Posted on 08/11/2004 6:34:48 AM PDT by NYer
SACRAMENTO, Calif. — Catholic teaching has called in-vitro fertilization techniques immoral for decades. But most Catholics still haven’t heard the news.
California attorneys Anthony and Stephanie Epolite found out the hard way that in-vitro fertilization wasn’t all it’s cracked up to be. After years of marriage, and facing her 39th birthday still without a baby, Stephanie turned to a fertility clinic.
Two years and $25,000 later, the couple had nothing but frustration and embarrassment to show for the time spent on in-vitro fertilization (in-vitro fertilization).
"We were emotionally, financially and spiritually spent," Stephanie Epolite said. "The clinic did no diagnostic tests. They loaded me up with fertility medication and determined the right time for retrieval of my eggs."
But, after the retrieval and the mixing of the eggs with Anthony’s sperm in the laboratory, still no embryo developed. "In the end, they told me I just had old eggs," Stephanie said.
She wishes she had known at the beginning what she has since learned: The Catholic Church forbids fertility techniques that try to make babies outside of marital intercourse. "There is no education out there about the alternatives," she said, "so Catholics are flocking to the fertility clinics."
According to the American Society for Reproductive Medicine, infertility affects more than 6 million American women and their spouses, or about 10% of the reproductive-age population. About 5% of infertile couples use in-vitro fertilization.
As to how many Catholic couples are among them, figures are hard to come by. But many Catholics seem unaware of the immorality of the procedure.
"Anecdotally, from our consultation experience here, Catholics using reproductive technologies are generally unaware of the Church’s moral teaching in this area," said Dr. Peter Cataldo, director of research with the Boston-based National Catholic Bioethics Center. "They’re not hearing it from the pulpit or elsewhere."
In her teaching on human reproduction, the Church seeks to safeguard human dignity. God wants life "to be the result of an act of love by those committed to loving each other," philosophy professor Janet Smith has written. Anything that assists the conjugal act achieve its purpose of procreation is licit; anything that substitutes for it is not.
In No. 2377, the Catechism explains why the Church opposes methods that separate marital love-making from baby-making.
"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. 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."
In successful in-vitro fertilization, a human life comes into existence outside the conjugal act and outside the womb. Conception is the result of a technician’s manipulation of "reproductive materials." The process for the collection of sperm often necessitates masturbation, which is itself immoral.
Father Tadeusz Pacholczyk, director of education at the National Catholic Bioethics Center in Philadelphia, explained that the Church teaches that the procedure is immoral for several reasons. "It undermines the meaning of sex. It violates the exclusivity of the couple’s marriage covenant," Father Pacholczyk said. "It says that it is okay to manufacture life in a laboratory as if it were a commodity, when it should be the result of human love."
"There’s also the ancillary evil of freezing embryonic humans that are later abandoned or poured down the sink if they are not useful," he added.
In addition, Father Pacholczyk noted that babies created through in-vitro fertilization have an elevated risk of birth defects.
"Studies have shown a sixfold elevated risk for in-vitro fertilization children contracting an eye disease called retinal blastoma versus normally conceived babies," he said. "In-vitro fertilization is very unnatural. You’re extracting ova from the woman, culturing them and inspecting the developing embryo in a laboratory setting. They are in a completely unnatural environment for a very long time before they are put back into the womb.
"Commercial interests offer in-vitro fertilization as standard practice," Father Pacholczyk said. "The Catholic Church is the only voice opposed to it."
But there are morally acceptable alternatives to in-vitro fertilization, and Dr. Thomas Hilgers is trying to let more Catholic couples know that.
In response to Humanae Vitae, Pope Paul VI’s 1968 encyclical reaffirming the Church’s opposition to contraception, Hilgers devoted his life to the study of human reproduction, developing the Creighton Model System of Natural Family Planning and eventually opening the Pope Paul VI Institute for the Study of Human Reproduction.
In 1991, Hilgers coined the term NaProTechnology (Natural Procreative Technology), a reproductive and gynecologic medical science that seeks to evaluate and treat a host of women’s health problems without the use of contraception, sterilization, abortion or artificial reproductive technologies, thereby making it consistent with Church teachings.
NaProTechnology first identifies the causes of infertility and then seeks to treat them. That’s not always the case at fertility clinics.
"The aim of most fertility clinics is to skip over the abnormality to try to get women pregnant," Hilgers said. "Yet when you skip over the causes, you end up dealing with them one way or another.
"It’s ludicrous to promote in-vitro fertilization as the help for the vast majority of 6.62 million with impaired fertility," he said. "When you listen to the national news and morning television shows, you think that in-vitro fertilization is the only thing available to infertile couples, yet less than 0.5% of infertile couples in the U.S. are helped by in-vitro fertilization each year."
Catholic theologians and ethicists would agree that NaProTechnology is morally acceptable, Cataldo said.
Cataldo pointed out that "certain drug therapies and egg-stimulating medications at doses that don’t have disproportionate risks for the children engendered or for the mother" also are acceptable. But other technologies, such as intrauterine insemination (IUI) and gamete intrafallopian transfer (GIFT) fall into a "gray area."
