What Does the Church Teach About IVF?

By Ryan Mayer

In-vitro fertilization (IVF) has been in the news recently after a court in Alabama ruled that human embryos created through the procedure deserve the same legal protections as minors and unborn human life per an already existing state law. The ruling came following the loss (death) of embryos in an Alabama clinic due to mishandling. The case has left many, especially Catholics who affirm the basic science that human life begins at conception, wondering about how we ought to think about the status of embryonic human beings and IVF procedures.^[1]

What is IVF?

Generally speaking, IVF involves the fertilization of one or more human ova with sperm in a petri dish. “In-vitro” is Latin for “in glass” and refers not to a single technique but to the location where fertilization takes place. The “glass” in the case of IVF procedures refers to a petri dish in a laboratory. After fertilization, one or more of the resulting human embryos—or rather, human beings at the embryonic stage of development—are transferred to a woman’s uterus. Embryonic human beings that do not develop as desired are often discarded.^[2] Surplus embryos, which are usually generated to maximize success rates, are often kept in cryo-preservation, sometimes indefinitely. There are an estimated 1.5 million “surplus” frozen embryos in the United States. In the 1987 Instruction Donum Vitae on Respect for Human Life, the Congregation for the Doctrine of the Faith says: “In consequence of the fact that they have been produced in vitro, those embryos which are not transferred into the body of the mother and are called ‘spare’ are exposed to an absurd fate.” (Donum Vitae, I.5)

IVF can be quite expensive (costing between $10,000 and up to $30,000 per cycle) and, because of its low success rates, it is not uncommon for multiple human embryos to be implanted at a time to maximize the chance that at least one will survive to gestation and birth. This can result in a woman becoming pregnant with two, three, or more human embryos, causing complications and even leading to what is euphemistically referred to as “selective reduction,” that is, the abortion of the “surplus” unborn human beings at the early stages of development. There are very few regulations, if any, that govern the IVF industry (hence the occasional news-worthy situation such as the recent Alabama case). A number of European countries regulate the fertility industry to a much greater degree than the United States, with regulations such as limiting the number of human embryos that can be generated in-vitro at a time or mandating that any human embryos generated are also implanted…the latter perhaps because of Europe’s sad history with eugenics.^[3] Europeans often refer to the fertility clinics in the United States as the “wild west” of the industry. In fact, the industry functions more like a commercial market than actual healthcare.

The Challenge of Infertility

Infertility can be a source of great pain and suffering for married couples. We hear, throughout Sacred Scripture, cries of pain and suffering from those experiencing infertility and barrenness: Abraham and Sarah, Isaac and Rebekah, Jacob and Rachel, Elkanah and Hannah, and Zachariah and Elizabeth to name just a few. The clear view from Scripture is that children are a great blessing and a gift from God, not a right to be obtained by any means necessary, even if infertility is a cause of great suffering.  On the part of the couple, the desire to welcome a child into a marriage is a natural and good desire and couples resort to technological intervention often as a result of a sense of desperation. The instruction Donum Vitae recognizes the goodness of the desire: “On the part of the spouses, the desire for a child is natural: it expresses the vocation to fatherhood and motherhood inscribed in conjugal love. This desire can be even stronger if the couple is affected by sterility which appears incurable.”(Donum Vitae, 8)  Dignitas Personae, the 2019 follow up instruction to Donum Vitae, reaffirms the goodness of the desire for children: “The Church recognizes the legitimacy of the desire for a child and understands the suffering of couples struggling with problems of fertility.”(Dignitas Personae, 16) The fertility industry preys on the good intentions, desire, and even the suffering, of the couple.

Is IVF Medical Treatment?

Infertility has a cause and medical treatments can play a role in helping couples overcome infertility (more on this below).  IVF, however, is not medical treatment, properly speaking, despite the fact that it is often euphemistically referred to as such. IVF does not actually treat the causes of infertility. A couple who is infertile before IVF, is still infertile after the fact, even if the technique is successful. Whatever was causing infertility in the couple, even if IVF has circumvented the cause, is still present. In fact, the development of treatments for causes of infertility has, no doubt, been impeded by the ability to simply work around them due to the availability of IVF. The causes of infertility in a particular couple, if they are not addressed, can also limit the effectiveness of IVF techniques. However, the fertility industry is generally not interested in treating the actual causes of infertility, only in the end “product,” which is why the industry functions more like a marketplace than healthcare. It deserves repeating, IVF is not medical treatment.

