Church Teaching - Reproductive Technologies

Infertility is an enormous cross to bear and the Church has great compassion for couples who struggle with this cross. As we read in Donum Vitae, the Instruction on Respect for Human Life from the Congregation for the Doctrine of the Faith, "the suffering of spouses who cannot have children or who are afraid of bringing a handicapped child into the world is a suffering that everyone must understand and properly evaluate."

Donum Vitae continues:

Overview of Church Teaching

Although a couple may have a strong desire for a child, it does not mean that they will have one.

A child is not something owed to one, but is a gift. The "supreme gift of marriage" is a human person. A child may not be considered a piece of property, an idea to which an alleged "right to a child" would lead. In this area, only the child possesses genuine rights: the right "to be the fruit of the specific act of the conjugal love of his parents," and "the right to be respected as a person from the moment of his conception." (Catechism of the Catholic Church, §2378, quoting Donum Vitae II, 8)

The Church explains that there are two intertwined purposes to the marital union: openness to children and the unity of the husband and wife (cf. CCC, §2366). By God's design, these two components are inseparable. Anything that attempts to isolate one purpose from the other is thereby immoral. Just like contraception is immoral because it attempts unity without openness to procreation, many reproductive technologies are immoral because they attempt procreation without unity. Because a child has a right "to be the fruit of the specific act of the conjugal love of his parents" (Donum Vitae, II, 8), conception should neither replace the conjugal act nor occur outside the woman's body.


What Reproductive Technologies Are Compatible with Church Teaching?¹

Any procedure which assists marital intercourse in reaching its procreative potential is moral. If conception occurs outside the marital embrace or adds a third party, it is immoral.

1. Observation of the naturally occurring sign(s) of fertility (Natural Family Planning). Timing intercourse on the days of presumed (potential) fertility for at least six months before proceeding to medical interventions.
   
   To learn more: NFP Basics
2. General medical evaluation of both spouses for infertility.
3. Post-coital test to assess sperm number and viability in "fertile type" mucus. These tests are undertaken after normal intercourse.
4. Appropriate evaluation and treatment of male factor deficiency. Seminal fluid samples can be obtained from a non-lubricated, perforated condom after normal intercourse.
5. Assessment of uterine and tubal structural competence by imaging techniques (e.g., ultrasound, hysterosalpingogram, etc.).
6. Appropriate medical treatment of ovulatory dysfunction.
7. Appropriate (usually surgical) correction of mechanical blocks to tubal patency (the state of being open). If tubal function cannot be restored, transfer of an ovum past the point of blockage into the uterine cavity -- "low tubal ovum transfer" (LTOT) preceded by normal intercourse during the fertile phase. In England, this procedure is called NEST (normal egg sonographic transfer).

¹ adapted from "Reproductive Technology (Evaluation and Treatment of Infertility) Guidelines for Catholic Couples"

An Explanation on the Problem with Assisted Reproductive Technologies that Involve a Donor Ovum or Sperm

"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 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.'" (CCC, §2376, quoting Donum Vitae II, 1)

Donum Vitae explains the problem with conception through heterologous IVF (in vitro fertilization) and ET (embryo transfer), "the technique used to obtain a human conception through the meeting in vitro of gametes taken from at least one donor other than the two spouses joined in marriage", as well as heterologous artificial insemination, "the technique used to obtain a human conception through the transfer into the genital tracts of the woman of the sperm previously collected from a donor other than the husband".  Click for information.

Through IVF and ET and heterologous artificial insemination, human conception is achieved through the fusion of gametes of at least one donor other than the spouses who are united in marriage. Heterologous artificial fertilization is contrary to the unity of marriage, to the dignity of the spouses, to the vocation proper to parents, and to the child's right to be conceived and brought into the world in marriage and from marriage.(36) Respect for the unity of marriage and for conjugal fidelity demands that the child be conceived in marriage; the bond existing between husband and wife accords the spouses, in an objective and inalienable manner, the exclusive right to become father and mother solely through each other.(37) Recourse to the gametes of a third person, in order to have sperm or ovum available, constitutes a violation of the reciprocal commitment of the spouses and a grave lack in regard to that essential property of marriage which is its unity. Heterologous artificial fertilization violates the rights of the child; it deprives him of his filial relationship with his parental origins and can hinder the maturing of his personal identity. Furthermore, it offends the common vocation of the spouses who are called to fatherhood and motherhood: it objectively deprives conjugal fruitfulness of its unity and integrity; it brings about and manifests a rupture between genetic parenthood, gestational parenthood and responsibility for upbringing. Such damage to the personal relationships within the family has repercussions on civil society: what threatens the unity and stability of the family is a source of dissension, disorder and injustice in the whole of social life. These reasons lead to a negative moral judgment concerning heterologous artificial fertilization: consequently fertilization of a married woman with the sperm of a donor different from her husband and fertilization with the husband's sperm of an ovum not coming from his wife are morally illicit. Furthermore, the artificial fertilization of a woman who is unmarried or a widow, whoever the donor may be, cannot be morally justified.

