In Vitro Fertilization: A Human Rights Perspective

Several months ago, I was asked to write an article about in vitro fertilization (IVF), the artificial reproductive technology which requires eggs to be retrieved from a woman’s body to then be combined with sperm in a laboratory setting to result in fertilization. After extensive research I began writing but couldn’t seem to finish the article, one of the reasons being the sensitive nature of the topic itself.

While pro-lifers can all agree that abortion is always wrong, this consensus is far from existent when it concerns IVF. We are rightfully willing to say that abortion is wrong regardless of the difficult circumstances of a crisis pregnancy, yet the pain of those who struggle with infertility often prevents pro-lifers from rejecting IVF. Add to that a lack of knowledge about what the procedure entails, and the fact that many of us know people either who’ve pursued this path or were conceived in this way, and it seems this subject belongs in the no-go zone.

Considering all this, what can I say? I would answer this question the same way as when teenagers ask me at the end of a presentation what I think about the morning-after pill or the IUD. What I think doesn’t matter. What matters are the facts about the issue at hand. What does it do? What is the effect on newly conceived human beings? How does it impact our view and treatment of human lives? Those are the questions we must answer in order to determine our attitude towards IVF.

Since Louise Joy Brown, the first-ever “test-tube” baby, was born in 1978, worldwide more than eight million children have been born who were conceived through IVF, with some sources estimating this number is nearing the 1.6 billion mark. It is not their births that are problematic; in fact, there’s reason to be glad that they survived! What demands our attention is what happened prior, at the beginning of their lives.

For those who do not acknowledge that human life begins at fertilization, the issue of IVF is hardly a moral problem. If embryos are not human beings like you and me, their (mis)treatment will hardly cause one to pause. If this is your view, I’d encourage first delving into the science of when life begins.

Who is conceived during IVF?

To quote Robert P. George and Christopher Tollefsen from their phenomenal book, Embryo: A Defense of Human Life,

The embryo, which is the product of the union of male and female gametes, just as in ordinary sexual reproduction, is a single, individual human organism, albeit one that is brought into existence outside of the natural environment it [he/she] needs to survive.

This fact must inform every discussion about and consideration of IVF, especially because it is often conveniently hidden by fertility clinics. The correct medical terminology is certainly used, such as zygote (one-celled embryo), blastocyst (five-day old embryo), and embryo (the term used during the first eight weeks of pregnancy). These are simply age categories, no different than toddler or teenager. For those that are not born, however, these terms are intentionally used to dehumanize and distance ourselves from them.

Our interactions on the street confirm this. I’ve often pointed to an image of a pre-born child aborted during the first trimester of pregnancy and asked, “Should we be allowed to do this to fellow human beings?” and the person replied, “It’s just an embryo!” as if one’s age category justifies ending their life. I’ll ask, “What kind of embryo?” and the answer, of course, is human.

While this article is written for those who value human life from fertilization onward, we too must be vigilant in order to not be influenced by the surrounding culture. A friend once told me about a family member’s IVF cycle, saying, “I think they lost an embryo, but they do have kids now.” “I’m sorry to hear they lost a child in the process,” I replied. My friend looked surprised. “What do you mean?” “Didn’t you just say they lost an embryo?” I asked gently. A long silence followed. “Wow,” she said, “I guess I knew that but never thought about it as a child too.”

I had a similar conversation when another friend mentioned that her brother and sister-in-law’s attempt at IVF wasn’t successful. “I guess the egg didn’t take,” she said. When I asked what she meant, she replied, “You know, they put the fertilized egg inside of her and she didn’t get pregnant.” I asked, “Wouldn’t they put an embryo instead of an egg inside of her?” She was confused. “I don’t really get it. She called it a fertilized egg.” I explained that this is a medically and scientifically incorrect term because an egg ceases to exist the moment fertilization takes place, which results in a new embryo. It didn’t seem to make a big difference to her.

Both friends are pro-life and condemn abortion as a human rights violation yet didn’t recognize the loss of these embryos as the deaths of their niece or nephew. The first (and perhaps most important) step, then, is to ensure we view and value every human life as equally valuable, whether it’s a tiny embryo in the lab, fetus in the womb, or infant in our arms. The issue is not who they are, but how they’re brought about.

What really happens?

