IVF - A Closer Look At An Unregulated Industry

In 1978, the first baby conceived by IVF was born. Nowadays, about 1-3% of all births in the US rely on this technology for conception. But after 40+ years of living with this technology, it seems as if Christians still don’t really know what to make of it. Denominational statements on the subject are sparse; even if a church has one, the laypeople are often the last ones to know about it. Despite the fact that IVF has been explicitly rejected by the Catholic church, a 2013 survey found that only 13% of professing Catholics agreed with the church’s stance.¹

Even as Southern Baptists tackle the issue for themselves,² the ethics surrounding IVF still seem to be largely unaddressed. After fighting abortion for decades, most evangelicals are quick to recognize an embryo as a person. Yet, in the evangelical mind, there seems to remain some kind of mental disconnect between the IVF procedure and the embryos that are lost along the way. It’s almost like we are just happy that a couple is able to get pregnant, mentally sweeping away all the thoughts of the discarded humans they made along the way.

But the consequences of apathy are starting to build. Some estimates believe that around 1.5 million embryos are currently being held in storage — a number that continues to climb.³ Some of the embryos are put up for adoption. Some are held onto for a few years before being terminated. Others are simply abandoned, left in suspended animation at the clinic by a mother who can no longer be contacted. Some Christians have decided to “adopt” these extraneous embryos. But even if you have a free uterus and enough cash to pay the “adoption” fees, there is still no guarantee that the embryo will implant, leaving you to wonder if you just participated in the loss of a human life.

IVF is a dirty business with an even darker underbelly. Ethics are often seen as optional, not a rule in a largely unregulated industry. Oh, there are undoubtedly ethics at play here, but for the people who are only used to talking about hypotheticals and whitewashed scenarios, the ethics of IVF may be a bit more dismal than anticipated.

The LGBT+ Factor

I suppose many people would want to initiate a discussion of IVF by framing the issue in the narrowest possible terms: how it affects the nice Christian couple struggling with infertility. But frankly, starting off the debate by boxing it into the smallest possible application does everyone a disservice. IVF has been around for over 40 years. The least we could do is take an honest look at all the fruit it has produced.

To start, it should be noted that — as far as demographics are concerned — the LGBT+ community is by far more invested in the use of fertility services. This degenerate group is approximately twelve times more likely to use fertility treatments, while about 80% of lesbians use anonymous sperm donors.⁴ In the UK, this small demographic, comprising merely 3% of the population, continues to find themselves overwhelmingly overrepresented in IVF services. “In 2008 only 27% of treatment cycles for patients in female same-sex relationships were for IVF, increasing to 45% in 2018.” ⁵ For a group that defines itself by rebelling against the natural order, this reliance on fertility services should come as a surprise to no one.

For the LGBT+ community, IVF is about far more than just “getting pregnant.” In lesbian relationships, for example, one woman may choose to have her eggs retrieved while the other then carries the anonymously fertilized embryo to term. This results in “two mothers,” where the woman giving birth is not genetically related to the baby. With IVF, LGBT+ partners now have the option of “gestational surrogacy,” where the woman carrying the child in her womb does not have to be the biological mother. Sodomites hoping to own a child of their own can also take advantage of this technology. The same-sex partners first acquire an anonymous egg, fertilize it with their sperm via IVF, and then transfer the embryo to a female relative who will then carry the child to term. As finding a surrogate is very expensive, this method avoids all the genetic drawbacks of incest while allowing the groomers to take advantage of a “family discount.”

Setting aside the egregious ethical violations of surrogacy, we quickly find ourselves asking what it even means to be infertile. When those tied in bonds of perversion claim that they are unable to conceive a child, we ought to celebrate that such an unholy union was incapable of producing life. Yet sheer hubris reigns supreme in today’s world, and society instead laments the LGBT+ couple’s “infertility.” Even now, insurance companies are starting to cover IVF procedures⁶ for people joined in these intentionally barren partnerships, despite the fact that there was never a medical issue to fix.