"Some moral theologians and ethicists see these techniques as assisting the conjugal act. Others see it as replacing it," he said. "Until such time as the Vatican speaks, Catholics contemplating the use of IUI or GIFT should inform themselves of both sides of the moral and theological argument and then make a decision in good conscience."
Regardless of the artificial method chosen, the cost of such techniques remains high and the success rates low. According to the 2001 Assisted Reproductive Technology Success Rates report compiled by the U.S. Department of Health and Human Services, a survey of 384 fertility clinics showed a clinical pregnancy success rate of 32%.
In a 1990 article published in Social Justice Review, then-associate director of the U.S. Catholic bishops’ Pro-Life Secretariat Richard Doerflinger noted that a survey of in-vitro fertilization clinics discovered that half of the clinics had never had a live birth after being in business at least three years, collectively treating more than 600 women and collecting $2.5 million for their services.
"Those with the extraordinary emotions that engulf infertile couples are extremely vulnerable," Hilgers said. "They are easy prey."
Not only do natural and morally acceptable alternatives such as NaProTechnology cost far less, but they also are more successful. The Pope Paul VI Institute boasts success rates ranging from 38% to 80%, depending upon the condition being treated.
Following the Epolites’ experience with in-vitro fertilization, Stephanie learned about the Pope Paul VI Institute from a Natural Family Planning counselor. In the fall of 2000, the couple applied to the institute, gathered charts they had kept that outlined vital signs related to fertility, and underwent diagnostic testing.
As it turned out, both had reproductive issues that their previous fertility clinic had never diagnosed. Anthony’s sperm count was low, and Stephanie suffered from endometriosis and blocked fallopian tubes.
Six months later, following treatment of their conditions at the Pope Paul VI Institute and at the age of 42, Stephanie conceived naturally. Their daughter, Claire Marie, was born Oct. 31, 2002.
"At the Pope Paul VI Institute, we saw compassion, concern, help and love," Stephanie said. "They provided individualized treatment, versus the empty feeling that we felt from the fertility clinic. Whereas the fertility clinic bypasses all the laws of nature, the Pope Paul VI Institute works with the laws of nature."
She sees the whole situation demanding these services as very concerning. In the case of an otherwise healthy woman with tubal defects or other reproductive injury, neither of us sees an ethical problem with offering a treatment whereby the patient could have a baby. However, both of us agree that a large fraction of these fertilizations should not be performed both for medical and ethical reasons.
First of all, there are usually good reasons the patients are having trouble conceiving. A lot of them have poor egg or sperm quality with markedly higher percentages of observable defects. Poor sperm with low motility normally wouldn't survive the trip up the uterus and into the tubes to fertilize. Low counts have a lower probability of successful implantation. Poor eggs more often fail to accept a sperm. In-vitro bypasses those deficiencies, but at a price. Babies born by in-vitro fertilization have higher birth defects, more immune system problems, and lower intelligence quotients than children conceived naturally (this in a population of parents able to afford the procedure). It would seem that the process abets undesirable combinations by failing to cull poor sperm and bad eggs. Then we take these (for lack of better words) less optimal combinations and implant them under ideal or even augmented circumstances doing everything possible to make sure they survive where they might otherwise be rejected by the body through a spontaneous abortion.
More disturbing is the ICSI process (Intracytoplasmic Sperm Injection), wherein a sperm is injected directly into the egg. The rate of birth defects and other congenital problems subsequent to this process is very high, in part because the procedure bypasses the usual process wherein an egg selects a compatible sperm. If you ever wanted to see the hand of God in conception, it is there.
Also disturbing (to her) is the number of couples entering the clinic who seem, upon first appearance, to be totally incompatible, just plain bizarro couples. She says half her job is managing frayed emotions of unstable women jacked up with hormones and suffering in rotten relationships. This is to say nothing of the number of lesbians visiting the clinic.
It used to be that the clinic only accepted stable married couples. In recent years with fewer cash patients and lower rates paid by insurance companies, the clinic is now accepting larger numbers of just about anybody in order to remain a profit center for the hospital. If the work wasn't so interesting, I don't think she would be doing it, preferring to take care of babies instead.
"we're just trying, in our weakness, to toe the line"
Whose line?
2352 By masturbation is to be understood the deliberate stimulation of the genital organs in order to derive sexual pleasure. "Both the Magisterium of the Church, in the course of a constant tradition, and the moral sense of the faithful have been in no doubt and have firmly maintained that masturbation is an intrinsically and gravely disordered action."137 "The deliberate use of the sexual faculty, for whatever reason, outside of marriage is essentially contrary to its purpose." For here sexual pleasure is sought outside of "the sexual relationship which is demanded by the moral order and in which the total meaning of mutual self-giving and human procreation in the context of true love is achieved."138
To form an equitable judgment about the subjects' moral responsibility and to guide pastoral action, one must take into account the affective immaturity, force of acquired habit, conditions of anxiety or other psychological or social factors that lessen, if not even reduce to a minimum, moral culpability.
