CultureWatch

Bill Muehlenberg's commentary on issues of the day...

Concerns about IVF

Aug 30, 2007

It seems that the more desperate an infertile couple is to have children, the more willing they may be to take risks, and the more willing they may be to jump at any new promised technological fix. This is of course understandable. The desire to have children is perfectly normal and healthy, and it is a genuine grief when couples cannot conceive naturally.

It is said that 12-15 per cent of couples are medically infertile (although that figure has been disputed for being too high). People finding themselves in this position are often willing to go to great lengths to have a child. In the past, one could not do too much about childlessness. But with the advent of Assisted Reproductive Technologies (ART), there are now a number of ways that children can be produced.

In vitro fertilisation (IVF) is perhaps the most famous, and the technique has been practiced now for around thirty years. Of course couples who experience a successful outcome with these techniques will be glowing in their praise for them – after all, they have finally obtained what they have so long desired.

While we might celebrate with these couples in their happy outcomes, this does not mean that we should minimise the numerous risks and downsides to such procedures. Indeed, there are many aspects of ART that we should be concerned about.

Before examining some of these problems, let me mention one glowing report about IVF as found in today’s paper (Herald Sun, 30 August, 2007). The author said the “results are miraculous,” and that IVF is a godsend for all who want kids, even “gay couples and single women”. She was so chuffed by the result that she has written a book, describing her experience and that of others.

She is a true believer, and shrugs off the concerns of critics. She says, “To the IVF critics, I ask this: ‘Isn’t it better to be born against all odds to people who truly want a baby, than to be conceived naturally by those who aren’t ready or prepared for the onslaught of parenthood?’”

Of course this response manages to commit two logical fallacies for the price of one. She is making a category mistake here (comparing apples with oranges), and creating a false dilemma (if not A, then B). As to the first, she needs to compare like with like. Sure, a wanted child is to be prefered to an unwanted child. But that is not the real issue here. A fair comparison would be to compare wanted IVF children with wanted natural-born children, or compare unwanted IVF children with unwanted natural-born children.

And concerning the second mistake, the issue is not choosing between either a wanted child or an unwanted child. The real point is to both have a wanted child, and to do what is in the best interests of the child. There are a number of aspects about ART and IVF that may not be in the best interests of the child.

So what are some of the concerns about IVF? Let me briefly mention a few. Elsewhere I have written more extensively on this issue, including a full set of references. This will just be a skeletal outline of that more detailed examination of the issue.

A first set of concerns has to do with financial considerations. Simply put, IVF and the other ART procedures are quite expensive. It is not uncommon for a couple to spend tens of thousands – sometimes even hundreds of thousands – of dollars on numerous IVF cycles.

And bear in mind that the fertility industry is just that: an industry. It is a business, and concerns for profit drive them as with any other business. So they are in the business of selling fertility treatment, whether or not it is always advisable or even needed.

But more important are the medical concerns. First and foremost, IVF is not a panacea. Success rates are still very low indeed. Perhaps only 15 to 20 per cent of couples actually end up with a baby. Thus the great majority will go away without a child, and without a lot of their money.

But health risks abound. The death rate of newborn IVF babies is around 11 per thousand, which is much higher than the national average. And around two in five IVF births are multiple births, which is problematic in itself. Studies have found that the high prevalence of twin and triplet pregnancies associated with IVF is linked to developmental problems and neurological complications in the IVF babies.

Also, IVF results in a higher rate of premature births, which are often associated with mental and physical retardation, and sometimes death.

There are also risks for the mothers. One study found that women who had been treated for infertility were three times more likely to develop ovarian cancer than women who were not.

Moral problems also arise. Consider the large loss of human embryos in the IVF process. Far more embryos are lost in the process than result in pregnancies. Indeed, multiple embryos are deliberately created to increase the success rate of the procedure. But what happens to all the spare embryos? Often they are simply destroyed; flushed down the sink. In seeking to create human life, these procedures end up taking perhaps even more human life.

Social problems and identity issues also come into play here. We are now just getting to discover how children feel about the whole IVF and ART process. As they reach adulthood, many have complained of a sense of alienation, insecurity and root-lessness.

