What You Haven’t Been Told and What You Need to Understand

In vitro Fertilization. In February of this year (2024), in a legal response to the the acidental thawing, and therefore death, of frozen human embryos in an Alabama IVF strorage facility, Alabama’s Supreme Court ruled that human embryos could be considered unborn children under Alabama’s Wrongful Death of a Minor Act. This sent media pundits and politicians into paroxysms of panic over the potential implications for IVF in America with many of them demonizing the ruling and ardently praising the “pro-life” procedure of IVF.

How should we think about this? Is IVF pro-life? Is it something Christians should support? As with all matters, it’s essential that we bring thoughtful Christian discernment to bear. This process may make some uncomfortable, especially those who have conceived or know children conceived through IVF. As we enter this coversation, therefore, it’s vital to keep the mercy of the Lord Jesus before our eyes. In Christ God lavishes His mercy on us. While Christian discernment may cause us to question the wisdom of IVF, we must ensure that the value and worth of individuals conceived through IVF is not questioned. Every human bears the image of God and has inestimable worth, but it is this very reality that will cause us to question the ethics of IVF.

Further, as we will emphasize toward the end of this article, those struggling to conceive children need encouragement, support, and compassion. This struggle may be a cross some, for reasons beyond our understanding, are called to bear. In such cases, we must not turn to ethically problematic procedures, but to the person and work of Jesus Christ. In Jesus the suffering One, we will find hope for the hurting. In Jesus, the One who died and rose, we will find grace sufficient for every burden.

How, then, do we bring Christian discernment to bear on the question of IVF? We begin by asking two basic, but essential questions:

1) What is it?

2) Are there moral concerns?

The rest of this article will provide answers to these questions. Before we dive into our questions, though, we need to establish two guiding principles that will ensure we are thinking Christianly about the issue, principles that will ensure we arrive at Christian answers.

Principle 1: The Creator comes before the creature.

Principle 2: The Creator tells us what is good.

In order to think Christianly, we must affirm these truths. They are non-negotiables. If we reject them, we reject Christian discernment.

Principle 1 tells us that the Creator gives life. Further, it tells us that the Creator sternly warns against the taking of life, specifically human life (see Genesis 9:6; Exodus 20:13). In ethical questions we will return again and again to this starting point as we consider first the Creator’s work and Word before we begin pursuing our desires.

Principle 2 tells us that the Creator calls life good. Further, He calls the one-flesh, procreative potential between a husband and a wife good. As such, He considers fertility good[1] and the receiving of children within marriage good.[2]

In fact, the Creator specifically blesses the one-flesh union of male/female with the potential to procreate (Gen. 1:28). This blessing must be appreciated. First, the Creator intends the blessing to be received within male/female marriage. Second, blessings are always given by the Creator, not claimed as a right by creatures. These insights will prove necessary as we bring Christian discernment into the question of IVF.

What is IVF?

What, then, is in vitro fertilization? The Latin words in vitro mean “in glass.” As such, in vitro fertilization is fertilization that takes place in glass, i.e. in a petri dish (which, in reality, is probably plastic). This is accomplished through a complicated process of harvesting a woman’s eggs and collecting a man’s sperm that are then combined in a petri dish to produce human embryos which will then either be transferred into the woman’s uterus or placed in frozen storage for potential future use or potential donating to science, discarding, or adopting[3] to other adults.

Harvesting a woman’s eggs involves injecting hormones into a woman’s body to stimulate the ovaries to produce multiple eggs (as opposed to the typical one per month), hormones to ripen the eggs, and hormones to prevent the premature release of these eggs. A hollow needle is, then, inserted through the abdominal wall to collect the eggs.