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.  (Donum Vitae, Does Heterologous Artificial Fertilization Conform to the Dignity of the Couple and to the Truth of Marriage?)

What about when there is no donor involved?

Techniques involving only the married couple (homologous artificial insemination and fertilization) are perhaps less reprehensible [than those involving a donor or surrogate], yet remain morally unacceptable. They dissociate the sexual act from the procreative act. The act which brings the child into existence is no longer an act by which two persons give themselves to one another, but one that "entrusts 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 [Donum Vitae II, 4]." "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 [openness to children and the unity of the husband and wife] and respect for the unity of the human being make possible procreation in conformity with the dignity of the person [Donum Vitae II, 8]." (Catechism of the Catholic Church, §2377)

Artificial fertilization/procreation that uses only the gametes of two spouses joined in marriage can be carried out by two different immoral methods:³

a)    Homologous IVF and ET: the technique used to obtain a human conception through the meeting in vitro of the gametes of the spouses joined in marriage.

b)    Homologous artificial insemination: the technique used to obtain a human conception through the transfer into the genital tracts of a married woman of the sperm previously collected from her husband.

Recall Church teaching on the origin of the human person:

The human person must be accepted in his parents' act of union and love; the generation of a child must therefore be the fruit of that mutual giving [Gaudium et Spes, §51] which is realized in the conjugal act wherein the spouses cooperate as servants and not as masters in the work of the Creator who is Love. In reality, the origin of a human person is the result of an act of giving. The one conceived must be the fruit of his parents' love. He cannot be desired or conceived as the product of an intervention of medical or biological techniques; that would be equivalent to reducing him to an object of scientific technology. (Donum Vitae, II, 4)

"If the technical means facilitates the conjugal act or helps it to reach its natural objectives, it can be morally acceptable. If, on the other hand, the procedure were to replace the conjugal act, it is morally illicit." ( Donum Vitae)  Donum Vitae continues

Conception in vitro is the result of the technical action which presides over fertilization. Such fertilization is neither in fact achieved nor positively willed as the expression and fruit of a specific act of the conjugal union. In homologous IVF and ET, therefore, even if it is considered in the context of 'de facto' existing sexual relations, the generation of the human person is objectively deprived of its proper perfection: namely, that of being the result and fruit of a conjugal act in which the spouses can become "cooperators with God for giving life to a new person" [Familiaris Consortio, §14]. These reasons enable us to understand why the act of conjugal love is considered in the teaching of the Church as the only setting worthy of human procreation. For the same reasons the so-called "simple case", i.e. a homologous IVF and ET procedure that is free of any compromise with the abortive practice of destroying embryos and with masturbation, remains a technique which is morally illicit because it deprives human procreation of the dignity which is proper and connatural to it. Certainly, homologous IVF and ET fertilization is not marked by all that ethical negativity found in extra-conjugal procreation; the family and marriage continue to constitute the setting for the birth and upbringing of the children. Nevertheless, in conformity with the traditional doctrine relating to the goods of marriage and the dignity of the person, the Church remains opposed from the moral point of view to homologous 'in vitro' fertilization. Such fertilization is in itself illicit and in opposition to the dignity of procreation and of the conjugal union, even when everything is done to avoid the death of the human embryo.

We must always remember, however, that even though conception through immoral means should never be supported, the child must always be cherished.  Donum Vitae continues:

Although the manner in which human conception is achieved with IVF and ET cannot be approved, every child which comes into the world must in any case be accepted as a living gift of the divine Goodness and must be brought up with love.⁵

What Reproductive Technologies are not moral?

1. Obtaining a sample of seminal fluid by masturbation.
   
   Masturbation prohibits unity and is immoral. For more information, click here. Seminal fluid for testing purposes may be obtained through a perforated condom during the marital embrace. The perforated condom allows for semen to pass through the condom, thereby making the act open to procreation. The condom also collects some semen which can be taken in for testing.
2. Artificial insemination by the husband (AIH) if the sample is obtained and handled by non-licit means (masturbated specimen) or by a non-spouse (AID) in any situation.
   
   Conception is disconnected from the conjugal act. Introducing a third party is unacceptable (AID). Another problem is that the sample is usually obtained by non-licit means (masturbation).
3. In vitro fertilization (IVF) and embryo transfer (ET)
   
   See below for an explanation of why they are immoral.
4. Zygote intra-fallopian transfer (ZIFT)
   
   Conception takes place outside the woman's body and is disconnected from the conjugal act.
5. Intracytoplasmic sperm injection (ICSI)
   
   Conception takes place outside the woman's body and is disconnected from the conjugal act.
6. Ovum (egg) donation

Conception takes place outside the woman's body and is disconnected from the conjugal act.  Introducing a third party, as is sometimes the case, is also unacceptable.

