A Biblical Response to Baby-Making: Surrogacy, Artificial Insemination, In Vitro Fertilization and Embryo Transfer
by Dawn McColley, J.D.
"Baby-making," the science of the future, has become the science of the present. Surrogacy, artificial insemination, in vitro fertilization (IVF) and embryo transfer are four of the methods used today to enable childless couples to have children. A few years ago the solution to infertility was adoption, but the legalization of abortion and the change in societal attitudes toward single parenting has dramatically decreased the number of children available for adoption. Beyond that, it has become increasingly important to potential parents to have a baby who is genetically like one, if not both, of them. To provide a child for a childless couple - an awesome and worthy achievement. Does it justify the means we have used to accomplish it? If the end is a good one, how should we decide what means are proper to achieve that end?
RESPONSE TO INFERTILITY
In a day in which everyone is concerned about his or her "rights" it is common for couples, even Christian couples, to feel that they have a "right" to have a child. However, our lives are not made up of "rights." Rather, we have been given responsibilities and God has graciously bestowed many of these responsibilities on us in the form of gifts. Children are not objects to which we have a right; children are gifts from God. Some God has blessed with many such gifts, and from some God has chosen to withhold that blessing. Infertility is a state, whether permanent or temporary, in which God has placed some couples. As devastating as the problem of infertility can be, these couples can, by God's grace, acknowledge His will in all things and recognize that the promise of Romans 8:28 is true and meaningful. Peter says, "In this you greatly rejoice, though now for a little while you may have had to suffer grief in all kinds of trials. These have come so that your faith - of greater worth than gold, which perishes even though refined by fire - may be proved genuine and may result in praise, glory and honor when Jesus Christ is revealed."1 If we see children as gifts rather than as a guarantee, then we can more readily accept God's will for our lives with a proper attitude.
God doesn't always give us what we want, no matter how desperately we want it. Paul asked the Lord three times for relief from his "thorn" but was refused.2 Our response in disappointment must be Paul's: to be content and to acknowledge that the Lord's grace is sufficient and that He is wiser than we are.
This is not to say that cures for infertility may not be used. God has given men the ability to invent and discover new and marvelous things, not the least being medical techniques. If there is a cure for infertility, then we certainly may use it, provided it falls within Biblical parameters. The question discussed in this article is the morality of methods like surrogacy, artificial insemination, IVF, and embryo transfer, which are not cures to infertility but alternative forms of conception.
SCIENCE AND TECHNOLOGY
Human beings are made in God's image: amazingly intelligent, ingenious, and creative. Our creative genius must be used with care, however. Any bystanders at the scene of the Tower of Babel might have been in awe of the ability and genius of the men who created such a structure. But God knew the hearts and the worldly presumptions of those men and was displeased. They were building for their own glory and wanted nothing to do with the God who created them. God did not appreciate their architectural genius and so foiled their plans.3
The same danger exists for us today. The tendency of man is to want to control his fate, to be the master of his destiny, to glorify himself; and this tendency leads him to believe that anything he can do, he should do.
Our advancements in science and technology must have Biblical bounds. Modern, humanistic man, like his forebears, has conveniently forgotten this boundary and eagerly seeks whatever ideas enter his head. When we attempt to master our own fate, not only do we fail to glorify God, we defy His deity. God, in His Word, has established the truth of His supremacy. This truth requires us to use our creative abilities for one purpose only - to glorify God. As Christians, we are not free to partake in all the developments that tempt us from every side. We must be careful to behave in a way that acknowledges God as Lord and Master of this universe and of our own bodies.
METHODS OF BABY-MAKING
The simplest form of IVF is that in which several ova are removed from the wife and fertilized with the husband's sperm in a petri dish. The fertilized ova are then placed in the wife's womb with the intent that a normal pregnancy occur. This method is one way a couple who cannot conceive naturally can have children who are genetically like themselves. IVF can also occur using the ova and/or sperm of donors, where, of course, the child would not be the genetic product of both husband and wife.
Artificial insemination is a common and simple procedure whereby the wife of an infertile man is artificially inseminated by the sperm of a donor. The child is genetically the wife's and in most states the husband is by law the father, eliminating the need for adoption. In situations in which the husband has viable sperm but conception hasn't occurred naturally, e.g., low sperm count, his sperm can be used in this procedure.
Embryo transfer is a method by which a donor woman is impregnated through artificial insemination with the husband's sperm. The embryo is washed Out of the donor's uterus before it has a chance to implant and is then placed in the infertile wife's uterus so that she may carry it to term. The danger here is that the embryo might implant in the donor's womb. The "solution" to this problem is often abortion.
