Commission on Biomedical Ethics - Archdiocese of St. Paul & Minneapolis

In Vitro Fertilization & Artificial Insemination

on Infertility and In Vitro Fertilization (IVF)

This section evaluates in vitro fertilization and artificial insemination. Two primary concerns of artificial fertilization and artificial procreation include how life is being transmitted and the well-being of that life (deeming all human life to be valuable).

Artificial insemination and in vitro fertilization differ in the technique used. Artificial insemination transfers collected sperm into the genital tracts of the woman; whereas, in vitro fertilization occurs when two gametes meet completely outside of the body.

In vitro literally means in glass, as in a test tube and is performed in a laboratory. In vitro is the opposite of in vivo (in a living organism). In vitro fertilization (IVF) is a procedure in which sperm are placed with unfertilized eggs in a Petri dish or a test tube to achieve fertilization. The embryo is then transferred into the uterus or cryopreserved (frozen). A human life begins at the moment of conception, which takes place when the sperm and the ovum unite; therefore, prior to implantation. Conception is synonymous with fertilization.

“The connection between in vitro fertilization and the voluntary destruction of human embryos occurs too often” (CDF, Donum vitae, 2). Additional moral problems arise when fertilized eggs are frozen. Through these procedures, “life and death are subjected to the decision of man, who thus sets himself up as the giver of life and death by decree.’ ‘Even today, the usual practice [of IVF] presupposes a hyper-ovulation on the part of the woman: a number of ova are withdrawn, fertilized and then cultivated in vitro for some days. Usually not all are transferred into the genital tracts of the woman; some embryos, generally called "spare", are destroyed or frozen. On occasion, some of the implanted embryos are sacrificed for various eugenic, economic or psychological reasons. Such deliberate destruction of human beings or their utilization for different purposes to the detriment of their integrity and life is contrary to the doctrine on procured abortion…” (CDF, Donum vitae, 2).

Many consider in vitro fertilization to be a tool to help couples who struggle with infertility. However, this procedure negates the sexual act that should take place between husband and wife. In regards to homologous artificial fertilization, “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.” (CDF, Donum vitae, 4a). “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” (CDF, Donum vitae, 4b).

In addition to homologous (gametes from married spouses) artificial fertilization, the in vitro fertilization procedure may occur heterologously (gametes come from a donor). “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” (CDF, Donum vitae, intro.)

There are several medical advances that can determine the cause of infertility, and provide treatment that is morally acceptable. NaPro Technology, developed by Dr. Thomas Hilgers, is a healthy and moral alternative.

2374 Couples who discover that they are sterile suffer greatly. “What will you give me,” asks Abraham of God, “for I continue to be childless?” (Gen 15:2). And Rachel cries to her husband Jacob, “Give me children or I shall die!” (Gen 30:1).

2375 Research aimed at reducing human sterility is to be encouraged, on condition that it is placed “at the service of the human person, of his inalienable rights, and his true and integral good according to the design and will of God” (CDF, Donum vitae. Intro., 2).

2376 Techniques that entail the dissociation of husband and wife, by the intrusion of a person other than the couple (donation of sperm or ovum, surrogate uterus), are gravely immoral. These techniques (heterologous artificial insemination and fertilization) infringe the child’s right to be born of a father and a mother known to him and bound to each other by marriage. They betray the spouses’ “right to become a father and a mother only through each other” (CDF, Donum vitae II, 1).

2377 Techniques involving only the married couple (homologous artificial insemination and fertilization) are perhaps less reprehensible, yet remain morally unacceptable. They dissociate the sexual act from the procreative act. The act which brings the child into existence is not longer an act by which two persons give themselves to one another, but one that “entrust the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children” (CDF, Donum vitae II, 5). Under the moral aspect procreation is deprived of its proper perfection when it is not willed as the fruit of the conjugal act, that is to say, of the specific act of the spouses’ union…Only respect for the link between the meanings of the conjugal act and respect for the unity of the human being make possible procreation in conformity with the dignity of the human person” (CDF, Donum vitae II, 4).