Although not typically acknowledged, this procedure (the injection of powerful hormones and the entire IVF process) carries significant risks for both women and the embryos that survive to birth (to say nothing of the vast majority of embryos who die or are discarded in the process). Women attempting IVF are at elevated risks for Ovarian Hyper Stimulation syndrome, loss of fertility, ovarian torsion (twising of the ovary, which may cause it to die), stroke, kidney disease, premature menopause, ovarian cysts, and death. One of the commonly used hormones, Lupron, isn’t approved by the FDA for fertility treatment and has a Category X rating (i.e. there is a strong likelihood that if a woman gets pregnant while taking it, her baby will be harmed). IVF pregnancies also carry significantly increased risks of gestational diabetes, 3^rd or 4^th degree lacerations at delivery, uterine rupture, and more.

Children born through IVF have elevated risks of heart defects, musculoskeletal central nervous system deformities, and preterm birth (also low birth weights). They also have elevated risks of high blood pressure, insulin resistance, childhood cancer, leukemia, and hepatic tumors.

Are there moral concerns with IVF?

The attentive reader will have already noticed several moral concerns with IVF, but there are more we must acknowledge. As we begin to highlight these moral concerns, we return to where we began: The Creator comes before the creature and the Creator tells us what is good. We do not and must not start with what the creature wants. We must start with what the Creator says. The Creator gives life and calls it good and sternly warns against the taking of it (and the embracing of procedures that unnessarily involve great risk to and great loss of life). Further, we must remember that life begins at fertilization. In other words, a person becomes a person at fertilization. You became you at fertilization. Fertilization does not produce a potential person; fertilization produces a person with potential. As such, every embryo created through IVF is a human person who bears God’s image and has God’s protective command surrounding him. These tiny human persons are our neighbors and we owe them protection and life. They should not be treated as property or commodities or as an adults’ rights issue.

Surely the thought of indefinitely freezing human embryos must give us moral pause. What will happen to them? These are persons, not things. How can it be morally acceptable to store living humans for future use or future discarding?[4] How is this not treating persons like property? And surely we must acknowledge that God never said adults have the right to children. We acknowledge the desire to have children as a good desire and we grieve deeply with the husband and wife who battle infertility,[5] but can we not see that regarding children as rights reduces their personhood in significant ways?[6] What person has the right to have another person?

And do we not hear same-sex couples echoing the same logic in their “right” to create and obtain children?  And do we not see how this mentality drives the donor conception industry in which children are forced into situations in which they must pretend that two moms or two dads is no different than a dad and a mom, in which they are forced to reduce their biological mother or father to “donor”[7] or must live their lives fearing they might marry an unknown half-sibling?

We must acknowledge that regarding children as a right that adults have is an adult-centric mentality, the same one that undergirds the claim that adults have the right to eliminate unborn children they don’t want. Christian morality calls us to consider the needs and wellbeing of the neighbor as equal to our own (love your neighbor as yourself).[8] IVF (and surrogacy), does not do this. As diffcult as it may be to admit, its driving concern is the wants of the adults.

Consider a few of the realities of IVF. Lab workers screen human embryos, dubbing some “acceptable” and some “undesirable.” One honest clinic acknowledged this:

While we can make educated guesses about an embryo’s potential based on the experience of many embryologists grading millions of embryos, there are many cases of embryos with poor grades that make pregnancies and perfect embryos that do not. Also, no matter the grading system, the embryo grades do not tell us what is going on inside the embryo genetically.[9]

Appreciate what was said. First, tiny humans are being graded. Imagine having someone line up a classroom of children and grade their worthiness to live based on his subjective assessment. Would you end the lives of the children deemed suboptimal? Why do we permit it with IVF? They are no less human and have no less worth than children who have been born, but they are more vulnerable. Shouldn’t they require greater protection? Second, this has happened to millions of human embryos. Millions! It’s truly unconscionable. Again, these embryos are no less human and no less a person than children outside the womb.