Further complicating infertility statistics is the sheer number of issues that can be resolved by lifestyle adjustments. Celebrity homosexual Colton Underwood, known for his appearance on “The Bachelor,” recently admitted during his IVF surrogacy endeavor that he had been effectively sterile and didn’t even know it. After quitting his testosterone-replacement drugs and cutting back on his hot tub time, the former football player and his fellow sodomizer were able to continue their nature-defying IVF excursion.⁷ But in today’s obesity epidemic, one has to wonder if rising infertility in the overall population is to be expected. As the average age of marriage continues to rise, even married couples may find themselves struggling to reproduce. Such is to be expected when the average window of procreation has been shortened by almost 10 years.

Infographic: Americans Are Getting Married Older Than Ever | Statista

Notice how this marital data coincides with the “baby boom” of the 20th century

In my estimation, it would be a grave mistake to separate our assessment of IVF technology from the society that enables it. Lifestyles that were previously incapable of reproduction now thank science for closing the gap. Marriages that would have had children sooner, now thank science for allowing them to have children on their timeline instead of nature’s. Frankly, it’s difficult to even categorize IVF as a fertility treatment, as it essentially renders the natural baby-making process irrelevant. But as far as the LGBT+ community is concerned, the ability to procreate outside of natural means is a wish come true. For the affluent groomer household, IVF is essential to legitimizing their pseudo-family, making the technology almost irreplaceable.

Murder By The Numbers

This sort of discussion is almost never about what is; rather, what could be. Even Christians who were privy to the rampant embryo destruction felt like IVF clinics just needed a few common-sense regulations in order to be ethically acceptable. But what would those regulations look like? Laws against embryo disposal could certainly be a start, but what other regulations could be in place to verify that IVF does not result in unnecessary embryo loss? For that matter, is any embryo loss necessary?

For standard IVF, the answer is a resounding yes. This process starts by injecting the woman with fertility drugs. These drugs stimulate the ovaries, causing them to release large quantities of eggs at once (usually, a woman only releases one egg per month). When this happens, the fertility clinic will harvest the mature and immature eggs. These eggs are then fertilized with the desired sperm by injecting it directly into the eggs. These eggs are then carefully observed as they grow in the dish. Some make it to the blastocyst stage; some do not. But before those tiny embryos are ready for the mother’s womb, some screening will often take place. At this step, embryos are graded based on how likely they are to implant in the uterine lining. In addition, there is often a genetic test as well. Those with too low of a grade are simply discarded, while embryos with a poor genetic test or merely undesired sex are also disposed of. So when a fertility clinic boasts a 50% success rate, we know right off the bat that a number of screens occurred to weed out low-quality embryos.

Some ethicists claim that 50% is a reasonable success rate, even compared to natural conception. We know that some fertilized eggs fail simply to develop or are unable to implant in the uterine wall. The Christian Medical Dental Association, a group known for their resistance to the trans movement, offered this bit of advice to couples thinking about IVF:

“…normal human reproduction results in the natural loss of a many embryos. After fertilization some embryos do not continue to develop. While the precise loss-rate is not known, it is estimated to be greater than 50%. Artificial reproductive technologies will also result in loss of many embryos. It is CMDA’s opinion that ART procedures should not be chosen that knowing result in a lossrate of embryos greater than that estimated to occur naturally.”
Christian Medical Dental Association (CMDA),”Statement on Assisted Reproductive Technology – updated in 2010⁸

Based on this advice, Christians would likely assume that as long as the IVF clinic boasted a 50% success rate, IVF would be morally permissible. But a closer look at the statistics tells us a different story.