In the United States the Centers for Disease Control (CDC) provide a detailed picture of the reality of IVF. These numbers are from 2015:

• 45,779 egg or embryo-freezing procedures were done that did not result in an embryo transfer.
• 182,111 IVF procedures were done with the intent to transfer at least one embryo.
• Of these 182,111 cycles, a total of 143,286 (78.7%) progressed to embryo transfer.
• Of these 143,286 embryo transfers to the uterus, 72,870 (50.9%) resulted in a pregnancy, but only 59,334 (41.4%) in a live-birth delivery.
• The 59,334 live-birth deliveries included 47,685 singleton live-birth deliveries (80.4%) and 11,649 multiple live-birth deliveries of 23,467 infants (19.6%), resulting in 71,152 live-born infants.

Let’s break that down. 182,111 IVF cycles were performed which resulted in 59,334 live birth deliveries and, some being multiples, 71,152 live-born infants. These numbers matter: only 30-40% of IVF cycles result in a baby in the parents’ arms. (In 2012, the Human Fertilization and Embryology Authority in the UK reported a 7% success rate. Improvement of technologies and, in a morbid irony, experimentation with embryos has led to an increase in babies born alive.)

What does this mean? If every IVF cycle resulted in the creation of only one embryo, at least 122,777 tiny human beings died in the process. But creating one embryo per cycle is by no means common practice in IVF clinics. Yes, it is possible to have only one or two eggs retrieved and fertilized, and I personally know couples who have opted for this route to decrease the risk of embryo deaths. Most clinics, however, will not cooperate with this request since it negatively affects their success rates.   

Canada’s self-proclaimed fertility resource FertilityMatters.ca recommends retrieving 15 eggs per IVF cycle:

When buying groceries at the grocery store, a dozen eggs might just be the right amount. When a woman is undergoing IVF, studies show that 15 eggs are ideal. It is fine to retrieve less than 15, as quality is more important than quantity and depending on the situations, more than 15 eggs are fine too. It is also important to note that retrieving a large amount of eggs does come with more risks; hyperstimulation and egg quality. When an IVF retrieval results in obtaining 15 eggs, you can expect approximately 30 – 40 percent blastocyst development rate (4.5 – 5 Day 5 embryos). A Day 5 embryo transfer (blastocyst stage), is the final and most successful stage before the embryo hatches and is implanted.   

Let’s set aside the disturbing comparison between human egg retrieval and grocery shopping and just play out this scenario. 15 eggs will result in approximately five blastocysts (five-day old embryos). The medical community strongly encourages transferring only one embryo at a time to achieve higher success rates and less medical risk for mothers and babies. This would mean that one, possibly two embryos are transferred to their mother’s womb. The other three are likely frozen or may be discarded, depending on the wishes of the parents.

What about the other 10 eggs? We simply don’t know. If other embryos were created, they would be graded. The ones that are deficient or don’t make it to day three or five will be disposed of. There are no statistics that show us how many eggs result in embryos—because it’s of no consequence to the clinics.

Online, a couple who did IVF but lost an embryo due to clinic incompetency recommended, “[ask] about the lab’s fertilization rate (how many harvested eggs are successfully fertilized with sperm) and how many embryos make it to a Day 5 blastocyst (the stage of the embryo with the highest success of implantation and pregnancy).”

Going back to the statistics, let’s say—being conservative—that 15 eggs result in five embryos. Half of those will result in a pregnancy, but only 40% (two out of five) will result in a live birth. This means that at least three out of five babies conceived through IVF die. Sadly, this number is likely much, much higher.

What happens in Canada?

Reliable Canadian statistics are difficult to obtain since reporting about reproductive health services is voluntary. I did, however, find a report on the Canadian Fertility & Andrology Society website, which includes the stats of 36 IVF clinics across the country. (Surrogacy.ca lists 53 IVF clinic across Canada, meaning that these numbers represent perhaps two-thirds of all IVF cycles.)

Between 2013 and 2016, the success rate per IVF cycle was 21.6% on average, but 39% for women under 35, 32% for women 35-37, 21% for women 38-40, 11% for women 41-42, and 5% for women 43 and older. These numbers are even lower than American and European statistics.

In total 33,092 IVF cycles were performed in 36 Canadian clinics in 2017. The BBC reports that IVF in the UK fails 70% of the time. If we apply American and European success rates of 30%, it would mean that 9,928 IVF cycles resulted in a live birth and at least 23,164 other tiny children were conceived through IVF who didn’t make it to birth (yet).

We can be certain, however, that this number is inexplicably higher since IVF cycles rarely result in the creation of one embryo. Let’s say every Canadian IVF cycle yields five to 15 embryos, which is much more likely. This means that in 2017 roughly 93,000 up to 324,000 other children were created who either died during the process, were discarded, or left by their parents in a frozen state.