After the “undesirable” human embryos are discarded, some of the “good” ones are selected for transfer and the rest, if not discarded, are placed into cold storage in case the first embryo (or embryos) doesn’t survive to birth. And the truth of the matter is that only a fraction of the human embryos fertilized through IVF will actually survive through transfer until birth. How small is this fraction? Sudies vary, but it seems to be between 10% and 20%. One researcher shared information from 2019, writing, “… in 2019 out of a million embryos involved in IVF cycles, 84,000 made it to term – the remaining 900,000 did not. By comparison, in the same year, the CDC reported 629,898 abortions.” [10] These numbers are staggering. IVF, a procedure that is routinely promoted as “pro-life,” brought death to more tiny babies than abortion, a procedure which unequivocally aims for death. We may not like it, but this is reality. As such, can discerning Christians continue considering IVF a pro-life practice?

But, some say, what if potential parents only fertilize as many eggs as they are willing to transfer? This removes many of the moral concerns with IVF, but leaves several significant moral issues unresolved. It still engages in an incredibly risky procedure with an astronomically high failure rate.[11] Eight to nine out of ten human embryos will not survive. Can Christians in good conscience support this? Can we really consider this a pro-life practice? The large quantities of hormones injected into women significantly elevate risks for negative health outcomes and studies are increasingly showing increased risks of negative health outcomes for children conceived through IVF.

There are more ethical concerns. Bioethecist Gilbert Meilaender raises the pesky question of the one-flesh union, observing that in begetting a child through the one-flesh union (as opposed to IVF) parents,

have not simply reproduced themselves, nor are they merely a cause of which the child is an effect… their love-giving has been life-giving; it is truly procreation.

Further, even if every embryo was transferred, Meilaender observes that it still perpetuates the “children as rights” mentality,

When we remember again the number of needy children who go unadopted precisely because of their needs, when we consider the degree to which new reproductive technologies have – in very short time – begun to teach our society to think about reproduction as a right to which everyone is entitled, when we ponder the implications of these technologies for our society’s understanding of children, we must ask whether Christians should not call a halt – at least for themselves. We do not have a story that teaches us to think of children as our entitlement or our possession… For knowing as we do that God has already provided the Child, we can free ourselves of the feverish need to have a child of our own, whatever the cost. Perhaps the greatest service we can perform for our own children and for the world into which they will be born is to live in such a way that we remind ourselves and others that each child is indeed not our product, our project, or our possession, but a “blessing” that “love gives again into our arms.”[12]

As emphasized earlier, the value and worth of individuals conceived through IVF is not being questioned. Every human bears the image of God. As C.S. Lewis so memorably phrased it in The Weight of Glory, “Next to the Blessed Sacrament itself, your neighbour is the holiest object presented to your senses.” And the unborn is our neighbor. This is what makes IVF morally problematic; it doesn’t honor the holy status of the unborn neighbor. How could any procedure that results in more unborn deaths than abortion truly honor the unborn?

Meilaender’s words are worth repeating:

When we ponder the implications of these technologies for our society’s understanding of children, we must ask whether Christians should not call a halt – at least for themselves.

Might this mean that some couples are unable to have their own biological children?[13] Yes. Might this be a burdensome cross they must bear? Yes. And might we, as a church, need to do a better job of supporting those who struggle with infertility? Yes. We have much to learn in this regard and much to change. Lutheran pastor Peter Brock, writes,

The church’s mercy to the infertile couple… means listening, suffering and groaning in prayer with them, interceding in prayer for them, and redirecting their focus to Christ on the cross. Mercy does not mean recommending an endless and possibly dehumanizing list of solutions or distracting from their loss with pious platitudes.[14]

Some are quick to move the conversation to adoption, but adoption should not be offered as a fix for infertility. Adoption is not about filling a need adults have (this would be treating children no different than IVF treats them). Adoption is about filling a need children have. It is not an adult-centric act, but a child-centric one. Further, for Christians, it can be a beautiful lived reflection of our adoption into God’s family.

Returning to Pastor Brock’s insights, the church best serves couples struggling with infertility by redirecting their focus to the cross of Jesus. There, in Jesus the suffering One, we will find hope for the hurting. In Jesus, the One who died and rose, we will find grace sufficient for each day. In Jesus, the One who comes to us with forgiveness, life, and salvation through His Word and Sacraments, we will find the hope that our hurt isn’t eternal.

