Infertility, which is defined as being unable to get pregnant after one year of trying, is a problem that affects millions of people around the world.1 However, with the advance of medicine and technology, many procedures that promise the opportunity to overcome this challenge have been discovered. This poses an ethical dilemma to every believer, especially to the one who is struggling with this issue and desires to have a child. How should a Christian think regarding the use of reproductive technologies? Can a Christian use these methods? Since the Bible is not explicit in the matter, I will suggest five biblical principles that should guide us in the assessment and decision making regarding the use of Assisted Reproductive Technologies.
Principle #1: Medicine And Technology Are Gifts From God
Before sin entered the world, infertility and its sorrows did not exist. The perfect plan of God was for people to “multiply and fill the earth” (Gen 1:28). Nevertheless, with the entrance of sin into the world, diseases, pain, and bodily malfunctions came also as a result.
Although God is our ultimate healer, He has given humanity the gift of medicine and technology to cope, endure, and fight against the various problems that have come from the curse. In spite the limited amount of biblical information regarding medicine, one still reads that physicians, oil, wine, and other treatments were used even among the community of faith (Luke 10:34; Jas 5:14; 1 Tim 5:23; Col 4:14).
Also, the Lord has commanded the believer to take care of his body to the best of his ability, given that his body belongs to God (1 Cor 3:16-17; 6:12-20). The concept of the stewardship of the body allows and, in some cases, demands that ethical means be applied in the treatment of bodily dysfunctions. Since infertility is nothing more than a bodily dysfunction in the reproductive system of one or both individuals seeking to have a child, it is appropriate to use medicine and technology to overcome infertility.
A common argument against treating infertility with medicine and technology is the biblical teaching that God is the one who opens and closes the womb (e.g. Isa 66:4). Although this is a valid concern, it is important to note that God’s sovereignty does not exclude human responsibility. In the mystery of God’s wonderful work and will, He ordains some people to struggle with disabilities and diseases, even from birth (Exod 4:11; Job 1-42; John 9:1-3). This knowledge does not preclude a person from seeking treatments to restore his health. On one hand, the believer must recognize that God is in control of all things; but, on the other, the believer is responsible to exercise dominion and stewardship in the areas in which God has allowed him to have a measure of control. For that reason, the use of medicine and technology to overcome infertility is not necessarily unethical; however, it is necessary to consider the boundaries and restrictions in the use of such technologies.
Principle #2: Abortion Is Sin
A boundary that must be placed on the use of Assisted Reproductive Technologies (ART) is the inclusion of abortion or the unethical treatment of the unborn during the procedures. Although abortion is normally thought of as an issue for women who do not want to have children, interestingly, it is also an issue for women seeking infertility treatments.
For example, a common practice during the infertility treatment known as In Vitro Fertilization (IVF) is to overproduce embryos. This is done due to the low likelihood of live-birth success in each attempt (around 20-40%)2, and the high cost of IVF (around $10,000 to $20,000 per round)3. Therefore, more embryos are produced than the couple can or are willing to carry in their first attempt as a “backup plan.” The remaining embryos are frozen for possible future usage. If the couple decides that they no longer need the remaining unborn children, they are “discarded” or donated. Other infertility treatments, such as Intrauterine Insemination (IUI), generally make use of fertility drugs that produce a release of multiple eggs. This procedure increases the chances of pregnancy, but it also increases the chances of multiple pregnancies. If the mother becomes pregnant with more children than she is able or willing to bear, she might contemplate selective pregnancy terminations.
From a biblical standpoint, there is no doubt that human life begins at conception (Ps 139:13) and every human being is made in the image of God (Gen 1:26), which entails the right to live and be treated with dignity and respect (Gen 9:6; Exod 20:13; Matt 5:21-22; Jas 3:9-10). Therefore, if the fertilization procedure involves the intentional abortion, mistreatment, or even a disrespectful handling of the unborn, it must be rejected. It is the couple’s responsibility to be well informed about the treatments and make sure to choose an option that treats the unborn as the image-bearer that he is with all his rights and privileges.
Principle #3: Procreation Is To Involve Marriage
With the advance of technology, people are now able to reproduce in multiple ways. It is only necessary to combine sperm with egg and implant the embryo in a suitable womb to make life possible. This can be done in multiple combinations as a result of sperm donation, egg donation, and surrogacy.
Although there is not an explicit command prohibiting the use of third-party arrangements in procreation, the Bible teaches that procreation is meant to take place in the exclusivity of the marital union (Gen 1:27; 2:24). To bring an outsider into the procreative process would implicate an intrusion in the exclusivity of the marital union, thus, violating God’s intended purposes.