Moral Considerations

Donum Vitae identifies two principal criteria for the evaluation of interventions in procreation: “The fundamental values connected with the techniques of artificial human procreation are two: the life of the human being called into existence and the special nature of the transmission of human life in marriage. The moral judgment on such methods of artificial procreation must therefore be formulated in reference to these values.” (DV, Introduction, 4) IVF, more often than not, results in the loss (death) of human life at the earliest stages of development. It is difficult to know for sure, but it is estimated that for every live birth as a result of IVF, up to a dozen or more human embryos are lost or end up in cryo-preservation. “Surplus” embryos can also be used for research or to mine (yes, this is the term that is used) for their stem cells. Discarding dozens of embryonic human beings, using them in research, or destroying them for their parts are all grave violations of the dignity and respect that should be accorded to every human being, especially at the most vulnerable, initial stages of life.

The second principle Donum Vitae identifies for evaluating technological intervention in procreation is the special nature of the transmission of new human life in the context of married, conjugal love. A married couple have the natural right to become parents, but not at all cost and by any means necessary. The procreation of new human life, precisely because of the kind of thing a human being is, namely the Image and likeness of God, has a particular context and particular means of coming into existence which alone respect this dignity. Donum Vitae summarizes this way: “Human procreation requires on the part of the spouses responsible collaboration with the fruitful love of God; the gift of human life must be actualized in marriage through the specific and exclusive acts of husband and wife, in accordance with the laws inscribed in their persons and in their union.” (DV, Introduction, 5) IVF separates the generation of new human life from the conjugal love of spouses. In fact, a couple need not even engage in sexual intercourse to conceive a child via IVF. In IVF, conception begins, not through married, conjugal self-giving, but as a result of laboratory techniques. Female gametes (ova) are obtained by surgical laparoscopy, often after taking hormones to cause ovarian hyper-stimulation, in which a woman ovulates multiple ova at a time (again, to maximize success rates), which can result in dangerous complications, even infertility. Male gametes (sperm) are usually collected through masturbation, which is itself an immoral act.^[4] IVF can even introduce third-parties into the process, as with surrogacy and/or the donation of gametes, which further separates the procreation of a child from the context of marital union. IVF separates the conception of new human life from marital love and reduces it to a technological process.

The children generated through IVF are often the forgotten factor in discussions around fertility. Children also have a right to be conceived as the fruit of mutual self-giving love on the part of his or her parents. IVF and other techniques that generate new life apart from this context do not reflect the equal dignity of the child engendered by his or her parents and set up a relationship of the dominion of the powerful over the vulnerable. As Donum Vitae observes, IVF “entrusts the life and identity of the [human] embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person. Such a relationship of domination is in itself contrary to the dignity and equality that must be common to parents and children.”(DV, II.b.5)

The Catholic Approach: Assistance vs. Replacement

As we have said, IVF does not actually treat the causes of infertility and so does not constitute medical care. This doesn’t mean that medical intervention is always unwarranted or immoral. In many cases, it is possible to actually identify the causes of infertility and treat them. At the risk of sounding flippant, this approach has a name…medicine. Two excellent Catholic approaches to treating the causes of infertility are NaPro Technology (short for Natural Procreative Technology) and FertilityCare, both developed by Catholic physician Dr. Thomas Hilgers. NaPro is an approach to treating infertility that respects the unborn and the dignity of marriage while working to treat rather than circumvent underlying issues. FertilityCare constitutes an overall approach to a couple’s fertility health using the Creighton model of fertility awareness.^[5] Both of these approaches actually have higher success rates than IVF.

The Ethical and Religious Directives for Catholic Healthcare Services, a set of guiding norms for Catholic healthcare institutions in the United States, makes a distinction between techniques and interventions that “replace” conjugal love from those that “assist” the act in achieving its end, namely conception of new human life. The ERDs state: “When the marital act of sexual intercourse is not able to attain its procreative purpose, assistance that does not separate the unitive and procreative ends of the act, and does not substitute for the marital act itself, may be used to help married couples conceive.”^[6]While IVF replaces the marital act and can even replace the couple entirely by substituting one or more of the couple through surrogacy or gamete donation, good medicine such as NaPro and Fertility seeks to assist a couple’s fertility  in achieving its natural end, rather than replace it entirely. This approach is a whole-person, or rather whole-couple approach that might involve hormonal regulation, relationship counseling, and even surgery to treat pathologies that might cause infertility.

Conclusion

Married couples who experience infertility should find compassion and support in Catholic healthcare institutions. Infertility is not merely a utilitarian problem, but a human problem. It doesn’t only raise issues related to conceiving children, but brings psychological, relationship, and even spiritual challenges, which IVF does nothing to address. IVF can, in many cases, exacerbate a couple’s suffering by further dividing conception of a child from conjugal love. Introducing third parties into attempts at conception through surrogacy and gamete donation can bring resentment, jealousy, relationship difficulties, even adultery. 

