Many Christians are uncertain about in vitro fertilization (IVF). Merriam-Webster defines it as the “fertilization of an egg in a laboratory dish or test tube … by mixing sperm with eggs surgically removed from an ovary followed by uterine implantation of one or more of the resulting fertilized eggs.” The process is controversial, emotionally charged, and frequently appears in the media and legislative discussions.
Shortly after we were married, my husband and I were diagnosed with infertility. As pro-life followers of Christ, we know that every life is sacred and begins at conception – even if that conception occurs in a petri dish. Although we were not very familiar with IVF, our primary goal was to honor the Lord in any decisions we made regarding our family, even if that meant forgoing the only options that might lead to having biological children.
So, we dove into “research” mode, asking questions and digging deep into the topic.
My intention here is to provide helpful insights for other pro-life couples dealing with infertility. In addition to clarifying medical terminology, I hope to offer biblical insights that will guide couples as they seek to build their families.
History and the typical protocol
In vitro fertilization was first performed successfully in Oldham, England, in 1978. A woman, Lesley Brown, was unable to conceive due to blocked fallopian tubes. Doctors retrieved a single mature egg from one of her ovaries and combined it with her husband’s sperm in a laboratory dish to form an embryo. This embryo was later transferred into her womb, where it implanted in her uterus and resulted in the birth of Louise Brown.
Over time, doctors came to understand that not every egg a woman produces is mature or healthy enough to use in IVF. Since the egg retrieval process was expensive and invasive, they recognized the benefit of harvesting more than one egg per retrieval. The doctors also discovered that medication could be administered to stimulate a woman’s ovaries to mature multiple eggs at once.
Today’s typical IVF protocol has evolved through efforts to maximize convenience and for financial efficiency. Generally, it involves giving high doses of medication to stimulate the production of roughly 8 to 14 eggs per cycle. However, some women may produce as many as 40 eggs in a single cycle. Embryologists then attempt to fertilize the mature eggs. On average, around 70-80% of these mature eggs will successfully fertilize.
Although the process happens in a laboratory, it marks the moment of conception when a new life, with its own DNA, is created in the image of God. It’s important to remember that while embryologists oversee IVF, only God, the Author of life, determines if any eggs will develop into embryos.
After creating multiple embryos, couples are often encouraged to have them screened for genetic testing, a process called preimplantation genetic testing (PGT), which screens for genetic abnormalities such as Down syndrome, cystic fibrosis, and Tay-Sachs disease. Embryos that are genetically abnormal are typically discarded. Couples are told that using them would significantly increase the chance of miscarriage.
Embryologists grade the genetically “normal” embryos to identify the strongest and healthiest ones. Together, doctors and couples decide how many embryos to transfer into the woman’s uterus. On average, there is about a 40% chance that an embryo will successfully implant in the uterus and continue to develop. Failure to implant is not directly related to the IVF process; rather, it is often due to genetic problems with the egg, the sperm, or a combination of both.
Additionally, problems with the uterine lining can also contribute to implantation failures. These factors can also affect natural conception; however, couples may be unaware that an embryo was ever created if the mother’s regular cycles are not being monitored.
To increase the likelihood of pregnancy, some couples choose to transfer multiple embryos at once, particularly if the woman is older. However, if too many embryos implant, the result can lead to a high-risk pregnancy. Therefore, if an ultrasound reveals that a woman is carrying quadruplets, she will be offered “selective reduction.” This is a first-trimester surgical procedure in which medication is injected to stop the heartbeat of one or more fetuses, thereby reducing the number of babies to one or two.
Common ethical dilemmas
The typical IVF protocol described above presents several moral and ethical dilemmas for pro-life Christian couples. However, it’s important to recognize that this protocol is not the only method for conducting IVF. At right is a discussion of these ethical issues, followed by potential ways they might be avoided.
IVF protocol alternatives
Many of the dilemmas mentioned at right can be thwarted by simply avoiding PGT and selective reduction or by only choosing fertility treatments and clinics that limit the number of embryos being created. Here are some examples:
▶ Rejoice Fertility in Knoxville, Tennessee, is an IVF clinic that is a “non-discard facility.” This term means that no viable embryo will be discarded, tested, or destroyed. The clinic also limits the number of eggs fertilized and encourages embryo adoption through the help of the National Embryo Donation Center.
▶ Louise Brown, the first baby conceived through IVF, was the result of a process called Natural Cycle IVF. In Natural Cycle IVF, no medication is administered to stimulate the woman’s ovaries. If this process results in an embryo, it can be transferred during the same cycle without needing to be cryogenically frozen.
▶ Minimal Stimulation IVF gives a woman a very small amount of medication to stimulate her ovaries to produce three to five eggs. It is done with the knowledge that typically not all eggs will be mature enough to use for IVF. Couples can choose to fertilize only the number of eggs they are comfortable safely transferring.
Personal convictions
In addition to IVF, various other methods of assisted reproductive technology (ART) now exist; however, some couples are still not comfortable pursuing any form of ART because it separates the moment of conception from the marital act. There is utmost respect for that conviction and for all believers who are seeking to build their families in the most biblically aligned, God-honoring way.
Christian conscience considerations
Selective Reduction
Selective reduction is another way to say “abortion.” By transferring only the number of embryos that a woman can safely carry to term, a couple can prevent situations where selective reduction might be deemed “medically necessary.”
PGT
Preimplantation genetic testing raises several ethical concerns for Christians. For starters, the Bible teaches that from the moment of conception, every human life is sacred and created in the image of God – even babies with genetic abnormalities. In addition:
1) PGT risks damaging or killing embryos who are only days old.
2) Recent studies prove that PGT often results in false positives and false negatives. Couples could end up discarding embryos that would have been genetically normal, or they could end up carrying a baby with a genetic abnormality.
3) PGT can be used to discard babies who don’t match the desired sex.
Unused embryos
After a successful embryo transfer, many couples are left with multiple unused embryos. They are presented with several options:
1) Discard the embryos, or donate them to science. Though they are small, these embryos are created in the image of God and precious in His sight.
2) Cryogenically preserve the embryos. Also known as “freezing embryos,” this is an option that many couples pursue initially. They pay a storage fee and later transfer additional embryos as they continue to build their family. After having multiple IVF babies, some couples will find themselves with a moral predicament: They now have a blossoming family but still have frozen embryos. Various factors may hinder them from transferring these remaining embryos. Commonly, these include family finances, the mother’s health and age, or death of a spouse. Often couples stop paying the storage fee, in which case, many of these abandoned embryos are discarded.
3) Donate them to other couples for adoption.
Other considerations
Conscientious couples using IVF typically limit the number of eggs they fertilize and make plans to freeze only a small number of embryos. They also commit to transferring every embryo in a timely manner. However, important considerations remain: Does the clinic have a backup generator to keep the embryos frozen in the event of a power outage? What happens if the couple is unable to transfer for unforeseen reasons?
Placing unused embryos for adoption is a selfless act for those who can no longer transfer their embryos created through IVF. However, couples often find it emotionally difficult to part with their embryos. Many embryo adoption agencies do not guarantee that the embryos will be placed with Christian couples. Additionally, an increasing number of same-sex couples are pursuing embryo adoption.
(Digital editor's note: This article was published first in the January/February 2025 special pro-life issue of The Stand. Click HERE for a free six-month subscription.)