And what of those conceived with, say, anonymous donor sperm? Many children conceived by IVF have spoken of the loss and/or confusion of identity. In an age that emphasises knowing one’s roots and searching one’s genealogy, the dilemma of IVF children is greatly heightened. As one young woman put it, “I’ve always felt like a social guinea pig, an experimental guinea pig. . . . I am absolutely adamant from my experience and from the experience of other people like me that any form of anonymous donation is a violation of our human rights and our identities.”

Family issues also arise. The mother-father-child family unit is being stretched and reconfigured almost out of recognition in these new biotechnologies. Consider these examples. A number of fertility clinics have admitted that fathers are donating sperm to their infertile sons to help them have children. Just how will the child feel as a result of such a union?

In England a woman has given birth to her own grandchildren. Her daughter had IVF treatment, and used her mother as a surrogate, by having the embryos implanted in her, ending up with twins. Talk about strained relations! And in another bizarre IVF case in Britain, a set of twins born via IVF have three mothers and two fathers. One of the three mothers is their grandmother, who has delivered her own grandchildren.

As much as possible, children deserve their own biological mother and father, not a set of various “parents” or a committee.

Finally, there are philosophical problems. Do we have a right to children? What is the relation between parent and child? Does a parent own a child? The difficulties of such questions are highlighted with issues like surrogacy. Who is the parent? Who is the owner? Who does the child belong to?

As one bioethicist notes, we have “a right to try for a baby whenever we want, but that is not the same as claiming the right to a baby. Slavery was abolished because we recognised that one person could not use another to fulfil their needs, and we need to be cautious before responding to the heart-rending pleas of couples who say that they need to have a child to fulfil their aspirations.”

In sum, we perhaps need to be a bit more cautious before throwing our arms wide open to IVF and ART. While infertility is a genuine source of heartache and grief, it is questionable whether these procedures are always the proper answer.

Perhaps we should put more money into the causes of infertility. Our research dollars should be aimed at solving or relieving these problems, instead of pouring money into treating the symptoms. And perhaps other options, such as adoption, need to be more fully explored.

Infertility is a very real nightmare for many, and we can all sympathise with those experiencing it. But we should think more carefully about the various shortcomings of the new reproductive technologies before we further head down this path.

www.news.com.au/heraldsun/story/0,21985,22330916-5000117,00.html

[1427 words]

16 Responses to Concerns about IVF

  • Where does the grace of Christian submission and contentment come in this discussion? Admitedly we applaud medical help when curing disease, and it is no hightened spirituality to refuse such help, but in the case of infertility the boundary between lawful and unlawful interference is easily crossed.
    Christ would not make bread out of stones to satisfy his hunger because in the circumstances to do so was unlawful. Yet in other circumstances he multiplied five loaves and two fishes to feed a multitude.
    Divine providence must be considered in the discussion at some point. Is it not the essence of covetousness to desire what God in his wisdom has withheld from us in the lawful way of obtaining what we wish for?
    John Nelson

  • Thanks John

    Yes you are right on both fronts. For the believer, there are questions about prayer, the will of God, and so on to be considered. It is possible that God can miraculously intervene in these cases at times.

    And yes, medicine has shifted over the years, and now seems more concerned about treating desires than treating disease. Indeed, it must be remembered that in spite of IVF and ART, a couple will still remain infertile.

    Bill Muehlenberg, CultureWatch

  • Bill

    Normally you’re quite good but this was pretty poor.

    How could an infant mortality rate of 11 per THOUSAND be seriously used as an argument against IVF? That’s 989 new babies being born into the world, Bill. 98.9% is a pretty good success rate.

    Are you suggesting people in Africa should stop having babies because their mortality rate is higher – 50,100?

    I’m 22 but my number one dream is to be a great father. I don’t even have children but I know I love them already. Just like you no doubt love yours. In fact, most Dads say the birth of their kids is the best day of their lives…

    When I get married it would be devastating to me personally if I were unable to be able to raise a couple of kids in the ways of God.

