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The Pain of Infertility

Having children is a wonderful blessing—God loves children.

  • Children are a gift from the Lord (Psalm 127:3). What joy it is when the Lord “settles the barren woman in her home as a happy mother of children” (Psalm 113:9).
  • From the beginning, God has intended people to “increase in number” (Genesis 1:28).
  • Jesus made it clear that he sees children as special and worth blessing (Mark 10:13-16).
  • God considers his followers so dear that he calls them “God’s children” (Romans 8:16).


Being unable to have children can be a terrible burden
.

  • It’s a particularly severe form of our “bondage to decay” (Romans 8:21) in a fallen world.
  • The longing for “the redemption of our bodies” (Romans 8:23) can be especially intense.
  • Infertility plagued all three of the main ancestral women of the Christian faith:
    • Sarah, the wife of Abraham, endures infertility for 25 years. God’s famous commending of Abraham’s righteousness by faith (Genesis 15:6) is in response to his accepting God’s plan for child-bearing—that Sarah would give birth (v. 4). Yet Sarah and Abraham later decide to take things into their own hands (“the Lord has prevented me from bearing children”—16:1-2) and use a surrogate!
    • Rebekah, the infertile wife of Isaac, only has kids after Isaac prays (Genesis 25:21).
    • Rachel, wife of Jacob is so upset by her infertility that she tells Jacob: “Give me children or I’ll die!” (Genesis 30:1). Jacob is not very understanding; yet he wisely says “Am I in the place of God, who has kept you from having children?” (v. 2).


God is the one who determines whether or not a particular person is to have children
.

  • Sometimes infertility is by God’s design, but we don’t know why. In the case of Hannah we simply read: “the Lord had closed her womb” (1 Samuel 1:5).
  • Sometimes infertility is by God’s design, and we only come to understand much later the unguessable reasons why it occurred. In the case of people working in Abimelek’s house, their infertility was because Abimelek intended to have a sexual relationship with Abraham’s wife Sarah since Abraham said she was his sister (Genesis 20:4-5, 17-18)!
  • Sometimes infertility is for reasons unknown in a fallen world (e.g., Sarah in Genesis 16:1; Samson’s mother in Judges 13:2; the Shunammite woman in 2 Kings 4:14).
  • We should not presume anything about what God will allow us to do in life (James 4:15).
  • Even things we think obviously good for us may not be, based on all that God knows. God has good purposes for those who love him even in the face of trials (Romans 8:28).

So Many Ways to Make a Baby

So many technologies have developed now, used in so many combinations, that there are so many ways to make a baby! Here are a few of them that people commonly consider:

  • Fertility drugs: A woman or a man takes drugs that will hopefully increase their fertility and enable them to procreate a child.
  • Intra-uterine insemination (IUI): A woman receives hormone treatments to stimulate egg production; a man’s sperm is injected into her uterus, where conception occurs.
  •  In vitro fertilization (IVF): A woman receives hormone treatments to stimulate egg production; some egg(s) are moved from her body to a lab dish and mixed with a man’s sperm; one or more resulting embryos are transferred to the woman’s uterus.
    •  Intra-cytoplasmic sperm injection (ICSI): One sperm is sometimes inserted directly into one egg in order to produce an embryo.
    • Preimplantation Genetic Testing (PGT): Embryos are often tested before transfer to identify those with genetic disorders (to discard) or with desirable traits such as a particular gender (to transfer).
    • Embryo freezing: When more embryos are produced than are needed for immediate transfer into a woman’s uterus, they are often frozen and later thawed.
    • Mini IVF: Less hormonal stimulation makes this less risky and less expensive than traditional IVF and produces fewer eggs and embryos.
  • Gamete intra-fallopian transfer (GIFT): A woman’s eggs and a man’s sperm are transferred to a woman’s fallopian tubes, where conception hopefully will occur.
  • Zygote intra-fallopian transfer (ZIFT): After a woman’s egg(s) and a man’s sperm have been combined in a lab to produce an embryo or embryos, the embryo or embryos are transferred to a woman’s fallopian tubes.
  • Surrogate motherhood: one woman endures a pregnancy for another and gives up the child to her at birth.
    • The surrogate may be impregnated by the father’s sperm; or
    • A couple’s child, conceived via IVF, may be transferred to the surrogate’s uterus.
    • Surrogacy is usually commercial (done for a price) but not necessarily so.
  • For alternatives, see the “Openmindedness” section below.

