Thursday 8 March 2012

The Catholic Church on infertility

Everyone knows that the Catholic Church considers children to be “the supreme gift of marriage” – in fact the Church says “By its very nature the institution of marriage and married love is ordered to the procreation and education of the offspring and it is in them that it finds its crowning glory” (Catechism of the Catholic Church 1652).  What then of married couples who struggle with infertility?  Many Catholics are not clear as to what the Church permits in this case.  If children are such a good thing, then surely medical practices to help couples conceive must be good?  If not, why not?  What are Catholics “allowed” to do about infertility?  Is this a grey area?

In fact the Church’s teachings are clear even in the face of all the scientific progress that has been made in this area and the various medical techniques available.  Any medical procedure must be evaluated in the light of the fundamental teachings of the Church’s gospel of life: 

Human life must be respected and protected absolutely from the moment of conception.  From the first moment of his existence, a human being must be recognised as having the rights of a person – among which is the inviolable right of every innocent being to life (CCC 2270).  This is specifically extended to embryos created in a laboratory:  “Human embryos obtained ‘in vitro’ are human beings and subjects with rights: their dignity and right to life must be respected from the first moment of their existence” (Donum Vitae I). 

Every human being is to be respected for himself, and cannot be reduced in worth to a pure and simple instrument for the advantage of others (DV I). 

Sexual intercourse has both a unitive and a procreative significance which “man on his own initiative may not break” (see CCC 2366).  This means that procreation cannot be separated out as an independent process; see point below.

Every human being is always to be accepted as a gift and blessing of God. However, from the moral point of view a truly responsible procreation vis-à-vis the unborn child must be the fruit of marriage (DV II).  Thus “the only acceptable way of conceiving a child is through sexual intercourse between a husband and wife” (Pope Benedict XVI, Pontifical Academy for Life General Assembly February 2012). 

A child is not something owed to one, but is a gift... In this area, only the child possesses genuine rights. (CCC 2378). 

Couples who discover that they are sterile suffer greatly. (CCC 2374)

Looked at in the light of these basics, most fertility treatments are easily enough understood in terms of their moral status.  The gravest difficulty with IVF is that it involves the destruction of human beings.  The woman is given a hormone to stimulate her ovaries to produce several eggs because, as the HFEA website puts it, “with more fertilised eggs, the clinic has a greater choice of embryos to use in your treatment”.  From the eggs that are successfully fertilised in the laboratory with sperm (from the woman’s partner or a donor), “the best one or two embryos” are chosen for transfer into the womb.  Remaining embryos can be frozen for the future use of this or another couple and destroyed at a later date if not used, or destroyed straight away.

As well as the destruction of human life, of course, IVF also involves conception outside of the context of sexual intercourse, and often use of sperm from a third party outside the marriage.  It should also be remembered that it has a relatively low success rate, can be catastrophically expensive and is not without medical risk.

Some Catholics, realising that IVF treatment involves the creation and destruction of “spare” embryos, ask what the problem is with techniques like GIFT (Gamete Intra-Fallopian Transfer) where the healthiest eggs and sperm harvested as above are placed together into a woman’s fallopian tubes for fertilisation to happen “naturally”, or artificial insemination using eggs and sperm from the couple only and no third party.  Especially in the case of artificial insemination where no surplus embryos are produced, they ask what the problem is.  Surely all that is happening is that a certain mechanical act is being bypassed?

This is a harder one to understand and explain, especially to non-Catholics who do not share a conviction that the two aspects of sex – procreation and intimacy – should not be artificially separated.  It is here that we need to explore the idea of the meaning of sex as the context in which a child is conceived.  Sex is an expression of the total self-giving of a man and a woman to each other, holding nothing back, with the inclusion of their fertility.  A baby is the fruit of this self-giving and thus natural conception speaks of the nature of the human being, created in, through, because of and for love.

Natural conception also speaks of the nature of the human being as an end in him/herself, a gift arising out of  the couple’s mutual love but not “something” they have a right to claim. The human person has a greater dignity than that.  For the same reason that we do not have a right to manipulate our fertility through artificial contraception, we do not have a right to “play God” through the use of artificial reproductive means to ensure a child.  We are, as Humanae Vitae prophetically claimed, “ministers not masters” of a plan bigger than us.  Once we start to regard ourselves as masters, to consider even our own biology as raw material for the use of our intellect – however worthy we feel our motives to be – and having no value or meaning inherent in itself, we are on that notorious "slippery slope".  This is why Pope Benedict XVI recently spoke (addressing the Pontifical Academy for Life General Assembly) of  “temptations leading scientists to offer unacceptable infertility treatments such as in vitro fertilization [which] include ‘easy money or, even worse, the arrogance of replacing the Creator.’  He noted that such pride endangers humanity itself.” (LifeSiteNews.com, 27 Feb).

