominal pain, nausea and moodiness" and "in 3 to 5 percent of cases, hyper-stimulation of the
ovaries occurs, causing severe abdominal pain; on rare occasions, surgery is required and the patient can be left
infertile. Other risks of retrieval include lacerations, ovarian trauma, infection and anesthesia-related
complications."

Then there is the risk of genetic defect to the child that is being conceived. A prominent study in the New
England Journal of Medicine. concluded that infants conceived with the use of intracytoplasmic sperm injection
or in vitro fertilization have twice as high a risk of a major birth defect as naturally conceived infants.

Twenty-six of the 301 infants conceived with intracytoplasmic sperm injection (8.6 percent) and 75 of the 837
infants conceived with in vitro fertilization (9.0 percent) had a major birth defect diagnosed by one year of age,
as compared with 168 of the 4000 naturally conceived infants. As compared with natural conception, the odds
ratio for a major birth defect by one year of age was 2.0. Infants conceived with use of assisted reproductive
technology were more likely than naturally conceived infants to have multiple major defects and to have
chromosomal and musculoskeletal defects.

Another study reported in the New England Journal of Medicine, 2002, concluded that "the use of assisted
reproductive technology accounts for a disproportionate number of low-birth-weight and very-low-birth-weight
infants in the United States, in part because of absolute increases in multiple gestations and in part because of
higher rates of low birth weight among singleton infants conceived with [in vitro fertilization]."

Despite health concerns for the mother and child, what is most disconcerting is the loss of human life in the
practice of these reproductive technologies - it is stunning. The process of IVF involves the retrieval of many
eggs from the woman's ovaries, which have been stimulated through drugs; as many as twelve eggs are
harvested for each IVF attempt. A single microscopic sperm is injected into each ovum to ensure fertilization.
Once the embryos have been created they are 'inspected' and three of the 'healthiest' are chosen for implantation.
Each implantation is referred to as a "cycle". The use of three embryos ensures that at least one will 'take'.
However if all three are successful, two will be selected for a process called "selective reduction', most
commonly known as abortion.

In a story reported in the Toronto Star, February 23,1998, called the "Human Egg Trade," statistics from the
Human Fertilization and Embryology Authority in England revealed that the IVF success rate per attempt
ranged from 4.9% to 23.7%, with a national average of 14.5%. Of the 20,000 British women who had test-tube
baby treatments that year, there were approximately 3,500 live births resulting from the treatments. Given only
the transfer of 3 embryos to the 20,000 women, 60,000 embryos would have been created and implanted. This
number excludes the embryos that were not chosen for implantation but may remain in a frozen state. The
resulting 3,500 live births means that 56,500 human embryos were lost in the process.

In a 1999 National Center for Chronic Disease Prevention report , American figures showed that there were
86,822 transfers with approximately 3 embryos per transfer. Excluding the embryos that were not chosen for
implantation, calculations show some 260,466 human embryos created for the process of which 30,285 live
births resulted. Approximately 230,181 human embryos did not survive the process. Incidentally, the United
States released figures in May indicating that they have over 400,000 frozen embryos being stored in the
country's 430 fertility clinics; a number much larger than they had originally anticipated.

In Canada, the Canadian Fertility and Andrology Society reported for 200. that there were 5,188 IVF cycles
with 2-3 embryos transferred for each cycle. Approximately 15,564 embryos were created which resulted in
1,452 live births. Again about 14,112 embryos did not survive the procedure.

There is a minefield of ethical questions that surround a procedure in which such a staggering loss of life is
inevitable. Though infertility can be painfully disappointing for parents, do they have the right to use
technology to mandate the existence of their children. Are children the property of their parents. Do they exist to
serve the needs and desires of their parents, however noble or sincere those wishes are, or do they have a
purpose unto themselves. How far can we go in forcing the hand of the Author of Life to grant to us the fruits of
the womb?

What does the Catholic Church say about in vitro fertilization?

CONGREGATION FOR THE DOCTRINE OF THE FAITH

INSTRUCTION ON RESPECT FOR HUMAN LIFE IN ITS ORIGIN

AND ON THE DIGNITY OF PROCREATION
REPLIES TO CERTAIN QUESTIONS OF THE DAY

Heterologous artificial fertilization (the technique used to obtain a human conception through the meeting in
vitro of gametes taken from at least one donor other than the two spouses joined in marriage) is contrary to the
unity of marriage, to the dignity of the spouses, to the vocation proper to parents, and to the child's right to be
conceived and brought into the world in marriage and from marriage. Heterologous artificial fertilization
violates the rights of the child; it deprives him of his filial relationship with his parental origins and can hinder
the maturing of his personal identity. The desire to have a child and the love between spouses who long to
obviate a sterility which cannot be overcome in any other way constitute understandable motivations; but
subjectively good intentions do not render heterologous artificial fertilization conformable to the objective and
inalienable properties of marriage or respectful of the rights of the child and of the spouses. (Sec. II A, para. 2)

Homologous artificial fertilization, (the technique used to obtain a human conception through the meeting in
vitro of the gametes of the spouses joined in marriage) in seeking a procreation, which is not the fruit of a
specific act of conjugal union, objectively effects an analogous separation between the goods and the meanings
of marriage... Fertilization achieved outside the bodies of the couple remains by this very fact deprived of the
meanings and the values which are expressed in the language of the body and in the union of human persons.
(Sec. II B, para. 4b)