1. "Surrogate" uterus (surrogate motherhood)
   
   "It offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents" (Donum Vitae)

What is In Vitro Fertilization (IVF) and why is it immoral?

"In vitro" means "in a glass". In IVF, conception occurs, not in the woman's body as a result of the conjugal act, but "in a glass" through an act separate from the marital embrace.

What are the steps involved?¹

1. Ordinarily, the woman is treated with hormones to stop her natural cycle and stimulated to ripen a number of ova. The ova are harvested from the follicle with a needle under ultrasonic guidance. The needle is inserted either through the vagina or abdomen.
2. Ova are incubated in the laboratory with a carefully washed and adjusted specimen of semen [usually acquired through an immoral act of masturbation] to allow fertilization.
3. Prior to implantation in the woman's uterus, embryos are examined in order to select the "best." Sometimes, one cell is removed for genetic testing. To date, visual inspection of the embryos has been totally unrelated to their subsequent course--health or otherwise.
4. Usually at least two embryos are implanted; in some centers, as many as four are implanted with the hope of getting at least one live baby. At times, three or four embryos thrive. Some clinics then offer the mother "embryo reduction" (selective abortion) to allow only one or two fetuses to develop further.

Why “frozen embryos”?²

Because the endometrium is considerably changed by the stimulation of ovaries to produce eggs, it is the practice in some centers to freeze the embryos and to implant them in a subsequent natural cycle. Overall success rates in terms of having a living child range from 16-20%. The disposition of frozen embryos varies with the wishes of the parents. "Spare embryos" may either be preserved, donated to other women or to researchers, or destroyed.

1. adapted from "Reproductive Technology (Evaluation and Treatment of Infertility) Guidelines for Catholic Couples" http://www.nccbuscc.org/prolife/issues/nfp/treatment.htm

2. Ibid.

Quick Explanation of the Immorality of In Vitro Fertilization (IVF)

There are two major problems with babies conceived in vitro:

1. it opposes the purpose of the marital embrace
2. it is contrary to the inherent dignity of the new life conceived

It can also be contrary to the dignity of the parents and their marriage if it involves a donor or a surrogate. See above for more information.

It opposes the purpose of the marital embrace

There exists, by God's design, a twofold purpose to the marital embrace: procreation and unity. These two aspects cannot be separated. IVF attempts procreation without unity. Procreation must come from the conjugal act. Instead of new life (procreation) coming from the love of husband and wife (unity), a child is created in a laboratory. When donor eggs or sperm are used, even more problems arise. A third person is involved in the creation of new life. Often a child created through heterologous IVF is often unaware of the identity of his biological father/mother who donated his/her gamete.

It is contrary to the inherent dignity of the new life conceived

There are multiple ways in which IVF is contrary to the dignity of the new life created:

1.  opposes the child’s right to be conceived in a particular way

A child has a right "to be the fruit of the specific act of the conjugal love of his parents" (Donum Vitae[DAI20] , II, 8). Creation "in a glass" by a scientist offends his inherent dignity.

2.  treats the child as an object instead of a gift

No one has the "right" to a child, but a child is a gift from God. Implanting multiple embryos hoping that one will survive offends the child's dignity. Each embryo is a unique, unrepeatable child. Choosing the "best" embryo and implanting it also offends the dignity of each child created.

3.  it often destroys innocent life

IVF destroys innocent life. The embryos (little babies!) that are not implanted are used for scientific research or simply discarded. Although a baby may be born (success rates are significantly low, however) and that child has inherent dignity, other lives are destroyed in the process. Often multiple embryos are implanted in hopes that one will survive. If multiple babies are developing the doctors may "selectively reduce" (meaning abort) those who seem to be less healthy (or valuable) than the others. "Over 90% of the embryos created perish at some point in the process" (⁹ John M. Haas, " Begotten Not Made: A Catholic View of Reproductive Technology").  IVF usually involves choosing one life over others which is always morally apprehensible.

Learn More:

Life-Giving Love in an Age of Technology (from the USCCB)

Dignitas Personae (from the CDF)

Donum Vitae (from the Congregation for the Doctrine of the Faith)

In-Vitro Fertilization: The Human Cost (from the USCCB)

In Vitro Fertilization / Reproductive Technology

Assisted Reproductive Technologies are Anti-Woman

Assisted Reproductive Technology and the Family

Infertility and IVF: A Teachable Moment