Assessing the natural mortality rates is actually a bit of a hot topic in the scientific community. Not only are the a significant number of unknowns for this statistic, but these numbers have been highly contended in settling abortion laws. Justice Munby, presiding over a case regarding the lawfulness of the morning-after pill,⁹ concluded that less than 15% of fertilized eggs result in a live birth. Not only did his notoriously ill-informed decision legalize “Plan B,” but Munby’s misinterpretation of the data even made its way into future textbooks.¹⁰ While the exact loss rate remains a bit of a mystery, concluding that 85% of all humans die before they are born is an absurd estimate. In reality, this estimate is lower.

“For women of reproductive age, losses between implantation and clinical recognition are approximately 10–25%. Loss from implantation to birth is approximately one-third.”
Jarvis G. E. (2016). Early embryo mortality in natural human reproduction: What the data say. F1000Research, 5, 2765. https://doi.org/10.12688/f1000research.8937.2

So, if we follow the CMDA’s advice and measure the attrition rate, IVF could — in theory — be morally acceptable, right? Let’s find out. To better explain the success rates, some clinicians refer to the “IVF funnel.” The funnel lists each step in the IVF process, along with various expected loss rates. Keep in mind that each of the probabilities in these steps can vary greatly with age.

Step 1: Egg retrieval — In standard IVF, gathering as many as possible will increase the available pool of genetic material. The prudence of using drugs to harvest mass quantities of mature and immature eggs has yet to be determined.
Step 2: Fertilize the eggs — The eggs are placed in a petri dish, and fertilization is attempted. At this point, approximately 20-30% of the eggs will fail to fertilize.
Step 2.5: Fertilization method — Based on the limited studies, it is unclear at this time how the different fertilization methods affect implantation rates. Some studies have suggested that ICSI (the regular method) had 2-3x lower rates of implantation and live birth than the IMSI alternative.¹¹
Step 3: Embryo Growth — Once fertilized, eggs will need to spend a few days growing. In a normal pregnancy, this would occur as the newly fertilized embryo (now a “zygote”) travels down to the uterus, eventually growing into the “blastocyst” stage. For IVF, this formation process occurs entirely in a petri dish, where only 30-50% of the embryos survive.
Step 4: Embryo Selection — Of those that do survive, fertility specialists will attempt to weed out abnormal embryos. This may involve discarding embryos with genetic abnormalities or even those of undesired sex. “Grading” also takes place at this stage, where the clinic attempts to rate the likelihood of success for each surviving embryo.
Step 5: Embryo Transfer — Once an embryo has been selected (often the one with the highest grade), implantation is attempted. Success rates vary, but in 2021, the chances of having a live birth from this process were 24-49% (depending on age).¹²
Results: Based on these rough estimates, a single embryo’s chances of being born via IVF are 5%- 19% (70% * 30% * 24% vs 80% * 50% * 49%). Keep in mind that this rough estimate does not even include fresh vs. frozen rates, IMSI vs. ICSI, multiple vs. single transfers, etc.

Current IVF practices are designed to de-emphasize the loss of embryos in order to raise the overall odds. The goal of the “IVF funnel” is to maximize the chances of getting pregnant, not maximize the survival rate of individual embryos. However, discarding even the littlest human is not an option for the discerning Christian. With these statistics in mind, we recall the CMDA’s advice for considering IVF: “ART procedures should not be chosen that knowing result in a loss of embryos greater than that estimated to occur naturally.” If couples naturally lose 50%of embryos made through intercourse (a very generous estimate), then IVF falls far, far short of the standard. Even under ideal circumstances and at the optimum maternal age, the chances of being born from an IVF procedure are incredibly poor.

Yet skeptics may be inclined to think this an unfair comparison. After all, if any of these couples could conceive naturally, they would have already done so. So, the skeptic argues that IVF’s embryo loss rates ought to be compared to that of infertile couples. Though such a comparison is certainly interesting, it is also readily apparent that very few people can define what it means to be “infertile.” For example, some studies estimate that one in six women will conceive naturally — AFTER having a child via IVF.¹³ Other studies have suggested that this number could be even higher. So, even if we do attempt to compare IVF to “infertile” couples, we still have to reckon with the fact many of these women are more than capable of getting pregnant naturally. What some physicians have dubbed “unexplained infertility” is merely a diagnosis offered to couples who have no scientific explanation for why they have not gotten pregnant within a year. A seemingly arbitrary standard, “unexplained infertility” accounts for over 10% of IVF users.¹⁴. The discerning Christian has no choice but to ask: Is “unexplained infertility” simply medical jargon for “rejecting God’s timing?”

