What's Wrong with In Vitro Fertilization?
by Natalie Hudson, Executive Director of Right-to-Life of Toronto
Infertility, an untold anguish suffered by thousands of couples, is on the rise with approximately 600,000 infertile individuals in Canada today. The ongoing cycle of hope and despair a couple experiences as they await the outcome of pregnancy tests can be emotionally grueling. Studies have shown that women experiencing infertility can suffer emotional distress and anxiety levels as high as patients who suffer with cancer and heart disease.
There are several methods, natural and unnatural, employed in the attempt to conceive, one of them being In Vitro Fertilization (IVF). Many of those unfamiliar with the rigors of the IVF process, laud it as a solution to the problem of infertility. Madame Justice Prowse in the recent BC Court of Appeal endorsement of same-sex marriages stated that access to reproductive technologies makes procreation available to gay couples - but does it really. What are the implications of this technique, both ethically and practically speaking?
An article from the New York Time. reprinted in The Canadian Journal of Infertility Awareness wrote about the tremendous emotional stresses a woman has to undergo in the IVF process. Quoting Dianne Clapp, the Medical Information Director for Resolve, a national infertility support organization, it reported,
Women have numerous pelvic exams and often take ovary-stimulating drugs via painful injections. Some drugs tend to cause emotional swings. On an almost daily basis, women have blood drawn to monitor hormone levels. Ultrasound examinations are performed to examine their eggs. The patients can become consumed by the details of their hormone levels or the status of their eggs and embryos.
"There are patients who simply do not have the emotional stamina to cope with this process," says Dr. Linda D. Applegarth, Director of Psychological Services for the Center for Reproductive Medicine and Infertility at the Weil Medical College of Cornwell University in New York.
The physiological dangers involved in harvesting eggs for IVF treatments were reported in a Washington Post article in December of 2001. Drugs taken to stimulate ovulation commonly cause "PMS-like symptoms such as bloating, abdominal pain, nausea and moodiness" and "in 3 to 5 percent of cases, hyper-stimulation of the ovaries occurs, causing severe abdominal pain; on rare occasions, surgery is required and the patient can be left infertile. Other risks of retrieval include lacerations, ovarian trauma, infection and anesthesia-related complications."
Then there is the risk of genetic defect to the child that is being conceived. A prominent study in the New England Journal of Medicin. concluded that infants conceived with the use of intracytoplasmic sperm injection or in vitro fertilization have twice as high a risk of a major birth defect as naturally conceived infants.
Twenty-six of the 301 infants conceived with intracytoplasmic sperm injection (8.6 percent) and 75 of the 837 infants conceived with in vitro fertilization (9.0 percent) had a major birth defect diagnosed by one year of age, as compared with 168 of the 4000 naturally conceived infants. As compared with natural conception, the odds ratio for a major birth defect by one year of age was 2.0. Infants conceived with use of assisted reproductive technology were more likely than naturally conceived infants to have multiple major defects and to have chromosomal and musculoskeletal defects.
Another study reported in the New England Journal of Medicine, 2002, concluded that "the use of assisted reproductive technology accounts for a disproportionate number of low-birth-weight and very-low-birth-weight infants in the United States, in part because of absolute increases in multiple gestations and in part because of higher rates of low birth weight among singleton infants conceived with [in vitro fertilization]."
Despite health concerns for the mother and child, what is most disconcerting is the loss of human life in the practice of these reproductive technologies - it is stunning. The process of IVF involves the retrieval of many eggs from the woman's ovaries, which have been stimulated through drugs; as many as twelve eggs are harvested for each IVF attempt. A single microscopic sperm is injected into each ovum to ensure fertilization. Once the embryos have been created they are 'inspected' and three of the 'healthiest' are chosen for implantation. Each implantation is referred to as a "cycle". The use of three embryos ensures that at least one will 'take'. However if all three are successful, two will be selected for a process called "selective reduction', most commonly known as abortion.
In a story reported in the Toronto Star, February 23,1998, called the "Human Egg Trade," statistics from the Human Fertilization and Embryology Authority in England revealed that the IVF success rate per attempt ranged from 4.9% to 23.7%, with a national average of 14.5%. Of the 20,000 British women who had test-tube baby treatments that year, there were approximately 3,500 live births resulting from the treatments. Given only the transfer of 3 embryos to the 20,000 women, 60,000 embryos would have been created and implanted. This number excludes the embryos that were not chosen for implantation but may remain in a frozen state. The resulting 3,500 live births means that 56,500 human embryos were lost in the process.