I'm not sure what they mean when they say "the deliberate use of the sexual facility outside of marriage." Does that mean it's o.k. for married people to masturbate?
Not that it'll make a difference to you but the cold hard facts are that the vast majority of fertilized eggs never make it -- whether in-vitro or in-vivo. They weren't "sacrificed". You'd be surprised how many babies you (or your wife if you're a guy) "sacrificed" in order to have your children.
My point was that the way the system is set up (quite deliberately I might add), the clock is against families producing enough babies to maintain the society. I don't think you would dispute that.
Having a child right now would be incredibly selfish. And since I want something better for my children than what I had growing up in a single-parent home, I am not willing to put my personal needs above the best interest of my child.
Your choices are more complex than that. Please see post 41.
Don't bet on that. My older daughter (11) is a year into college calculus. I know professors who will attest to her work. She'll attend a JC for chemistry, biology, and physics lab work.
Homeschooling is nice and everything, but there is just no way a parent can teach college level physics or engineering as well as a good professor can (unless that parent is a physicist or engineer themself, but then I seriously doubt they would be staying at home).
I am a trained engineer.
And many people meet and get married in grad school, so your age of 35 for marriage makes no sense.
Those "ages" were for completion of the process. My estimated age for marriage of post graduate educated parents is 30. By the time they get settled financially to have kids, it was 35. It's far more common than you think, especially with more kids starting school at an older age. My wife sees them all the time.
True. Masturbation is a mortal sin, and has always been considered so, as is evidenced by the fact that when Onan in the Old Testament committed coitus interruptus, God slew him for it. The punishment for it, obviously, is not what it was back then, but the gravity of the sin is still the same. I believe every Protestant denomination would have condemned it similarly even just a half century ago.
Regarding the folks on here who can't agree with the Church's teaching in this area, the reason in vitro has to be considered immoral is because the husband has to commit a mortal sin in order for this process to work. Even if no abortions are involved. You can't commit evil so that a good may result, therefore, no in vitro.
As the article points out, also, it is trying to do an end run around normal reproduction anyway. Doctors should be trying to help couples conceive naturally.
It is different for everyone, I guess.
Thanks! I knew someone would explain it. That's why I adore FR - there's an expert around here on just about any subject.
Studies are all over the map on this. I've never heard of the immune system problems. The IQ claim is bogus as followup studies have no lasting effect on IQ. You also have to be careful when reading the studies to find out if there were early deliveries, etc.
More disturbing is the ICSI process (Intracytoplasmic Sperm Injection), wherein a sperm is injected directly into the egg. The rate of birth defects and other congenital problems subsequent to this process is very high...
Only if you consider going from 4% to 6% "very high".
So what do I with my children? Should I let someone like you adopt them, since I've mortally sinned to conceive them?
By the way, would it be immoral if my wife assisted me in producing the sperm, and I did not handle myself?
And really, Claud, if you're a man, are you asserting that you've never committed this sin?
Include allergies and asthma.
The IQ claim is bogus as followup studies have no lasting effect on IQ.
IQ can be compensated over time, and we are talking about an affluent population. That it can be mitigated does not mean that there is no effect.
Only if you consider going from 4% to 6% "very high".
Last I heard it's 10%. That's very high. It is second hand information from my wife.
Good post.
Need help from orthodox Catholics here:
-- What do you say to Lance Armstrong when he had testicular cancer? He froze his sperm so that he could be a father in the future. I don't know the exact procedures by which his wife was impregnated, but they have 1 or 2 kids now.
No cheap shots about the fact that they're divorced now and he's seeing Sheryl Crowe. That's irrelevant to the question at the moment, which is whether or not he was wrong in doing what he did so he could have a chance to be bio father in the future (his chances for being one as a result of intercourse ended when the testicular cancer operations were performed).
And if The Church sees this as wrong (which I suspect it does), exactly why?
True indeed. It's a tool. It's not the best way to do things, but it can be the best alternative under the ciricumstances. Like any tool, it can be abused and, sadly, often is.
Seems that you've got a problem with lower IQ folks being conceived. How do you feel about Down's Syndrome? How about other physical impairments. Ignoring your second hand statistics, I think you're attitude towards other's intelligence would make you a big fan of Eugenics.
By the way, both of my IVF children are normal and seem pretty smart, but maybe I'm just too dumb to know there's something wrong with them.
At the risk of exposure for ignorance, how does the Pope Paul VI Center find out a guy's sperm count is low without having a sperm sample to count from?
I would think the husband would have to masturbate to provide the sample. Surely the Center doesn't ask the husband to commit a mortal sin--or do they have an onsite confessional for this purpose? (weak attempt at humor)
I merely point out that there are risks attendant to a process that doesn't completely replicate the original.
Ignoring your second hand statistics, I think you're attitude towards other's intelligence would make you a big fan of Eugenics.
This comment is beneath contemptable.
By the way, both of my IVF children are normal and seem pretty smart, but maybe I'm just too dumb to know there's something wrong with them.
Now we get to the real issue (which my wife brings home daily). Best you get some counseling for that.
Tell me about it. I have been trying to explain this to Catholic family and friends all my adult life.
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