    People don’t choose to be medically infertile but you would seek to punish them for this.

    Mat

  • Thanks Mat

    But you make several mistakes here. You do not provide a full name, as required in my commenting rules.
    And you seem to have confused the issue. The success rate of IVF is around 15 – 20 per cent. Mortality rates for infants born though IVF is a different matter. And it should be a concern to anyone in the West if a baby’s chances of dying are increased. So this has nothing to do with a 98 per cent success rate, but a higher death rate which should make us think more carefully about ART.

    And that point was just one of many I presented here. The cumulative case of the many concerns outlined in this article should be something all of us take into account as we consider using these techniques.

    And I stated several times in this article that the desire for kids is quite normal and vital. There is certainly nothing in this article to suggest that I am ‘punishing the infertile’ as you foolishly suggest.

    The point was that we need to think and pray about both the means and the ends. Having children is a good end, but not every means is necessarily moral, or safe, or wise.

    Bill Muehlenberg, CultureWatch

  • Sorry about breaking your rules.

    Sure, we should take those concerns into account when using technology such as IVF.

    On the other hand, we should use IVF while taking those concerns into account. Life is the greatest miracle of all.

    Not every means is necessarily moral, safe or wise. I don’t think IVF fails on any of those criteria.

    The statistic of 1 in every 33 kids in an Aussie classroom born to IVF says it all. I’m sure all are loved just as much as other kids are, and so they should be.

    Matthew Newton

  • “Not every means is necessarily moral, safe or wise. I don’t think IVF fails on any of those criteria.

    The statistic of 1 in every 33 kids in an Aussie classroom born to IVF says it all. I’m sure all are loved just as much as other kids are, and so they should be.”

    Matthew, two points if I may.

    First, the points that Bill was making demonstrate moral, safety and wisdom issues. It appears you have sidestepped all of his arguments with a sweeping contra-assertion, backed up with an ‘ends justify the means’ argument of 1 in 33 born to IVF.

    Then, I wonder if you have taken a wide enough angle to see the moral issue here?

    Broadly, God gives life and takes life. When we start interfering with the process of giving life, whether it be contraception, abortion or IVF and ART, we have to ask ourselves: to what purpose, for what goal, are we using such technology?

    Is it to glorify God, or is it to avoid His express will: “Be fruitful, and multiply, and fill the Earth.” ?

    Is it to submit intelligently to His purposes, or is it to selfishly wish away a so-called interference with living a comfortable lifestyle?

    Some of this moral dilemma emerges in that horrid phrase “unwanted pregnancy” over in the abortion debate. The idea is that adults (and not so adult either) can indulge their passions without considering the consequences (that’s traditionally called ‘hedonism’ of course).

    So much of our Western civilization is at risk: many actions are visibly irresponsible, precisely because we have built up a molly-coddling, nanny government approach to life – someone else will be called upon to overcome the negative effects of almost any action.

    That is, actions have become divorced from consequences. We especially see this in the mentality that infects many minority lobbying groups who seek to lift restraints on behaviour. The argument goes ‘since we can avoid the consequences, we no longer need to avoid the behaviour. Therefore let us remove the restraint.’

    The same moral problem arises in the ART and IVF debate as in the abortion/contraception debate: we just turn the coin over. The argument goes “here is this great technology, so let’s use it to fulfill this short term goal of having children.”

    Scripture tells us that Sarai/Sarah was barren, and Abraham had gotten to 75 years and then 100 years old before God intervened. Considerable humility and submission would have been required for up to 80 years, considering that Abram’s name meant “exalted father” (‘Hey Abram, I can only see a fence running around your yard! No change from last year and the year before, eh?’).

    Initially, they had a try at fulfilling God’s promise by surrogacy, but that led to world-wide consequences which are still with us.

    I doubt if Sarai or Abram had really thought through the consequences of a Middle East in such a mess as we see it today, do you agree?

    John Angelico

  • Another observation to make about IVF is that many of those who access this service are infertile due to age. Delaying children until the late thirties and the necessary extended use of contraceptives is often the cause of the problem. Part of the answer then is not more IVF & ART but to encourage a change in community attitude away from selfish lifestyles that would delay children until it is almost too late.