So is that it?  Does the Church say something about the “great suffering” of infertile couples and then, feeling she has done the sympathy bit, get on with her scientist-bashing?  Not at all.  The human person’s rational intellect and creativity are gifts from God and reflections in us of God’s image.  The Pope also said, when making the remarks above, that medical research and treatment is “scientifically the correct approach to the issue of infertility,” but that it must respect the natural moral context for the creation of children.  He expressed fears that concentrating resources on the development of methods of assisted reproduction had led to a situation where “scientism and the logic of profit seem to dominate the field of infertility and human procreation, to the point of limiting many other areas of research”.

This view was echoed, on the same occasion, by Dr Thomas Hilgers (who opened the Pope Paul VI Institute for the Study of Human Reproduction in 1985 to develop infertility treatments which respect the dignity of human life).  Hilgers remarked, “Were it not for the race to create children artificially, we probably would have had a cure for infertility by now.”

So what of ethical fertility research?  It exists and its fruits can be found in NaPro Technology which, in the words of Chelsea Zimmerman, “can and has helped women successfully achieve and maintain pregnancy without having to resort to manufacturing their children in petri dishes or inject themselves with a stranger’s sperm. Using this technology, couples respect and cooperate with [God’s] divine plan for the creation of human life rather than taking the matters of life in their own hands and forcing God to cooperate with them.” It works with the woman’s natural cycle to identify and treat various causes of infertility and recurrent miscarriage and is available in the UK; see http://lifefertilitycare.co.uk/

For those needing persuasion, Chelsea links to a page which lists peer-reviewed academic papers supporting NaPro’s efficacy: http://www.naprotechnology.com/references.htm

I close with some more words from Chelsea, because I can’t put the case better than she does.  “To those who struggle with infertility, the Catholic Church is not your enemy. She wants what is best for both you and the children you so desire...  Never forget that no prayers go unanswered and all suffering, given over to the Lord bears fruit in some form... Whether you seek to welcome a new member to your family through (ethical) fertility treatment or even the always loving option of adoption,  remember that children are a gift, not a right. Keep the focus of your marriage on you and your spouse giving and receiving the total gift of self while loving God and trusting Him for the timing of children – if they should ever come.”  

8 comments:

  1. We had fertility issues. I used charting to correct this and in 3 months got pregnant. I also self treated a long luteal phase. Wasn't aware of this clinic though - we used Toni Weschler: Getting to Know Your Fertility. Cannot recommend it highly enough. Just pray he doesn't go too much longer overdue as we are both SO ready for his arrival now.

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  2. Thanks for the recommendation which I hope will be helpful for others... My three were all well overdue, so I know the feeling of being more than ready for the delivery!! All best wishes for the birth - really looking forward to the good news x

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  3. It's my understanding that GIFT is a reproductive technique that can be legitimately available to Catholics if certain conditions are observed:
    http://www2.loras.edu/~CatholicHE/Arch/Sexuality/Gamete.html
    Thankyou for a very thought provoking post! X

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    1. Thanks Amanda, that's interesting. I don't think the Vatican has specifically pronounced on GIFT, which is why it is open to bioethicists and doctors (and couples) to interpret its moral status, using a conscience informed by "classic theological principles" as the article says. I think Catholic couples would need to be clear though when discussing the technique with their doctors that the ova need to be collected following an act of natural sexual intercourse and that the sperm must be collected via this act, as I would doubt this is how it is usually done? You would know more than me about the techniques though.

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  4. No, sadly ethical fertility treatment is somewhat of an oxymoron & most couples are either unaware of the issues or too desperate to care. I'm sure, as you say, the current a-moral climate in our culture is caused by the reduction of sex to a recreational activity and children to a commodity. It's very important that articles like this are "out there" informing people, so huge thanks.
    Sadly NaPro Technology is beyond the pocket of most people as these clinics are private. But worth reminding couples that the NHS can help with certain causes of female infertility without the need to resort to techniques like IVF.

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  5. It's a pity that some of the funds channelled towards IVF (which I believe you can get on the NHS?) isn't directed towards providing NaPro techniques instead... but that would require a huge climate change... Ref back to Dr Hilgers' comment above about where our resources are concentrated!

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    1. Just what I was thinking myself...
      Especially if there is good evidence for it's effectiveness.

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  6. Children are a gift from God, he might not have everyone in the list for this kind of gift, or He just wants to give this gift on His own time, or He just finds us so far from our Faith that gives this kind of struggle to get closer to Him, and then a miracle could happen and there you have the Gift of life! Just always is important to know God knows the best for all, and He knows what struggles ad suffering we have that makes us closer to the cross of His only Son. Remember always have Faith and accept our Father's will, but also follow the path that He has given us by practicing what is acceptable for His eyes. May God bless you...

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