Choosing designer babies and killing the rest

Canadian statistics show that when IVF cycles do not result in the transfer of an embryo, 31.6% of the time this is because parents opt to “freeze all” to allow for pre-implantation genetic screening and diagnosis testing (PGS & PGD). The same report shows a steady increase in the number of IVF cycles that do genetic testing.

According to the Toronto Anova Clinic, “PGS/PGD can increase the chances of pregnancy, minimize the risk of pregnancy loss, and afford the parents the chance to avoid undesired genetic traits.” Does anyone ask what’s done to the embryos that don’t meet the mark? Let’s be clear: “avoiding undesired genetic traits” involves the intentional destruction of children who do display those traits.

It gets worse. The firm Genomic Prediction made the news last week, announcing a new genetic test is likely to predict which embryos have a low IQ. According to the firm’s co-founder Stephen Hsu, “It isn’t accurate enough to predict IQ for each embryo, but it can indicate which ones are genetic outliers, giving prospective parents the option of avoiding embryos with a high chance of an IQ 25 points below average.” Again, we must ask the question: how will the parents “avoid embryos” that are undesirable? At best they will be frozen, but most likely their short lives will end by being discarded or used for research.

Frozen in time

Imagine a news story that announces a revolutionary new technique which allows parents of unwanted infants to freeze their little ones for an indefinite amount of time. For a storage fee, their burden is lifted, though prolonged freezing may result in the eventual expiry of their offspring. Unthinkable, isn’t it? Yet every day, IVF clinics across the world freeze human beings who are only nine months younger through a practice called cryopreservation, facilitating the creation of ‘excess’ human beings.

In addition, the number of embryos cryogenically frozen in storage continues to increase as families undergo IVF. In 2011, over 600,000 frozen embryos were stored in the United States, but the latest numbers show that there are now over 1,000,000 embryos in frozen storage in the US alone. 

What is to be done with those babies? While many parents don’t intend to ever transfer these embryos for a chance at life, they also can’t handle the thought of throwing them out. Month after month, year after year, they pay storage fees to keep their children frozen in time. Alternatively, they can be discarded or donated to scientific research. Whoever heard of parents donating their born children to science? Last year, I wrote about a new and truly nauseating option: turning one’s leftover embryos into jewelry. A final, life-affirming alternative, which has gained more attention in recent years, is to choose an adoptive family through snowflake embryo adoption programs, such as Nightlight.

Completing the dehumanization

For IVF-conceived children, surviving the selection, thaw, and transfer, then implanting into the uterine lining and not miscarrying during the first weeks or months doesn’t guarantee safety either. IVF has resulted in another gruesome practice, sometimes called the plus-one-minus-one pregnancy. While single-embryo transfers are highly recommended by the medical community, women still opt for multiple-embryo transfers, which can result in unwanted or even dangerous situations.

From David Picella, a family nurse practitioner quoted in The Culture War, “Pregnancy risk increases dramatically with the number of babies in the womb. Frequently women are compelled to selectively ‘reduce’ (i.e. kill) additional babies in the womb due to unacceptably high pregnancy risk.”   

One woman describes watching the abortion of one of her twins, not because of a particularly high risk to her health, but because she and her husband simply didn’t want more children. “What I couldn’t foresee, lying there on the table, was how guilty I’d feel watching my son struggle with having to share his mother with only one sibling: the girl I’d give birth to seven months later.”

It is mindboggling to think that children designed to make the perfect family are then intentionally destroyed. And yet again reality is disguised through carefully chosen words. “Watching my son struggle with having to share” wasn’t just a toddler having a tantrum for another baby sitting on his mom’s lap. It was a little boy fighting an abortionist’s needle with potassium chloride being inserted into his tiny heart.   

Commodity culture

When I first heard about commodity culture, I had to look up the meaning. According to Merriam-Webster, to be considered a commodity, something must be standardized or indistinguishable from other products, must be usable, and its price or demand must create a market for it. Human beings should never fall into the category of commodities, yet we’ve arrived at a point where people are being used as objects that come with a huge price tag through an institutionalized market which uses, misuses or discards them as is seen fit.    

Consider the anonymous donation of sperm and egg cells, intentionally robbing resulting embryos of a biological connection or even any knowledge of their genetic parents. Consider surrogacy, where women’s bodies are being used as walking incubators through contracts that often involve poor women from developing countries. Consider the grading of embryos, resulting in the destruction of human beings with Down Syndrome or other genetic abnormalities. Consider the selection of children based on gender, looks, or even intelligence. Consider the experimentation and research done on the bodies of tiny human beings in the name of science, less than a century after Dr. Mengele’s gruesome experiments with vulnerable people in concentration camps came to the light. And now, consider the swapping of embryos like hockey cards in the school yard.    