By the numbers, it’s quite clear that current IVF practices are unconscionable. Comparing fertility rates is often the difference between an unknown and an unknown, but comparing embryo loss rates — the very thing most Christians ought to be concerned about — results in a clear ethical condemnation of IVF just the same. Yet even with these numbers available. Many claim that IVF can, in theory, be done ethically. But does such a path exist?

Is There an Ethical Way?

While Christians across the denominational spectrum have, at minimum, expressed caution towards the procedure, a number of ethicists leave room for an “ethical” IVF. Even though this practice is very uncommon at fertility clinics, some Christians believe that natural cycle IVF can be done ethically. Unfortunately, the evangelical debate on IVF has been relatively small. Someone researching the topic may stumble across Wayne Grudem’s assessment, who believes IVF to be morally permissible so long as it is done in such a way that no embryos are intentionally discarded in the process, yet he gives little to no detail about how this could be done. Approaching the subject from a different angle, Andrew T. Walker and Matthew Anderson argued that IVF ought to be rejected outright, as it is an unnatural “means” of procreation.¹⁵ In a similar argument, Catholics appeal to “natural means” as the basis of their response. The Donum Vitae, also called “Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation,” quickly became the go-to Catholic document regarding IVF.¹⁶ Advocating for human dignity, the pope argued that even if IVF was done in a way that actually valued embryos, fertilization outside the womb ought not to be performed. Baptist abortion abolitionist Dusty Deevers makes a similar argument: that procreation outside the womb goes against Christian anthropology. “God ordained child-bearing to be the result of natural, corporeal or bodily sex with in heterosexual marriage,” Deevers reminds us, citing Psalm 139:13, “He did not prescribe or promote any other means for reproduction.”¹⁷

For certain couples struggling with infertility, perhaps this advice was enough. But when IVF became a political battleground, the ethical questions surrounding this practice were being asked by more than just barren couples. Is bypassing anthropology really and truly a sin? Is the appeal to “natural means” the only thing holding back IVF from being performed in an ethical way?

To this point, Christians have been quite clear on the duty to avoid intentional embryo death but much less unified on avoiding unintentional embryo death. The push for “natural-cycle IVF” stems from this lack of clarity, suggesting that such a process may be morally permissible for Christians. This procedure retrieves and fertilizes one egg at a time, keeping the woman’s natural egg-release schedule intact. By doing so, only one embryo is handled at a time, as no selection or screening process is involved.

Yet the embryo loss rate continues to plague even the “ethical” IVF process. Bradley Pierce, executive director of the abortion abolitionist group in Texas, claims that such abysmal rates changed his own opinion on this matter. Citing a 3%-12% chance of survival, Pierce calls such odds an “extreme risk of death.”

Bradley Pierce: “According to the data I have reviewed, between 8 and 32 children die in the IVF process for every 1 live birth.”

Given the statistics, the distinction between intentional and unintentional death barely functions as a distinguishing principle. In the case of IVF, this difference between intentional and unintentional is merely the difference between murder and manslaughter. To put it another way, ethical IVF is not like murdering your infant with a handgun; it’s more like allowing your toddler to play on the interstate.

Christian ethicists have tackled this subject from a number of angles, and for the most part, I’ve appreciated their thoughts. But when it comes to convincing the general public — to advocating for Christian policies — the mere possibility that IVF could be done ethically leaves the door wide open. For years, the pro-life crowd reminded us that embryos are living beings, and their work paid off. Now, we need to convince the public that IVF, even “ethical IVF,” will endanger children and result in more loss than life.