Marriage and Childbearing

The model for marriage: A man and woman so unified together that nothing separates them.

  • From the beginning, God’s model has been that “a man leaves his father and mother and is united to his wife, and they become one flesh” (Genesis 2:24). Being “one flesh” includes not only relational unity but also sexual unity (1 Corinthians 6:16).
  • Jesus quotes the Genesis passage, saying it’s this way because “at the beginning the Creator made them male and female” (Matthew 19:4-5; see also the echo in Ephesians 5:31.)


The model for childbearing
: A married man and woman producing children through their one-flesh union.

  • Genesis 1:27-28 indicates that Adam and Eve, a married couple (Genesis 4:1) created to have a “one flesh union,” are to “be fruitful and increase in number.”
  • If one wants to have sexual union with someone, they must marry (1 Corinthians 7:1-2).
  • “Sexual immorality” and “adultery” (e.g., 1 Corinthians 6:9-19; Exodus 20:14) involve having a one-flesh union with someone other than one’s partner in marriage.
  • Science teaches how appropriate the “one flesh” model is for the childbearing aspect of a marriage relationship: a wife’s egg and her husband’s sperm become one (embryo). That is the “fruit” that results from the sexual aspect of the one flesh union in Genesis 1.
  • Marriage is a “covenant” (Malachi 2:14) that commits a man and woman to keep the marriage distinctives, including sex and childbearing, within the marriage relationship.

Killing Embryos
  • In Genesis, God creates many categories of living things. Those that are “human” are created “in his image” (1:27) and for that reason are never to be killed (9:6). Human embryos are living beings and are human (as opposed to some other category).
  • Embryos are morally responsible persons. David sees himself as the same sinful person in the womb as when an adult (Psalms 139:15-16; in 51:5 he refers back to conception).
  • Jesus affirms the significance of the entire human lifespan by coming to this world not as an adult but as an embryo whose discarding would have indeed killed the Son of God.
  • Right after Jesus’s conception, Mary visits Elizabeth who calls her “the mother of my Lord” (Luke 1:43). She’s a mother already because she has a son already—an embryo.
  • Elizabeth is also pregnant and her “child” leaps in response to Mary’s arrival. The word here (Luke 1:41) refers to a born “child” (brephos) all six other times it is used in the New Testament. In other words, one is a person regardless of how old, born or unborn.

My Responsibility or Technology’s?

Two mistaken views about how using technology to do something affects the ethics:

  • It makes it more ethical: Doing something using technology somehow distances us from what’s going on; unethical actions can become ethical if done by technology.
    • For example, one might say it’s wrong to conceive a child with a neighbor; but if the two people use technology to bring the sperm and egg together, that’s OK.
  • It makes it less ethical: ethical actions can become unethical if technology is involved.
    • For example, one might say a married couple can have a child; but if they use technology to bring the sperm and egg together, that’s unnatural/wrong.


A biblical view
instead asks us to look at what the people involved are actually doing. Technology enables them to do it more efficiently. But technology is basically a means rather than what’s making an action right/wrong. The right people must be doing the right action.

  • Wrong person: In 2 Chronicles 26:18-19, King Uzziah holds a censer to burn incense. Though that technology would burn it more effectively, that doesn’t mean it’s OK for him to use it. Burning incense to God in the temple is wrong for a king to do.
  • Wrong action: In Genesis 11:3-4, the people use building technology, well-used elsewhere, to build a tower as high as the heavens. Using technology doesn’t change the wrongness of their action—i.e., trying to become so great that they can rival God.
  • Right action: In 2 Kings 5, Namaan travels to Elisha to be healed of leprosy. Elisha proposes a low-tech solution—wash in the Jordan River 7 times. Namaan refuses, saying that using a human procedure is wrong—health should just come directly from God in response to prayer (v. 11). He is chastised for being unwilling to use human means.

An Example: In-Vitro Fertilization

Only a man’s sperm and his wife’s eggs should be used. See “Marriage and Childbearing” above.

  • If sexual intercourse isn’t involved, using donor eggs or sperm isn’t adultery. But it’s wrong because two unmarried people are having a child together.
  • It’s also wrong because the husband-child and wife-child relationships are intentionally being created unequal. That’s different from redemptively entering into unequal relationships with already existing children (e.g., in second marriages).


IVF should only be carried out in a way that doesn’t kill embryos
. See “Killing Embryos” above.