Surrogacy has received much media attention of late. This method is generally used when the wife is infertile. A contract is signed by the couple and the surrogate stating that the couple will pay all necessary expenses and will take custody of the baby when it is born. The surrogate is artificially inseminated with the sperm of the husband. The husband is the legal father of the child who must be relinquished by the surrogate and adopted by the wife. An alternate form of surrogacy is used when the wife is fertile but cannot carry a child to term. The wife's ovum is fertilized with the husband's sperm in vitro, then the embryo is implanted in the womb of the surrogate. The embryo is the genetic product of the husband and wife, however the legal ramifications are still being sorted out.
RESPONSE TO BABY-MAKING
What is a Biblical response to these amazing scientific breakthroughs in baby-making and how ought we to respond? There are three truths that must fence the Christian's acceptance of modern solutions to the problem of infertility:
1. The embryo is a human being from conception and must be treated with the respect that God requires of us in treating all of His image-bearers.
The Bible is clear about who man is and what is his relationship to God.4 The Bible is also clear about God's relationship to the developing baby in the womb,5 its nature and abilities,6 and God's plan for its future.7 Therefore, the embryo ought never to be the subject of experimentation that is not intended for its own benefit. Our God is not a utilitarian God. It does not matter what scientific "good" might come from such experimentation, nor how many other lives could be saved.
It is a common practice in many baby-making techniques to discard embryos who have not developed normally and to encourage the abortion of fetuses who have genetic or physical problems. These practices are contrary to God's law8 and must be repudiated. If Christians are looking at options for themselves, they must be aware of these occurrences, seek to educate their physician regarding the evil of treating the embryo as a pre-human, and refuse to allow these practices to occur with their offspring.
2. God has ordained heterosexual monogamous marriage. Any attempts to have children must take place within this relationship.
Marriage was designed to provide companionship,9 to provide sexual fulfillment,10 and to produce children.11 The Bible doesn't rank these purposes in any particular order and, therefore, none should be overemphasized or purposely de-emphasized.
Marriage is an exclusive relationship. Man and wife are said to be-come one flesh.12 Although several polygamous marriages are seen in the Scriptures, monogamous marriage is presented as the ideal, the only permissible type of marriage now. The Bible does not provide for the fulfillment of intimate companionship, sexual fulfillment or childbearing outside of that relationship.13
Thus, there is no justification for the use of any form of baby-making in any relationship other than marriage. Homosexual relationships, whether "married" or not, violate God's law14 and do not justify the use of medical technology in order to bear children.
We see in Scripture that the sexual act is reserved for the marriage bed only.15 Since sex outside of marriage is wrong, babies ought not to be conceived outside of marriage. Thus the single woman who wants to use artificial insemination in order to bear a child of her own without being "tied down" to a man, or because she feels that she will never be married, is violating God's standards.
Not only is it permissible that only married couples attempt to have a baby, but because of the exclusivity of the relationship, it is important that only those two be involved. Some call the use of third party donor gametes (i.e., sperm and ova) adultery, even though there has been no physical unfaithfulness. Regardless of the name given to it, the use of donor gametes is an act that includes a third party in an event that was meant to remain strictly within the marriage covenant.
Because of the special union in marriage, problems such as infertility are shared by both spouses and should be borne by both. Our traditional marriage vows say, "for better for worse, ... in sickness and in health." By using the gametes of a donor, the fertile spouse refuses to share the burden.
This refusal to share burdens is not a Biblical response to God's will, nor is it the way Christian spouses ought to treat each other. Children are not the sole, sacred purpose of marriage. If God has chosen to withhold that blessing from one spouse, He necessarily chose to withhold it from the other.
3. The relationship between a parent and his or her offspring is a sacred one that must be protected and encouraged.
An 89 year-old friend of mine told the story of when her parents were expecting their third child. They were asked by some friends who were unable to conceive if they would be so kind as to give up their third baby. After all, they had a girl and a boy and hopes for more. When her parents refused, the couple was offended. Were her parents selfish and unfeeling toward this poor couple who longed for children? Should they have given up that baby? They already had children and were able to have more (and did - eight altogether). We would regard any such request as preposterous and would think any parents who gave up their child for this supposedly worthy cause irresponsible, cruel, and unfeeling. Of course, there are instances in which the best decision for the baby and for the parents is to relinquish that baby in adoption, but for loving parents it is an exquisitely painful thing and is not done simply because they should share. We do not consider children fungible goods to be bought, sold, or shared.