The spouses cooperate as servants and not as masters in the work of the Creator who is Love. In reality, the
origin of a human person is the result of an act of giving. The one conceived must be the fruit of his parents'
love. He cannot be desired or conceived as the product of an intervention of medical or biological techniques;
that would be equivalent to reducing him to an object of scientific technology. No one may subject the coming
of a child into the world to conditions of technical efficiency which are to be evaluated according to standards
of control and dominion. (Sec. II B, para. 4c)

...Techniques of fertilization in vitro can open the way to other forms of biological and genetic manipulation of
human embryos, such as attempts or plans for fertilization between human and animal gametes and the
gestation of human embryos in the uterus of animals, or the hypothesis or project of constructing artificial
uteruses for the human embryo. These procedures are contrary to the human dignity proper to the embryo, and
at the same time they are contrary to the right of every person to be conceived and to be born within marriage
and from marriage. (Sec I, para. 6)

IVF Violates Human Dignity

Science and technology have made enormous contributions to our lives and society. But the fact that a certain
procedure is technologically possible, does not make it ethically right.

What is in vitro fertilization?

"In vitro" literally means "in glass." In vitro fertilization is a process whereby human life is generated in a
laboratory environment like a glass petri dish.

How is in vitro fertilization carried out?

In vitro fertilization begins when fertility technicians administer hormone treatments to a woman. The hormones
hyper-stimulate the woman's ovaries to produce a number of eggs at one time. The eggs are collected from the
woman's body and then combined with sperm. The resulting embryos are nourished in laboratory cultures and
inserted into the woman's body with the hope that one embryo will successfully implant in the lining of the
womb and develop. The process is very controlled and involves numerous trips to the in vitro fertilization
center.

How does in vitro fertilization cause the death of human embryos?

The Jones Institute, one of the pioneers of in vitro fertilization, reports that only 10 to 20% of the human
embryos produced by in vitro fertilization ever result in a normal pregnancy. The Centers for Disease Control
estimated that in 1998, 28,000 babies were born through in vitro fertilization in the United States. This means
that 140,000 - 280,000 human embryos are missing from the equation for that year alone.

What happens to the rest of the embryos?

Many embryos die in the transfer process since they are fragile.
Some embryos are unwanted and eliminated because they are considered genetically inadequate.
Some embryos are stored alive in freezers.
Some embryos are simply killed as they are washed down the sink.

Why is this wrong?

It is a scientific fact that human life begins at conception/fertilization. From conception, a human embryo has a
complete genetic code and his or her growth and development is totally coordinated from within. Human
embryos are human children--sons and daughters!

"Human life must be respected and protected absolutely from the moment of conception. From the first moment
of his existence, a human being must be recognized as having the rights of a person."

When this fundamental moral line is violated or obscured, categories of people become devalued and they
become easily used for utilitarian purposes.

What about infertile couples who desperately want a child?

No one has the right to a child. Even for the most loving of couples, there is no right to a child through either
normal conjugal relations or reproductive technologies.

In vitro fertilization turns children into commodities. When a couple undergoes in vitro fertilization, they are
saying, "We want a child no matter what," and the child becomes an object. This evolves into a selective
mentality, whereby couples choose the kind of child they want.

Above all, a child is a gift. Gifts should not be controlled or manipulated. Cooperating with God's plan for
human procreation ensures that all children are accepted as gifts.

If in vitro fertilization did not bring death or harm to human embryos, would it be okay?

In vitro fertilization is wrong because it separates human procreation from conjugal union. In the process,
couples make themselves the masters of human life instead of its stewards.

Conjugal union has both a unitive and a procreative purpose. In other words, conjugal intimacy is meant to
express both love and fruitfulness.
Because the human person is a unity of body and spirit, both the unitive and procreative meanings of the
conjugal act must be expressed spiritually and physically. The Biblical notion of "two in one flesh" (cf. Gen
2:24) has a concrete significance here.

Spousal union is expressed both spiritually and physically. And at the same time, the procreative dimension of
conjugal union yields both spiritual benefits and physical fruits. When conjugal union is physically fruitful, a
couple participates in God's creative act instead of dominating it.

How does marital integrity protect human dignity?

Maintaining both the unitive and procreative meanings of conjugal union guards against the demand for
children as a right and the use of spouses for sex. Respect for love and life as essential aspects of martial
integrity helps ensure that spouses and children are appreciated as gifts. On a profound level, marital integrity is
needed to protect human dignity.

Sometimes an embryo will die in normal conjugal relations. Why is it a big deal if embryos
die in the process of in vitro fertilization?

In normal conjugal relations, no one makes the intentional choice to cause the death or harm of embryos. With
in vitro fertilization, there is an intentional choice to carry out a procedure whose consequences are known in
advance.

Isn't adoption the same as demanding a child?

Adopting a child is accepting someone who, because of some unfortunate circumstance, needs a loving home.
Adoption is a generous act focused on a child who already exists.

Using in vitro fertilization is not accepting a child as a gift, but rather manipulating a child into existence.