I honestly felt like throwing up when I read a recent news story entitled, “Mom to the internet: anybody want to trade my girl embryo for a boy?” Her very own words: “Now I have a commodity—something I can leverage.” Two days later, a follow-up article reported that offers have come in from around the world, meaning that “The Brooklyn IVF mom who offered to swap her girl embryo for the boy embryo of her dreams is on course to create her perfect family.” And only one week later, the internet revealed that the “couple desperate to swap girl embryo for a boy find a trading partner.” The latter is a Pennsylvania couple that conceived an embryo with a donor egg and the husband’s sperm in 2013, which resulted in the boy “they now have on ice.” “I was devastated it was a boy,” the mom commented. “It wasn’t a tough decision not to go ahead and implant the boy.”

Is there anything more revolting that parents offering their child online for a swap, simply because he/she is not of the preferred gender? In fact, this story is what made me continue writing my article about IVF. When children are being created en masse in an environment that threatens their tiny lives and then treated and traded as commodities, we must speak up.

As George and Tollefsen write, “For parents to make use of their children, even in their embryonic stages, seems, again, grossly unfair to these most vulnerable of members of the human family.”

What about pro-life couples using IVF?

At this point, one might counter this enormous list of concerns about IVF with the option that some pro-life families pursue: the retrieval of one or two eggs of the mom to be fertilized in vitro by the sperm of the dad, followed up by the transfer of any resulting embryos to the mother’s womb without any freezing. Could that be a moral way to use an otherwise immoral method?

In a conversation about IVF with a dear friend who has walked the long road of infertility with her husband for many years, she shared how much she understands why couples end up at the IVF clinic. In their experience, IVF was not presented as a last resort, when all other treatment options fail, but immediately promoted as the gold standard amongst all fertility treatments. 

“It feels cruel,” I expressed to my friend, “when you’ve never faced infertility yourself and then condemn someone’s last chance at having a biological child.” She completely disagreed. “Infertility is hard, really hard. But those of us who experience it have no monopoly on suffering. Suffering doesn’t give us license to do whatever we want to fix it. Just like you can say a pregnant woman may not choose abortion in her difficult circumstances, you should be able to say that a woman facing infertility may not choose an option that will put the lives of at least 70% of her children created in the lab at risk for death.”

For those who’ve already chosen IVF and have embryos who are still frozen, as Russell Moore puts it, “the issues are simple, even if the consequences are complex… I’d advise you to meet with some respected spiritual advisers, to look at your situation and come up with a map to take responsibility for your children. The first step is to start thinking of them that way, not as your ‘embryos’ or a project to be managed, but as your children…”

A powerful picture

Years ago, I was part of a pro-life evening where various difficult issues were discussed, one of them being IVF. A young man present shared an analogy to explain why he and his wife couldn’t in good conscience choose IVF.

Imagine a busy street with two buildings facing each other on each side of the road. In the building on the right, several floors up, there’s room with infants being cared for by professionals. In the building on the left, there’s a room directly across it with childless couples desiring to become parents. It’s impossible to cross the busy street to get the babies into the arms of the parents, but there’s a solution. The infants could be tossed through the air, through open windows, from the one room into the other. Some of the couples will get lucky and end up with a baby in their arms, but there’s a catch. Seven out of ten infants won’t make it through the open window of the building on the left and instead, fall to their death in the street below.

The question he posed was this one: Would it ever be moral to intentionally expose your children to such a risk, after having them created in the building on the right in the first place? It’s a powerful way to demonstrate the enormous risk IVF places children in as a result of the parents’ choice to pursue this reproductive technology.

A human rights perspective

The purpose of this article has been to create awareness about what IVF entails, how it affects the youngest of our kind, causes millions of children to lose their lives worldwide, and largely contributes to the commodification of human beings. Others have approached this issue from a policy perspective, such as ARPA Canada, or from a religious and/or relational angle, such as the Reformed Pro-Lifer in previous years and Stephanie Gray in her recent series, The Ethics of IVF.

CCBR takes a human rights perspective, from which it follows that no one “should ever willingly engage in activities that would deliberately threaten the life or health of human beings at any stage of development or in any condition” (George & Tollefsen).

For the love of all human beings, we must recognize the imminent danger IVF inherently brings to tens, if not hundreds of thousands of the very youngest amongst us. To be clear, rejecting IVF must have no negative impact on the value of those who’ve already been conceived in this way, whether born or pre-born. In fact, it’s their infinite value and our concern for each of them that makes this technology so questionable. We must respect each human life while working hard to ensure less embryos are created in such a precarious position in the first place.