Being a pastor of family ministries with three healthy children, it is hard for me to counsel other couples on infertility. I have also been on the other side of the table facing these infertility choices in my first marriage. There was a choice we faced regarding selective termination if we did conceive after hormone therapy. In a way, I am glad we did not conceive because my ex-wife and I opposed each other on this procedure. I was opposed to the procedure while my wife accepted it. As a pastor having to counsel others with the problem of infertility, there are a lot of choices to be made regarding infertility.
I believe God has given doctors the technology to assist couples in the process of conceiving a child. How far a couple goes to conceive a child is the problem we are facing as Christians in today's culture. Assisted reproductive technologies allow many couples with infertility problems to bear children. But with the plethora of options come tough decisions. Couples must weigh the financial, emotional and physical costs of each treatment against its chances of success. The ethical ramifications of creating life in a lab is also a consideration Christian couples often look to their faith for guidance. God has given us the job of exercising dominion over all the earth (Gen. 1:26), which includes using medical technologies to assist us in reproduction.
The first step in infertility treatment is diagnostic testing for would-be parents. Treatments may be as simple as drugs to stimulate ovulation or as complicated as in vitro fertilization. Some couples may achieve pregnancy quickly, but others may have to decide to pursue assisted reproductive technologies. Since the first "test-tube baby" was born, in vitro fertilization has become a common procedure in fertility treatment.
A key issue couples considering in vitro fertilization is the use of their embryos. The woman often produces more eggs than can be used during a single IVF attempt. The extra embryos can be frozen to use in subsequent procedures, or a couple may have them destroyed, kept in storage indefinitely or donated to another infertile couple. Another issue is how many embryos should be placed back in the uterus. The fewer used, the lower chances of multiple pregnancies and a higher risk for complications. The more used, the couple faces the issue of more embryos taking hold in the uterus and having to decide terminating one or more of the fetuses to give the remaining ones a better chance of survival. Each couple must decide how many eggs to fertilize, what to do with extra embryos and how many to put back.
I can explain the medical aspects of conception, but the couple will have to decide what their definition of conception is. They will be the ones deciding when life starts and at what stage life begins in the cells. I would urge couples to fully understand any procedure they're considering and to be sure the procedure honors the dignity of human life, even at the one-celled stage. In my view, that is when human life begins.
A couple can undergo fertility treatments without compromising their beliefs. With advances in IVF procedures, fewer embryos can be placed back in the uterus while taking full advantage of the chances of a possible pregnancy. For those couples that are concerned with what to do with their frozen embryos, embryo adoption is becoming more popular. Or couples may limit the number of embryos created to those needed for the specific procedure. This may be more costly, especially if several treatments are needed. But if a couple were concerned with the morality of frozen embryos, this would be a viable option.
Another concern with IVF is how the sperm is taken from the male donor. Clinics have rooms with magazines and videos for the male to use to help in collecting semen samples. This is a moral problem that must be addressed by the husband and wife. There are other options that a male can use to collect the sperm sample. Samples can also be collected from a man who is aroused simply by the idea or presence of his own wife. This would be the course of action I would suggest to the couple.
Another concern with IVF is the use of a donor's eggs or sperm. The use of donor gametes is a difficult decision that couples are facing in today's society. One spouse may approve the use, but the other may not. I believe we need to turn to the Bible to make our decision on using a donor's gametes. The Bible assumes that the people who are procreating children are going to be the ones raising them. Children were meant to be raised by a husband and a wife who love each other, and are going to care for that child. This is evident in Genesis and the creation story. Adam and Eve are supposed to "increase in number" (Gen. 1:28, NIV). All reproduction is supposed to be between husband and wife. This is why I believe the Bible is telling us to keep procreation between a husband and a wife without introducing another person's egg or sperm.
Surrogate parenting is a complicated topic that is not specifically mentioned in the Bible. It has become one of the hottest topics dealing with reproductive technologies. We hear about mothers carrying embryos for their daughters, a sister for a sister, or a friend for a friend. In the news, it is a "feel good" story that tends to get a lot of attention. But as Christians, how are we to look at surrogate parenting?
Surrogate parenting may happen between family and friends, but it has also become a business with a lot of money involved. A surrogate willingly bears a child for a couple who has contracted her to do so. In a good situation, the surrogate gives up the child she has borne to the couple. But there have been many cases where the surrogate wants to keep the child she has borne and fights the couple in court for custody of the child.
Surrogacy does not involve a lot of medical technology to accomplish. It usually takes place by artificial insemination. The largest factor that becomes complicated in surrogacy is the use of lawyers and detailed contracts. The news has publicized several of these cases involving parents who used a surrogate to carry their child, and the surrogate changing her mind wanting to retain the child. This is a major reason why Christians should not use a surrogate to carry a child for them. I believe children should be raised between a husband and wife without any outside intervention. There are a lot of problems, such as custody, that can arise when you bring in a third party. God intended children to be raised by a husband and wife only.
Another problem with surrogacy is the children have become objects that are being bought and sold. This is a violation of the Thirteenth Amendment to the Constitution that outlawed the sale of human beings, such as slaves. Human rights are also being violated because these children are made in God's image. People are not to be sold for a price.
Another possible problem that could arise with surrogacy is that commercial surrogacy has the potential to become exploitative. There are a lot of circumstances and people that can be exploited in surrogacy arrangements. By offering a woman a certain amount of money to do something she normally would not do can be exploitative.
Another problem that arises from commercial surrogacy is ensuring the mother is going to give the child to the parents after she has carried it for nine months. There is usually a contract that says the surrogate will relinquish her parental rights to the child she has carried for the contracting parents. The problem arises when the mother wants partial custody of the child with the father who gave the sperm. The couple will have gone through the entire process thinking they were going to have sole custody of this child, but they end up having to share custody with the surrogate. It is wrong to think that this woman who has carried this child for nine months will be able to give the child up easily.
By giving the couple all of the information above, I feel they should be able to make an informed decision on what processes they can try. I would talk with them about their feelings on the processes we talked about, and ask if they have any questions that I could try and answer. If I could not answer the questions, I would try to find the answers through other sources so the couple would not be uninformed. With all of the choices available today, prayer and research are the best tools we have to find out what God expects from us as Christians.