This is how we bring Christian discernment to the question of IVF.[15] – Pastor Conner

[1] Calling fertility good doesn’t mean that a couple is mandated to have as many children as possible. Spacing/limiting the number of children in marriage may be necessary in a fallen world, but this never makes fertility not good.  Sadly, the good of fertility is grossly underappreciated by our culture today that has largely embraced a contraceptive mentality that has led to a widespread ignorance of the good gift of fertility, how it works, how it changes with age, and how it should be honored. Further, without getting too far afield, any objective study of this contraceptive mentality will reveal how it has led to an increased objectification of women, the mental separation of procreation from sex, surprise pregnancies that are regarded as the woman’s “problem,” years-long side-effects for women from taking strong hormones to suppress ovulation, the unspoken truth about how contraceptives work (thinning the endometrium lining, thereby potentially making it more difficult for a newly fertilized embryo to implant), the increased difficulty women experience in getting pregnant after coming off contraceptives, and on and on.

[2] We must emphasize here that this does not imply in any way that children conceived outside marriage aren’t good.  They are.  Life is good and they bear the image of God. What is not good is the conceiving of children outside the one-flesh union of male/female marriage. This acts against the good of the Creator who has specifically and explicitly called the receiving of children within male/female marriage good.

[3] Much of the world prefers the word donating instead of adopting. Adopting implies that the embryos are, in fact, human. As such, we use the word that accurately reflects reality. These embryos are tiny humans. They are not donated; they are adopted.

[4] Researchers estimate that over 1,000,000 tiny human embryos are currently frozen in storage in America!

[5] Katie Schuermann offers a thoughtful and compassionate response to couples who struggle with infertility in her book He Remembers the Barren.

[6] We must also acknowledge that many women seeking IVF aren’t actually infertile, but due to many years of being on contraception, they are now experiencing difficulty conceiving.

[7] I remember reading a recent article on this in which a child’s mother told her child, “You don’t have a dad. You have a donor.” Is this not an injustice to the child?

[8] I highly recommend the work of Katy Faust, founder of the children’s rights advocacy group Them Before Us (www.thembeforeus.com).

[9] Cited in “A Comprehensive Report on the Risks of ART” from The Center for Bioethics and Culture Network.

[10] See IVF: A Second Front in the Cause for Life by Stephen Austin and Expendable lives: Abortion and IVF share the same adult-centric priorities by Katy Faust

[11] Some offer “natural cycle IVF,” which avoids the high doses of hormones, but appears to have an even lower success rate than stimulated IVF, so still brings with it great moral concerns.

[12] See The LCMS and Infertility Ethics by Peter Brock

[13] Many medical professionals are quick to recommend IVF, but another option exists: Restorative Reproductive Medicine, which seeks to understand what underlying medical issues might be contributing to the difficulty in achieving pregnancy. Many couples have achieved pregnancy through this medical care. Those interested can learn more here: https://cbc-network.org/

[14] The LCMS and Infertility Ethics by Peter Brock

[15] For those wishing to get better equipped to bring a Christian, pro-life understanding into these sorts of bioethical questions, I recommend The Charlotte Lozier Institute (https://lozierinstitute.org/) and Lutherans for Life (https://lutheransforlife.org/).

About Lutheran Family Service & Life Advocacy Work

Lutheran Family Service is a Recognized Service Organization (RSO) of the Lutheran Church—Missouri Synod (LCMS) that informs, educates, equips and activates our LCMS congregations to stand up and defend the value of human life.

Jesus calls us to influence our culture. He tells us we are the light of His truth in this dark world (Matthew 5:14) and that we are to be like salt preserving this truth and defending it (Matthew 5:13). One of the ways we do this is in the public square is through our elected officials. Part of our Christian responsibility as citizens is to be a voice for God’s truth in the ears of those who represent us. Learn more about life advocacy HERE.