Artificial insemination is a transfer of previously collected sperm into the woman's genital tracts. The procedure involves a fine catheter (tube) that is inserted through the cervix (the natural opening of the uterus) into the uterus (the womb) to deposit a sperm sample from a donor other than the woman's mate directly into the uterus. The purpose of this procedure is to achieve fertilization and pregnancy. Artificial insemination can take place by a donor or husband. AID (artificial insemination by donor) is also called heterologous insemination. It is distinguished from homologous insemination that is artificial insemination by husband (AIH).

Eugenics is meant to improve the genetic constitution of the human species by selective breeding. With modern technology, this can take place through in vitro fertilization, where one can select certain physical traits of a donor, e.g. eye color, height, etc. This is particularly dangerous when one reduces a human being to its future potential, i.e., unborn fetuses may receive a diagnosis of a disability and are therefore terminated before birth since they do seem to provide a genetic improvement to society.

Fertilization is the process of combining the male gamete, or "sperm," with the female gamete, or "ovum." The product of this combination is a cell called a zygote. In the case of humans, the zygote is a developing baby.

Homologous artificial fertilization or procreation means the technique used to obtain a human conception using the gametes of the two spouses joined in marriage (CDF, Donum vitae, intro.).

Heterologous artificial fertilization or procreation means techniques used to obtain a human conception artificially by the use of gametes coming from at least one donor other than the spouses who are joined in marriage (CDF, Donum vitae, intro.).

Infertility is a time where a couple is not able to conceive. Some of the causes of infertility are for men, a sperm disorder. Infertility causes in women can be an ovulation disorder, blockage of the fallopian tubes, and hormonal defects.

NaProTECHNOLOGY (Natural Procreative Technology) “is a new women's health science that monitors and maintains a woman's reproductive and gynecological health. It provides medical and surgical treatments that cooperate completely with the reproductive system. Unlike common suppressive or destructive approaches, NaProTECHNOLOGY works cooperatively with the procreative and gynecologic systems. When these systems function abnormally, NaProTECHNOLOGY identifies the problems and cooperates with the menstrual and fertility cycles that correct the condition, maintain the human ecology, and sustain the procreative potential. Women now have an opportunity to know and understand the causes of the symptoms from which they suffer” (www.naprotechnology.com).

For thousands of couples suffering from infertility, the advances in reproductive health have given many new hope--and, in some cases, new life. However, with progress comes the burden of ethical responsibility--a burden many in the field seem unwilling to shoulder. This weekend, The Washington Post published an emotionally-charged article, "Too Much to Carry," that did an admirable job portraying the wave of selective reduction that often accompanies modern fertility treatments. Doing her best to put a human face on the inhumane procedure, author Liza Mundy visited the offices of Dr. Mark Evans to observe the dark side of in-vitro fertilization (IVF) for herself. The experience, as she tells it, was an eye-opening one. If IVF were as simple as fertilizing one egg with one sperm, the process would be less troubling. Yet for several of these at-risk women, doctors insist that to make the pregnancies more "viable" there must be less competition in the womb. This often means that "excess embryos" are created, implanted, and destroyed after tests are performed to determine which of the fetuses are healthiest. In some instances, Mundy was present for the "reductions" and describes the horror of seeing tiny lives, once active on the ultrasound screen, quickly silenced by a lethal injection to the heart. The "selection process" is also used to single out small victims that doctors suspect have Down syndrome or other maladies, which, 85% of the time is used to justify an abortion. In one visit, Mundy describes the patient crying, "Oh, my gosh, I can really see it! I can see the fingers!" and then sobbing uncontrollably as the small baby goes still. Another woman says, "It's killing me that we're going to do this. I never thought I would feel that... I'm vehemently pro-choice." Yet the sight of seeing the needle, as one nurse puts it, "chasing the babies" who try to get away, overwhelms mothers. This same nurse, a new mom herself, has trouble with the procedure because she feels like they are "playing God." "Some of these people tried to get pregnant...and prayed to God. And now that they're pregnant, they're telling God, 'You gave me too many.'" Rather than using IVF as an end to create life, the process is all too often a means that destroys it. This article serves as a timely call to conscience in an era when couples consider it a "right" to have children but seek freedom from the unintended consequences. (Courtesy of the Family Research Council)

Additional Resources

Too Much to Carry?

Women pregnant with multiple fetuses face one of the toughest choices imaginable: Risk the health of all, or take the lives of some