    Ewan McDonald, Victoria.

  • Thank you Bill.

    It would be interesting to get some sort of an idea of other ways that people seek to overcome infertility, and their satisfaction rates.

    IVF has the status of approved medical intervention. That means there will be many people ready to put all their hope, and massive investment, into IVF, without investigating other choices. And they may choose to be blind to the empirical facts that you’ve illustrated for us, Bill.

    My wife and I were facing the prospect of limiting our family size due to health and pregnancy issues. We determined to exhaust every work-with-nature option, and that’s when we got onto supplementing certain missing nutrients, and we haven’t looked back.

    And friends who did the same now have a second child after 7 years of hoping.

    Michael Casanova

  • Matthew said, “Not every means is necessarily moral, safe or wise. I don’t think IVF fails on any of those criteria”

    I would have to disagree, when a life such as an embryo are so blatently disregared I think this is a moral issue. If the cells are dividng and growing as they are in embyos then there is life. If these embyos are washed down the drain as they often are then there is no real diference between this and abortion.

    Caleb Podhaczky

  • IVF is personal and experienced in reality by infertile couples – not peole with negative opinions on IVF. Let us be. You go ahead and live your life – kiss your son good night, help your daughter with her homework, plan your family holiday etc. We can only hope for this life.
    Jack Mater

  • Thanks Jack

    But if you read the article carefully, you will find that I commiserated with those who are infertile. It is always a sad situation. I was simply giving the evidence of some dangers and problems that people need to be aware of. You seem to be shooting the messenger here.

    Bill Muehlenberg, CultureWatch

  • The ONLY objection I have to IVF per se is the possible destruction of embryos. In reality, however – this is not as widespread as one might believe as there are rarely many embryos yielded to even freeze and then dispose of in the first place. I am adamantly opposed to the destruction of life – but I am sure many “IVFers” would agree with me on THAT point.

    Re comments about age-related infertility – that is a gross over-generalisation. Step inside an infertility forum and I think you will be very surprised at the ages of the women and men there. There are several individuals in their early 20s experiencing infertility (PCOS, endometriosis, premature ovarian failure, etc).

    EVEN IF infertility is due to “age related factors” – and yes, this can certainly be the case – is it not “smug and judgmental” to point the finger at those individuals? “There but for the grace of God go I!” Perhaps these women simply have not met appropriate husbands – there can be a whole “myriad” of circumstances that can explain such delays in seeking to bear children. It is foolish to assume such people have been selfish and have had self-indulgent lifestyles – I don’t think $5000/IVF cycle leaves a couple with a lot of “spare disposable income”……

    Furthermore, with respect to “age related infertility” perhaps societal institutions (including the church) need to take on a more “pro-family” stance. The church today is failing young men and women and not being the beacon it should be in a society where mothering (particularly full-time) is a seen as a second-class choice. Men and women are experiencing great role confusion – contributing to delays in approaching normal milestones such as getting married, and having children. Today’s churches are becoming more and more “worldly” – across the board. This is something that is noted by Christians and non-Christians alike. How sad.

    So, you see, the factors are quite complex.

    Some of the comments re “medical aspects” can be applied to SEVERAL GROUPS in our community with respect to procreation. Bill, you claim a higher rate of medical anomalies amongst IVF babies. Are you willing to concede that such arguments can be applied to: people with genetic conditions such as breast cancer, mental illness, polycystic kidneys, etc, etc – the list is ENDLESS. Would you comment on members of THESE groups who choose to go forth and multiply?

    Just to conclude – I think we need to be very careful not to come across as “holier than thou” – the old “God has blessed ME” routine / prosperity based doctrine – which is serving to alienate the masses from churches today.

    I choose NOT to judge those of you seeking assistance via IVF – I wish you well – may you too know the joys of parenthood soon………..

    Tracy Wildi

  • Thanks Tracy

    But all I have done in this article is present some of the problems associated with IVF – nothing more. This information can be found in the scientific and medical literature. You are unhappy with those findings, so you choose to shoot the messenger, instead of offer an argument.

