Tuesday, May 31, 2005

what the Church says about in-vitro fertilization: a primer

The BBC recently reported that Pope Benedict has given his backing to calls for a boycott of an Italian referendum on fertility rules, which include rules on limits to in-vitro fertilizations (IVF). The referendum in June will ask Italians to lift restrictions on embryo research, IVF's, and egg and sperm donation. Currently in Italy there are laws that ban embryo research and which restrict the numbers of eggs that can be fertilized during each attempt at insemination using the methods of IVF

Meanwhile in the U.S., the House last week passed House Resolution (HR) 810 which will authorize the federal funding of stem cell research which requires the destruction of human embryos. Many if not all of the embryos used for embryonic stem cell research will come from surplus embryos from IVF's currently stored in fertility clinics. These embryos originate from couples wishing to have a child. If passed by the Senate, and if there are enough votes to overcome a threatened veto by the President, this bill could become law.

The usual argument I hear from those in favor of embryonic stem cell research upon hearing my own opposition to it is: "Well, these embryos are going to be flushed down the toilet anyway. So, why not use them for good?" This is the same argument that Sen. Arlen Specter (R-Pennsylvania) articulated last week at a news conference. Yes, one acquaintance actually said "flushed down the toilet" which is probably literally true because he works as a doctor. And some folks I know weren't aware that the Church opposes IVF because it hasn't been widely referred to in the media or elsewhere.

The Church's opposition to IVF flows directly from what she says about the dignity of each person and about marriage. To unpack this teaching, here's a quick primer on the two main methods of IVF.

What IVF is and its two major procedures
First, IVF is a procedure that induces pregnancy by the removal of eggs from the female, then a laboratory fertilization with sperm from the male, and then the transfer of the embryo back to the uterus. It is used by couples who could not produce a pregnancy through natural means.

The first usual method is called homologous artificial fertilization. With this method, the egg or the oocyte and the sperm all come from the one couple who wish to have a child. Usually, several eggs are retrieved from the female's ovaries.

The doctors don't have to wait for the female to naturally ovulate so as to take her oocytes. Rather, these eggs are obtained from the female through a procedure called "controlled ovarian hyperstimulation" in which the female's ovaries are hyperstimulated to produce multiple pre-ovulatory eggs through the use of hormones. Then, the eggs are retrieved from the ovaries via laparoscopy. At laparoscopy, the ovary is stabilized with grasping forceps. Then a long stainless steel beveled needle is introduced through an incision for the operating laparoscope. The ovarian follicle is punctured, and the follicular fluid along with the ovum is retrieved into a trap. With regards to sperm, this is usually obtained from the male through masturbation.

The other method is where either an egg, or sperm, or a fertilized egg (an embryo or blastocyst) is donated to a couple wishing to have a child. Also, sometimes, a surrogate mother is used. This is called heterologous artificial fertilization.

As mentioned earlier, several eggs will be used for IVF and usually several embryos will be produced by this process. This is to maximize the chances of pregnancy. The embryos that are found either defective, or are not implanted into the female, are then either discarded or preserved through freezing (cryopreservation).

It is the thought of several members of Congress and those who favor embryonic stem cell research to utilize these spare embryos for research purposes, a research which will most likely cause their termination. In order for stem cells to be obtained from an embryo, the embryo will have to be destroyed.

What the Church says
As mentioned earlier, the Church's teaching on IVF flows from her vision of the role of sex within marriage and her view of the dignity of humans.

For the Church, there is an inseparable connection between the two meanings of the marital act. It unites and binds husband and wife in a physical way, which mirrors the emotional and spiritual bond between them. Also, the marital act is that expression of love between the husband and wife which also has as its fruit the begetting of a new human being. What homologous artificial fertilization does is separate these two meanings of the marital relationship.

To use the words of the Congregation For the Doctrine of the Faith's Instruction on Respect For Human Life in Its Origin and on the Dignity of Procreation, with IVF "procreation is deprived of its proper perfection when it is not desired as the fruit of the conjugal act, that is to say of the specific act of the spouses' union." When fertilization is achieved outside the bodies of the couple, the begetting of another human life is thereby "deprived of the meanings and the values which are expressed in the language of the body and in the union of human persons."

Rather than from a physical act of love between mother and father, a child is sired through artificial means. According to the Church, this diminishes the twin meanings of sex in marriage by separating them. Detractors would argue, "well, but they can't conceive through natural means, so basically you're depriving the couple of the gift of life." I'll get to that later.

With regards to heterologous artificial fertilization, the Church sees in this process a violation of the couple's "exclusive right to become father and mother solely through each other." The CDF adds that "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 of regard to that essential property of marriage which is its unity."

Related to this is "surrogate" motherhood, which according to the CDF "represents an objective failure to meet the obligations of maternal love, of conjugal fidelity and of responsible 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; it sets up, to the detriment of families, a division between the physical, psychological and moral elements which constitute those families."

The dignity of the child is also what's at stake in this. The Church believes that the one conceived must be the fruit of the parents' love--manifested in their physical union. The CDF articulates it in this way: the child "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. No one may subject the coming of a child into the world to conditions of technical efficiency which are to be evaluated according to standards of control and dominion."

Now, having said all of the above, isn't it really rather unmerciful to deprive a couple of a child that they really long for when they can have the benefits of this reproductive technology? Certainly sterility is a source of suffering for these couples, and I certainly understand and sympathize with them.

The Church enjoins them to draw closer to God in this trial: "The community of believers is called to shed light upon and support the suffering of those who are unable to fulfill their legitimate aspiration to motherhood and fatherhood. Spouses who find themselves in this sad situation are called to find in it an opportunity for sharing in a particular way in the Lord's Cross, the source of spiritual fruitfulness." This is not easy. I think one of ways I could be of service to couples who come to me with this burden is to provide my counsel, support, prayers, presence, and love. It will be tough, and I pray I am provided the strength to be a loving minister for them.

What one gleams from the CDF's words is noteworthy. It brings us to ask the questions: What is God telling the couple in their condition of sterility? How does their marriage still function as a service to the wider community without offspring? The answers which only the couple can answer I can only imagine will lead them to some unexpected yet welcome personal insights and blessings.

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