APPLYING THE PRINCIPLES TO BABY-MAKING
It is in light of these three principles that the four methods of baby-making will be discussed.
Surrogacy is perhaps the most blatant example of a wrongful use of modern technology. For two reasons Christians should not consider this method an option. First, it is clear that a third party is being drawn into the intimate marital relationship. Instead of relying solely on his wife for all aspects of marital pleasure, the husband has used another woman to achieve his heart's desire.
Second, when a woman becomes a surrogate mother she reduces herself to a mere incubator. She must convince herself that the baby, who is genetically hers, belongs to someone else. She must suppress any maternal feelings she has for her baby. If the alternate form of surrogate parenting is used and the baby is not genetically hers, the bonding that occurs during prenatal development is not necessarily diminished and her maternal feelings must still be suppressed. It might be argued that in this case her denial is good and necessary. She is performing a selfless act by conceiving and bearing a baby for a childless couple. She should be commended. However, it is clear that surrogacy cheapens the maternal relationship and makes it something easily broken. It denies the natural feelings that God has created between mother and child. Christians must uphold and honor this maternal relationship.
Using our three principles we can see that there is no problem with artificial insemination if the husband's sperm are used to fertilize his wife's ovum. Using donor sperm, however, violates both the principles that surrogacy violates. The marriage covenant is broken by including a third party in the process and a man, although in a much less personal way than in surrogacy, is enabled to procreate without being responsible for his children's nurture. God did not create us for procreation only and He did not give us the option of having children without having true responsibility for them. Under God's creation-order, fathers and mothers nurture and care for their children, they don't merely receive intellectual gratification from their children's existence.
Embryo transfer presents a Christian with the same concerns as does artificial insemination through a donor. Even though the wife carries the child to term, she and her husband have made use of the gamete of another woman and have broken the marital covenant. And, like artificial insemination, the donor woman is not able to take proper responsibility for her offspring.
IVF is a different question. Using the previous arguments it can be said that using the gametes of any but the spouses is unbiblical. This leads us to the question of whether IVF, using the gametes of the husband and wife, is an appropriate option for Christians? There is no danger of breaking the marriage covenant here. It is obvious that God has blessed us with medical technology that can circumvent many physical problems. Some Christians believe that there is a point at which they must accept God's will for their lives and that IVF is going too far. Others believe that their time and money are well spent in the pursuit of having a child in this way. These controversial choices must be left to the couple, with two limitations. The first is that only their gametes be used. If one spouse is unable to provide gametes, the couple is not qualified for this option. The second is that all fertilized ova or embryos must be implanted regardless of their condition.
Typically, improperly developing embryos are discarded and sometimes experiments are performed on extra embryos. These practices must not be allowed because they violate our first principle that embryos are human beings created in God's image.
Another problem with IVF is that it is often ineffective. Usually several ova are fertilized and placed in the uterus to increase the chances of successful implantation. In some cases, however, multiple pregnancies have resulted that are doomed to certain or almost certain failure. The solution that has been used in some of these cases is called fetal reduction, which is the killing of all but one or two of the unborn infants in order to increase the chance of their survival. This method has had significant success in ensuring that parents who use IVF (or fertility drugs) will have surviving children. Fetal reduction is said by some to be necessary because it's better to have one or two surviving infants than none at all.
Christians must recognize that despite the appearance of reasonableness, fetal reduction is not an option. Sovereignty over life and death be-longs to God alone. Fortunately, the number of ova fertilized in IVF procedures can be controlled - therefore, the number of embryos put back into the uterus can be regulated. The physician must decide from a medical standpoint how many infants could survive gestation and only that number of ova should be fertilized. Thus there ought never to be the "need" for fetal reduction in IVF. Although this limitation reduces the chances of success, Christians should not put themselves in situations where their children could not possibly survive.
God's will for our lives is always for our good and for our further sanctification.16 If infertility is His will, we must accept it with submission and humility and look only for solutions to the problem that are in accordance with Biblical principles.
If we believe that both marriage and parenthood are God-ordained relationships, then we can easily reject surrogacy, artificial insemination with donor sperm, and embryo transfer, since they violate those relationships. The morality of IVF is less clear and Christians who desire to use it must do so within the bounds set by Scripture. "Whatever you do, do it all for the glory of God."17
In order to glorify God we must protect and preserve human life at all stages of development. For God has known us in the womb - "your eyes saw my unformed body ..."18 We must protect the marriage covenant - couples must share one anothers burdens and be one as God commands them to be. Finally, we must honor the relationship between parents and children. We must value and cultivate a society where attachments to our children are far from a matter of indifference and are held to be sacred.19