Here’s a primer to get you up-to-speed on how to counsel couples considering or involved in assisted reproductive technology.
Editor’s note: November is National Adoption Month
By Aaron and Jennifer Wilson
With 1 in 6 people struggling with infertility, it’s not a question of if, but when, pastors and church leaders will be asked about assisted reproductive technology (ART). Couples in your congregation are likely facing weighty choices about fertility treatments and may be looking to you to help them navigate the ethical considerations.
Many pastors, however, majored in theology—not biology—and feel ill-equipped to counsel couples considering ART. But no issues related to when life begins (a topic Scripture clearly speaks to) are above a pastor’s pay grade. Here’s a primer to get you up-to-speed on how to counsel couples considering or involved in assisted reproductive technology.
1. What exactly is IVF?
In an in vitro fertilization (IVF) cycle, a woman is given medicine to mature her eggs for surgical retrieval. Reproductive endocrinology professionals then fertilize as many of the mature eggs as possible in a petri dish or through a method called intracytoplasmic sperm injection (ICSI).
Three to seven days later, one or more of the embryos that were created are transferred to a woman’s uterus. The hope is at least one will implant in the uterine lining, continue growing, and be born about nine months later.
2. Are there ethical concerns with IVF?
Yes. Each time an egg is successfully fertilized, a human embryo is formed. Scripture makes it clear that a human embryo is a microscopic image-bearer of God (compare “what is conceived” with an unborn “child” in Matthew 1:18 and 1:20). If there is one takeaway for pastors to impress upon couples involved in ART, it would be to understand that embryos, though microscopic, are life created in God’s image and must be treated as such.“Pastors should impress upon couples involved in assisted reproductive technology to understand that embryos, though microscopic, are life created in God’s image and must be treated as such.” — @AaronBWilson26, Jennifer Wilson Click To Tweet
The driving issue with IVF is couples often have more embryos than can safely be transferred to the wife’s uterus at one time. This poses questions to couples considering the implications of IVF (should they proceed knowing there’s a likelihood of creating more human life than they intend to give a chance of birth?) and to couples who have completed an IVF cycle and have “leftover” embryos.
3. What happens to the remaining embryos following an IVF cycle?
In a typical in-vitro-fertilization procedure, there is a possibility many eggs will be fertilized. But only a select few will be transferred to a womb and be given a chance at birth. This often results in the remaining embryos (children) being cryogenically frozen or discarded/killed.
Christians can agree that killing human embryos is wrong, even under the guise of “donating them to science.” This leaves couples who have created excess embryos with embryo cryopreservation—a process that freezes an embryo’s development in time.
Couples can pay storage fees to keep their remaining embryos frozen. And—when they want to return for siblings—they can have another embryo transfer. Or, if a couple feels their family is complete, they can place their remaining frozen embryos for adoption.
Leaving embryos frozen long term is not the way God intends children to live. Yet, many couples operate with an “out-of-sight, out-of-mind” mentality. So they keep paying storage fees without making a plan for their unborn embryos.
Pastors should encourage couples in this situation to honor their children by taking life-affirming actions sooner rather than later. After all, parents won’t live forever. Delaying giving these embryos a chance at birth will eventually lead to adult children having to make decisions about their frozen siblings and paying for their storage fees.
4. I’m a theologian. Shouldn’t I leave ART advice to doctors?
Sadly, most fertility clinics do not hold a pro-life worldview and are primarily concerned with improving their clinic’s live-birth rates. Because they do not see embryos as children, they often provide counsel that leads to creating excess embryos without a plan for birth. Many medical professionals who are not pro-life are also quick to recommend discarding/killing these excess embryos or those they deem diseased or not “high quality.”
This is an area where ministry leaders must stand in the gap and provide compassionate, informed care to couples facing infertility.
5. What are ethically safe options for couples looking at assisted reproductive technology?
Option 1: Limited fertilization (natural IVF or mini IVF)
Couples can attempt to fertilize only as many eggs as they’ll immediately transfer to a womb (usually one or two). Christians should stand firm on their biblical values regarding when human life begins. And they should have a plan to honor all life they bring into the world. This can be achieved by limiting the number of embryos created during IVF to only the number that will be transferred.
A drawback to this option is that if fertilization doesn’t occur, the wife will need another egg retrieval, which is expensive and hard on a woman’s body. For that reason, one of the next two options may be preferable for couples.
Option 2: Egg freezing
Egg freezing removes the ethical dilemma of discarding embryos or leaving them frozen. If a couple needs additional eggs to attempt to fertilize following an unsuccessful IVF cycle, they can pull from this batch of unfertilized, frozen eggs in storage. When a couple feels their family is complete, they can discard the remaining eggs, since they are unfertilized and, thus, not human life.
Egg freezing is a life-affirming option for traditional IVF procedures. Encourage couples to speak up and ask for egg freezing if their fertility clinic isn’t presenting it as an option.
Option 3: Embryo adoption
Lastly, couples can pursue embryo adoption, which is a pro-life response to the issue IVF creates. In embryo adoption, an adoptive mother gives already-created embryos from another couple’s IVF cycle a chance at birth by allowing them to be thawed and transferred to her uterus. If one or more of the embryos implants, the adopting mother then carries and gives birth to the child or children, although she isn’t genetically related to them. Embryo adoption is also much less expensive than IVF or traditional adoption.
In the United States alone, there is an estimated surplus of 1 to 1.3 million human embryos—many of whom are available to be adopted. We have boy/girl twins we adopted as embryos. And there are many theological implications to consider.“Pastors and ministry leaders should be sensitive to infertility but also prepared to speak truth into the ethics regarding assisted reproductive technology.” — @AaronBWilson26, Jennifer Wilson Click To Tweet
6. What are other terms I might encounter when counseling couples about assisted reproductive technology, and how should I think about them?
- Intrauterine insemination (IUI)
- Donor egg/donor sperm
- Surrogacy/gestational carrier
- Pre-genetic testing (PGT)/pre-genetic diagnosis (PGD)
This article doesn’t allow space to define these terms and explore the ethics surrounding them. There are, however, red flags with several of these topics, and each should be considered through a biblical worldview. The Christian Medical and Dental Associations is a great resource where Christian medical professionals examine the ethics around such issues.
Shepherding infertile couples with grace and truth
Infertility is a common but often silent suffering many Christian couples experience. Pastors and ministry leaders should be sensitive to this issue but also prepared to speak truth into the ethics regarding assisted reproductive technology. Couples experiencing infertility are often hurting and confused by the many options available to them today. By digging into the issues with a biblical lens, you can guide them on their journeys with grace and truth.
Aaron and Jennifer Wilson are raising boy/girl twins whom they adopted as embryos from the National Embryo Donation Center.
For permission to republish this article, contact Marissa Postell Sullivan.
Aaron is the internal communications manager at Lifeway and an associate editor of Lifeway Research. He and his family are members of Redeemer Church in Hendersonville, Tennessee, where they serve together in the children’s ministry.