Sources:

1
“Abortion Viewed in Moral Terms: Fewer See Stem Cell Research and IVF as Moral Issues” – August, 2013 – https://www.pewresearch.org/religion/2013/08/15/abortion-viewed-in-moral-terms/
2
“US Southern Baptists condemn IVF procedure,” by Brad Brooks – https://www.reuters.com/world/us/us-southern-baptists-effort-enshrine-ban-women-pastors-falls-short-2024-06-12/
3
“Tens of thousands of embryos are stuck in limbo in fertility clinics” – January 17, 2019 – https://www.cbsnews.com/news/embryos-are-stuck-in-limbo-in-fertility-clinics/
4
Croll J, Sanapo L, Bourjeily G. LGBTQ+ individuals and pregnancy outcomes: A commentary. BJOG. 2022 Sep;129(10):1625-1629. doi: 10.1111/1471-0528.17131. Epub 2022 Mar 25. PMID: 35243765; PMCID: PMC9540187. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540187/
5
https://www.hfea.gov.uk/about-us/news-and-press-releases/2020/new-figures-show-how-different-people-are-using-ivf/
6
“NJ law expands health insurance coverage for LGBTQIA+ individuals for infertility treatments” – CBS News https://www.cbsnews.com/philadelphia/news/n-j-law-expands-health-insurance-coverage-lgbtqia-infertility-treatments/
7
Former Bachelor Colton Underwood Was Shocked by Infertility Struggle: ‘I Wish Somebody Had Educated Me’ – https://www.yahoo.com/entertainment/former-bachelor-colton-underwood-shocked-214021120.html
8
https://app.box.com/shared/static/uhjfta6jxaq0j9hw5t3p25wqvopg11oe.pdf
9
Mayor S. (2002). Court rules that emergency contraception is lawful. BMJ (Clinical research ed.), 324(7344), 995. https://doi.org/10.1136/bmj.324.7344.995/b
10
Jarvis G. E. (2020). Misjudging early embryo mortality in natural human reproduction. F1000Research, 9, 702. https://doi.org/10.12688/f1000research.22655.1
11
“These results demonstrated no significant difference in the fertilization rate between IMSI and previous ICSI cycles (67.7% vs. 65.0%). However, the pregnancy and implantation rates with IMSI were significantly higher than those of the ICSI cycles (33.3% vs. 12.5% and 14.6% vs. 5.4%, respectively; p<0.05). The miscarriage rate among pregnant patients (18.2% vs. 37.5%) showed no statistically significant difference between groups.” — Kim, H. J., Yoon, H. J., Jang, J. M., Oh, H. S., Lee, Y. J., Lee, W. D., Yoon, S. H., & Lim, J. H. (2014). Comparison between intracytoplasmic sperm injection and intracytoplasmic morphologically selected sperm injection in oligo-astheno-teratozoospermia patients. Clinical and experimental reproductive medicine, 41(1), 9–14. https://doi.org/10.5653/cerm.2014.41.1.9
12
See the CDC’s 2021 ART report – https://www.cdc.gov/art/reports/2021/index.html
13
“One in six women fall pregnant spontaneously after IVF,” 2019 – https://www.varta.org.au/resources/news-and-blogs/one-six-women-fall-pregnant-spontaneously-after-ivf
14
Egg/Embryo “banking” takes the number 1 spot. 40% of women seeking IVF do so for this reason – https://www.hhs.gov/about/news/2024/03/13/fact-sheet-in-vitro-fertilization-ivf-use-across-united-states.html
15
https://americanreformer.org/2024/01/protestant-denominations-need-stronger-leadership-on-assisted-reproductive-technology/
16
https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html
17
Dusty Deevers – “Loving Your IVF Neighbor”

IVF – A Closer Look At An Unregulated Industry

The LGBT+ Factor

Murder By The Numbers

Is There an Ethical Way?

Sources:

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Abortion

Modern Medicine

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