In a 1999 National Center for Chronic Disease Prevention report , American figures showed that there were 86,822 transfers with approximately 3 embryos per transfer. Excluding the embryos that were not chosen for implantation, calculations show some 260,466 human embryos created for the process of which 30,285 live births resulted. Approximately 230,181 human embryos did not survive the process. Incidentally, the United States released figures in May indicating that they have over 400,000 frozen embryos being stored in the country's 430 fertility clinics; a number much larger than they had originally anticipated.
In Canada, the Canadian Fertility and Andrology Society reported for 200. that there were 5,188 IVF cycles with 2-3 embryos transferred for each cycle. Approximately 15,564 embryos were created which resulted in 1,452 live births. Again about 14,112 embryos did not survive the procedure.
There is a minefield of ethical questions that surround a procedure in which such a staggering loss of life is inevitable. Though infertility can be painfully disappointing for parents, do they have the right to use technology to mandate the existence of their children. Are children the property of their parents. Do they exist to serve the needs and desires of their parents, however noble or sincere those wishes are, or do they have a purpose unto themselves. How far can we go in forcing the hand of the Author of Life to grant to us the fruits of the womb?
What does the Catholic Church say about in vitro fertilization?
CONGREGATION FOR THE DOCTRINE OF THE FAITH
INSTRUCTION ON RESPECT FOR HUMAN LIFE IN ITS ORIGIN
AND ON THE DIGNITY OF PROCREATION
REPLIES TO CERTAIN QUESTIONS OF THE DAY
Heterologous artificial fertilization (the technique used to obtain a human conception through the meeting in vitro of gametes taken from at least one donor other than the two spouses joined in marriage) is contrary to the unity of marriage, to the dignity of the spouses, to the vocation proper to parents, and to the child's right to be conceived and brought into the world in marriage and from marriage. Heterologous artificial fertilization violates the rights of the child; it deprives him of his filial relationship with his parental origins and can hinder the maturing of his personal identity. The desire to have a child and the love between spouses who long to obviate a sterility which cannot be overcome in any other way constitute understandable motivations; but subjectively good intentions do not render heterologous artificial fertilization conformable to the objective and inalienable properties of marriage or respectful of the rights of the child and of the spouses. (Sec. II A, para. 2)
Homologous artificial fertilization, (the technique used to obtain a human conception through the meeting in vitro of the gametes of the spouses joined in marriage) in seeking a procreation, which is not the fruit of a specific act of conjugal union, objectively effects an analogous separation between the goods and the meanings of marriage... Fertilization achieved outside the bodies of the couple remains by this very fact deprived of the meanings and the values which are expressed in the language of the body and in the union of human persons. (Sec. II B, para. 4b)
The spouses cooperate as servants and not as masters in the work of the Creator who is Love. In reality, the origin of a human person is the result of an act of giving. The one conceived must be the fruit of his parents' love. He 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. (Sec. II B, para. 4c)
...Techniques of fertilization in vitro can open the way to other forms of biological and genetic manipulation of human embryos, such as attempts or plans for fertilization between human and animal gametes and the gestation of human embryos in the uterus of animals, or the hypothesis or project of constructing artificial uteruses for the human embryo. These procedures are contrary to the human dignity proper to the embryo, and at the same time they are contrary to the right of every person to be conceived and to be born within marriage and from marriage. (Sec I, para. 6)
Natalie Hudson is the Executive Director of Right to Life Association of Toronto and Area. Originally from South Africa, she spent much of her youth as a ballerina dancing in San Francisco and in Winnipeg with the Royal Winnipeg Ballet. Her career was cut short in her early twenties due to an injury, but she soon found solace in studying the Great Books at Thomas Aquinas College, a Liberal Arts college in Southern California. She graduated in 1995 and worked on her Master's Degree in Theological Studies at Notre Dame Graduate School in Virginia. She was a high school teacher in Vancouver for four years and has recently completed a Graduate Business program at Capilano College in Vancouver. She has been speaking on Life Issues for the last three years and has addressed students of all ages. She is also on the Canadian Planning Committee for the Colebrook Society.