Not only does the Bible seem to object against third-party-parent arrangements, but biblical wisdom seems to discourage it as well. In every case, whether it be sperm donation, egg donation, or surrogacy, the child will have a biological link to at least one person that is not supposed to be considered his parent. By confusing, weakening, or severing these biological links, the child and/or his biological parents will suffer through emotional and social struggles. This scenario is seen in cases of adoption, with the difference that the adopting parents are rescuing the child from an already unfavorable circumstance. With the use of third-party-parent arrangements, the people involved in the procreation process create the unfavorable circumstances that characterize adoption.4 Therefore, choosing to sever or weaken the biological bonds between the child and his parents, just to fulfill the dream of becoming a parent, is at least unwise; and, in the case of the donor or surrogate mother, is tantamount to child abandonment.
Principle #4: People Are Stewards Not Owners
God is the true owner of everything (Ps 24:1) and yet, God has chosen to entrust human beings as stewards over His creation (Gen 1:26-31). The believer, especially, needs to strive to be a good steward of what God has entrusted him, since he will give an account to the Lord for his actions (Rom 14:12; 1 Cor 6:19; Col 3:17). This is an important principle to consider when it comes to the use of reproductive technologies. First of all, the couple needs to consider the great financial cost of these treatments. This is a personal decision, and the couple needs to pray and evaluate if the treatments are the best use of the money that God has entrusted them. Second, the couple needs to consider the physical risks involved with the procedures. Hormone medications and medical procedures can cause health problems ranging from mild discomfort to long-term illness.5 Since our bodies belong to the Lord, the Christian must prayerfully evaluate if undergoing these treatments entails a good stewardship of the body.6
Principle #5: Contentment Is A Requirement
Even before considering ART, and also during the searching process, the couple needs to have a right attitude. God commands us to be content in every situation (Heb 13:5; Matt 6:34; Phil 4:11-13). Contentment does not mean that a couple should not desire or even try to overcome their infertility. It means that they must be willing to accept the possibility that God may not want to grant them children of their own. Although the pain that comes from struggling with infertility is great and real, the couple must have a heart that trusts in the goodness and the plans of God regardless of their current circumstances and the outcome.
Practically, for some couples, contentment may mean to remain childless and devote themselves to the Lord in that way. For others, contentment may mean to proceed in the route of adoption. For others, contentment may mean to humbly pursue the ethical options provided by Assisted Reproductive Technologies. Still, for others, contentment may mean to continue living faithfully for the Lord, until, in His timing, He grants the couple their desire to have a child of their own.
God is sovereign over everything, including the hardships of infertility. Every struggling couple, then, will find their answers as they live with contentment, praying for God’s will to be done in their lives and growing in Christ in the midst of such difficult circumstances.
Conclusion
The purpose of this article has been to provide biblical principles by which Christians may be guided in assessment and decision-making regarding the use of Assisted Reproductive Technologies. The first biblical principle discussed was that medicine and technology are gifts from God that may be used to deal with infertility. The second biblical principle was that any form of treatment that includes abortion or a disrespectful mishandling of the unborn is categorically unethical. The third biblical principle was that procreation is meant to take place within the confinements of a marital union, thus excluding any third-party-parent arrangement, such as sperm donation, egg donation, and surrogacy. The fourth biblical principle discussed was that a person must be a good steward of the gifts that God has given him, including his body and possessions. The final biblical principle discussed was that God commands His children to be content in every situation they find themselves. The Christian must be willing to embrace the will of God for him with humility, knowing that God is sovereign and good. Therefore, as he humbly follows the principles given in Scripture, the Christian may rest assured that God is ultimately in control and He will do what is best for him in, through, and in spite of the struggle with infertility.
END NOTES
1 Approximately 6% of married women between 15 and 44 years old experience infertility only in the United States. Center for Disease Control and Prevention. Reproductive Health. n.p. [Cited 28 February 2008]. Online: https://www.cdc.gov/reproductivehealth/infertility/index.htm
2 Daniel S. McConchie, “An Ethical Perspective on Reproductive Technologies.” Center for Bioethics and Human Dignity. n.p. [Cited 28 February 2018]. Online: https://cbhd.org/content/ethical-perspectives-reproductive-technologies
3 Ibid.
4 David Vandrunen, Bioethics and the Christian Life (Wheaton: Crossway, 2009), 135.
5 American Society for Reproductive Medicine. “Prevention and Treatment of Moderate and Severe Ovarian Hyperstimulation Syndrome: A Guideline.” Fertility and Sterility 106 (December 2016): 1634-47. Cited 28 February 2018. Online: http://www.reproductivefacts.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/Prevention_and_treatment_of_moderate_and_severe_ovarian_hyperstimulation_syndrome_noprint
6 John F. Kilner offers a short but good discussion regarding health risks in using reproductive technologies in Why the Church Needs Bioethics: A Guide to Wise Engagement with Life´s Challenges (Grand Rapids: Zondervan, 2011), 50.