    Indeed, so desperate are you to shoot the messenger instead of dealing with the evidence that you make completely baseless and meaningless assertions. Just where in my article, Tracy, do I exhibit a holier than thou attitude? Just where, Tracy, do I tie in prosperity gospels and the like? Just where, Tracy, do I refer to the church, make one religious argument or cite one scriptural text?

    Like Jack, it appears you have chosen to not carefully read my article, and instead just attack me for making what most readers would consider to be a fairly innocuous and commonsense point: that with something like IVF, we need to proceed with caution given all the real risks and downsides associated with it.

    Bill Muehlenberg, CultureWatch

  • Bill – the comments to which you refer were extended to not only your input, but the input of some of the other contributors. It was a general response to a series of points – not only yours.

    I would be interested to hear, however, what research exists to support the assertion that IVF children feel a sense of “disconnectedness”. I do agree that that is a very real concern re anonymous donors – but I would be exceedingly surprised if research demonstrated that outcome within conventional relationships (by conventional I refer to a male and female relationship – preferably marriage.)

    I would also be interested to hear of the medical sources/journals that state some of the statistics you quote. I concur that there are risks attached to multiple pregnancies, but there I am not aware of (and clinics would deny) the presence of additional risks in singleton pregnancies.

    Re my comments about the church – I did not state that YOU mentioned the church. I chose to mention the church. I too am a Christian – and am simply pointing out some of the shortcomings of the church today with respect to social issues, and supporting conventional families and supporting and upholding the importance of motherhood. It was probably directed at Ewan’s comments. We, as a church community – SHOULD be doing more to promote families and to support families. Perhaps young people would not feel so “role conflicted” and not delay parenthood, with better support.

    I note you have used the phrase “shoot the messenger” a couple of times in your responses. Yes – you are presenting information – I am merely asking how informed and factual it is? You state that these findings are quoted within the scientific and medical literature. Could you please provide actual sources?

    Sincerely
    Tracy Wildi

  • Thanks Tracy

    But this website is not the place for lengthy, properly referenced research papers. So I will email you a fully documented paper I have written on this, containing 123 footnotes. I hope that satisfies your demands here.

    Bill Muehlenberg, CultureWatch

  • As a woman in her mid thirties unable to conceive naturally let me tell you being told that IVF is our only option is rather daunting and we are full of doubts and concerns.

    I was not fortunate to meet my husband younger and I had no idea medically I would be unable to conceive. If I had the good fortune to meet my husband earlier then fantastic but with what I have age does not affect my fertility as even if I were 22 years old sadly this issue we are having would still come into play.

    At the clinic there are many younger couples than ourselves we have seen and the times we have been not many older than us.

    It is a frustrating and scary journey when you run out of options and after having surgery to find out you have issues.

    I stumbled across this site as I searched concerns about IVF as naturally being told about this option is causing us to have reservations.

    The attitude out there is often upsetting and I never thought twice about IVF until now I am put in this position. I was always admanant that it was not natural nor God’s way. Now i think unless you are told you are suck or unable to conceive things may take a different perspective.

    Adoption is out of the question for us as it is a 4-8 year wait, lots of scrutiny, higher costs than IVF and no guarantee. Where we live there is also a cut off for age so even if we go down the adoption pathway we will be too old to adopt after the wait as there is no way we could adopt in the next few years as they interview you and process information etc…
    So that decision is out.

    So you are correct there are a lot of dilemmas in IVF but also everyone’s circumstances arising to IVF are different.

    We have not made a decision but it is frustrating to read other opinions on it, seeing so many conceive naturally and many not realizing what a miracle it is. Being a teacher, teaching some (not all) children that are unwanted or taken for granted is upsetting.

    Of course there are so many parents out there that love their kids and realise the miracle but being in education you see a lot that aren’t. For someone like me not able to do conceive then reading about IVF is frustrating and confusing!

    A scary pathway is all I can say…. What we choose we will decide at some stage.

Leave a Reply