  • Freezing of embryos is wrong since only about 75% (some local clinics) to 95% (top university health centers) of embryos survive the process.
  • No preimplantation genetic testing should be done for the purpose of discarding embryos with unwanted traits.
  • Only the number of embryos currently being transferred into the woman should be created.
  • Any additional eggs created can be frozen but should not be fertilized (yet).
  • Safer and cheaper Mini IVF is good to consider if a smaller number of eggs is sufficient.
  • If multiple embryos are transferred into the woman and more than are wanted implants, so-called “selective reduction” (killing those unwanted) isn’t acceptable.
  • Only one or two embryos should be currently transferred into the woman. One is safest for mother and child. However, other factors such as age and the risks of future IVF attempts should be discussed with the doctor.


IVF isn’t wrong just because it’s a technology
.

  • Giving an infertile married couple another way to bring their sperm and egg together is a blessing.
  • However, the wrong uses of that technology noted above remain wrong. See “My Responsibility or Technology’s?” above.

The Importance of Openmindedness and Prayer

Because not all women can bear children, it’s important for couples to be open to other options.

  • Embryo adoption enables a couple: to rescue a frozen embryo who will otherwise be left to die, to go through the entire pregnancy process, and to give birth to their child.
  • Adoption of an already-born child can also rescue a child in need of a family.
  • Having children, like getting married, is not God’s plan for everyone. As Paul explains regarding marriage, not having a spouse (or children) leaves one free to serve the Lord in ways that others are unable to do (1 Corinthians 7:32-35).


So much of faithful medical decision-making involves judgment–for example
:

  • recognizing how likely proposed procedures are to accomplish what they promise;
  • recognizing what procedures involve unacceptable risks to the mother or to embryos;
  • discerning whether the couple adopting a child as an embryo is what God intends;
  • discerning whether the couple adopting an already-born child is what God intends;
  • discerning if God’s purposes for the couple do not include child-bearing or child-raising.


Godly decisions depend on the prayers of both the infertile person and their supporters
.

  • God can, but need not, work through technology. Prayer demonstrates that we are trusting in God, not technology: “Some trust in chariots…but we trust in the name of the Lord our God” (Psalm 20:7). It took time, but Sarah came to trust God (Hebrews 11:11).
  •  Sometimes God wants to overcome infertility as an answer to the prayers of the person who is infertile, as in the cases of Rachel (Genesis 30:22) and Hannah (1 Samuel 1:27).
  • At other times God answers the prayers of the spouse of one who is infertile, as in the cases of the spouses of Rebekah (Genesis 25:21) and Elizabeth (Luke 1:13).
  • Yet God may also respond to the prayers of one outside the family of the infertile person—for example, Abraham’s prayers for Abimelek’s infertile family (Genesis 20:17).
  • “Be joyful in hope, patient in affliction, faithful in prayer” (Romans 12:12).

For Further Information

Books

  • Basic Questions on Sexuality and Reproductive Technology: When Is It Right to Intervene? (Gary P. Stewart et al., Kregel Publishing Company).
    • A team of Christian leaders provides practical responses to common questions about medical treatment decisions at the beginning of life.
  • Why the Church Needs Bioethics: A Guide to Wise Engagement with Life’s Challenges (John F. Kilner, ed., Zondervan, especially Part One)
    • Interacting with a real beginning-of-life situation, several Christian leaders explain wonderful resources the church has available to help families with tough decisions. 

Videos

  • “A Biblical Ethics for Today’s Reproductive Technologies” https://www.youtube.com/watch?v=V9gX-40_3C4
    • Author and teacher Scott Rae gives a 30-minute overview of how Christians can wisely approach the use of reproductive technologies in the face of infertility. 
  • “Anonymous Father’s Day” https://www.youtube.com/watch?v=fFd94VE–8g
    • The Center for Bioethics and Culture Network presents a 43-minute documentary on the growing practice of people using donor sperm (or eggs) to produce the child they want.

Websites

  • The Center for Bioethics & Human Dignity: www.cbhd.org
    • Articles and more from a Christian perspective on a wide range of ethical challenges in health care and biotechnology, including beginning-of-life treatment decisions.
  • Christian Medical & Dental Associations: www.cmda.org
    • Position statements and issue overviews from a Christian perspective on many health-related topics, including beginning-of-life decisions.

Contact the Lead Team