IVF and other techniques that replace marital love in order to generate new human life are not in keeping with the dignity of the spouses or the children they generate. IVF is a deeply inhumane and morally problematic process and does not constitute sound medical care. While this remains true, it is also true that every human life, regardless of the manner in which it is conceived, is a beloved child of God with immeasurable dignity. It is precisely because of this dignity that IVF is immoral. Couples experiencing infertility shouldn’t have their suffering preyed upon but be offered true compassion and hope by offering methods of identifying and treating the causes of infertility, such as Fertility Awareness and NaPro Technology. In cases where conception may not be immediately possible, they should be offered counsel and options such as adoption. In every case, the hope of children should always be viewed as a gift from God, not an absolute right.

An individual human life begins at conception. This is not a religious principle, but a simple matter of basic biology. Each and every one of us, including Our Lord in the womb of the Blessed Mother, came into the world as a single cell at the earliest stage of human development. It is no coincidence that Pope Saint John Paul II’s encyclical Evangelium Vitae, “The Gospel of Life,” was promulgated on March 25, the Solemnity of the Annunciation, when Jesus took on a human nature in the womb of Mary as a tiny, embryonic human being. Human embryos are not “potential human beings” or “fertilized eggs” (see below). They are human beings, at the earliest stages of development. As such, their lives are deserving of the moral and legal protections that ought to be afforded to all human beings.

To the question, “What Respect is Due to the Human Embryo?,” Donum Vitae answers “The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life….since the embryo must be treated as a person, it must also be defended in its integrity, tended and cared for, to the extent possible, in the same way as any other human being as far as medical assistance is concerned.” (DV, I.1)

Further Resources:

• Instruction Donum Vitae on Respect for Human Life in its Origin and on the Dignity of Procreation (Congregation for the Doctrine of the Faith, 1987)
• Instruction Dignitas Personae on Certain Bioethical Questions (Congregation for the Doctrine of the Faith, 2008)
• Encyclical Evangelium Vitae on The Gospel of Life (Pope St. John Paul II, 1995)
• Ethical and Religious Directives for Catholic Healthcare Services (US Conference of Catholic Bishops)
• USCCB, Secretariat for Pro-Life Activities, “In-Vitro Fertilization: The Human Cost,” (2024).
• National Catholic Bioethics Center

Glossary of Terms

Fertilized Egg- This is a misnomer. There is no such thing as a fertilized egg. An egg (ovum) that has been fertilized is not an ovum anymore. It is a new, individual human life at the earliest stage of development. The term “fertilized egg” is often used in media to obscure the fact that human life begins at conception.

Gamete- Sperm and egg cells. These are “haploid cells” meaning they carry half a genetic code and 23 chromosomes.

Human Zygote- A human being at the single-celled stage of development. A zygote is distinct from sperm and egg cells in that a zygote IS a new, distinct human being with a unique and complete genetic code and 46 chromosomes. A human being at the zygote stage of development is sometimes incorrectly referred to as a “fertilized egg” (see above). An ovum is a haploid cell (see above) while a zygote is a dipolid cell, meaning it has a full 46 chromosomes and a unique genetic code.

Human Embryo- A human being at the stage of development from first cell division to 8 weeks.

Human Fetus- Latin for “young one.” A human being at the stage of development from 8 weeks after conception to birth. Zygote, Embryo, and Fetus are three stages of development that a human being goes through while in the womb of his or her mother. Just as infant, toddler, adolescent, and adult are the stages of development human beings go through after they are born. Same individual human being, different stage of development. A human embryo, then, is not a “potential human being,” it IS a human being at the embryonic stage of development.

In-vitro Fertilization (IVF)- Process whereby a human ovum is fertilized “in glass” in a petri dish in a laboratory. The resulting human being(s) at the embryonic stage of development are later implanted in a woman’s uterus.

Ryan Mayer is Director of the Office of Catholic Identity Assessment & Formation for the Archdiocese of San Francisco where he works closely with the Department of Catholic Schools. He previously taught high school theology and bioethics for almost twenty years and has published in the St. John Paul II Journal of Bioethics and the National Catholic Bioethics Quarterly. He holds masters degrees in theology, philosophy, bioethics, and educational administration, has studied for a licentiate in bioethics at the Pontifical Athenaeum Regina Apostolorum in Rome, and received certification in healthcare ethics from the National Catholic Bioethics Center.

^[1] See the recent statement from Bishop Michael F. Burbidge of Arlington, Chairman of the United States Conference of Catholic Bishops Committee on Pro-Life Activities.

^[2] The eugenic nature of IVF should be immediately evident.

^[3] The United States is not innocent in this regard. In fact, many of Europe’s “racial hygiene” laws in the 20th century were modeled after state laws and movements in the United States, especially those promoted by the organization now known as Planned Parenthood. For more information on this, look at the Wikipedia articles on “Eugenics,” “Eugenics in the United States,” and “Eugenics in California.”

^[4] Catechism of the Catholic Church, 2352.

^[5] https://popepaulvi.com/about/

^[6] Ethical and Religious Directives for Catholic Healthcare Services, 38.