What about IVF?

Question 12016

IVF treatment is a subject I approach carefully, because behind almost every question about it is a couple carrying a grief that most people around them know nothing about. Infertility is a quiet sorrow. It comes with monthly disappointment, awkward conversations, and a church full of babies. Anything said about this must be said gently or not at all.

At the same time, gentleness is not the same as vagueness. There are genuine ethical questions here, and a couple deserves to know what they are before they begin rather than halfway through. So let me lay out both the compassion and the questions, because they belong together.

The desire for children is God-given

Let us establish this before anything else. The longing for a child is not selfishness dressed up as virtue. It is written into the created order. God told humanity to be fruitful (Genesis 1:28), and Scripture repeatedly presents children as a reward rather than a burden (Psalm 127:3).

The Bible is also honest about the anguish of infertility. Hannah “was deeply distressed and prayed to the LORD and wept bitterly” (1 Samuel 1:10). Rachel cried out, “Give me children, or I shall die” (Genesis 30:1). These are not portraits of women lacking faith. They are portraits of women in pain, and God does not rebuke them for it.

So a couple pursuing IVF treatment is not doing something suspect by wanting a child. The question is never whether the desire is legitimate. It is what may rightly be done in pursuit of it.

Is medical intervention itself a problem?

Some object that fertility medicine represents a failure to trust God. I do not find that argument persuasive, and I think it is applied inconsistently. We do not say the same about insulin, antibiotics or a hip replacement. Luke was a physician and Paul thought well of him (Colossians 4:14). Medicine is a good gift used within limits.

Nor does Scripture treat conception as a purely mystical event immune from ordinary causes. It is God who opens the womb, and it is also true that the ordinary means He uses are physical. Correcting a blockage or a hormonal imbalance is no more an affront to God than setting a broken bone.

The ethical weight in IVF treatment does not lie in the fact of medical help. It lies in what the particular process does with human embryos, which is a question of a different order.

What the process actually involves

Here is where couples need clear information rather than euphemism. Ovarian stimulation typically produces multiple eggs, which are fertilised in the laboratory. Several embryos may result. Some are transferred, often one or two. The remainder are frozen, donated, used for research, or allowed to perish.

Preimplantation genetic testing may be offered, screening embryos for abnormalities and selecting which to transfer. Where several implant, couples are sometimes offered what is called selective reduction, which means ending one or more of the developing lives so the others may continue.

None of that is hidden. It is standard practice, described in the clinic literature. But it is often absorbed at speed by a couple who are exhausted and hopeful, and I have known Christians who only realised what they had agreed to some time afterwards. That is why I want the details stated plainly here.

When does the life begin?

Everything turns on this. If a human embryo is a human being, then the storage, selection and discarding of embryos is not a technical matter. It concerns persons.

Scripture speaks of God’s knowledge of and involvement with the individual before birth in terms that are hard to restrict to the later stages of pregnancy. “For you formed my inward parts; you knitted me together in my mother’s womb” (Psalm 139:13). “Before I formed you in the womb I knew you” (Jeremiah 1:5). David traces his sinfulness back to conception itself (Psalm 51:5).

The Hebrew of Psalm 139 uses golem, an unformed substance, and still speaks of it as the psalmist himself. I take the biblical position to be that human life, and therefore human personhood, begins at conception, and that every embryo created in a laboratory is a person who did not exist before and cannot be uncreated.

The forms of IVF treatment a Christian can accept

That conviction does not rule out IVF treatment entirely, but it does rule out a good deal of common practice. What it points towards is a restricted approach: fertilising only the number of eggs that will actually be transferred, transferring all embryos created, declining selective reduction, and refusing routine screening whose purpose is to discard the imperfect.

Clinics can and do accommodate this, though it usually lowers the success rate per cycle and raises the cost, and a couple should expect to have to insist. It is worth asking these questions before signing anything, and worth asking them in writing.

Donor gametes raise a separate issue. Introducing a third party’s genetic material into the conception of a child within a marriage sits uneasily with the one-flesh exclusivity of Genesis 2:24, and there are questions of identity and disclosure for the child that surface many years later. I would counsel great caution there.

The embryos already in storage

A pastoral complication that is rarely discussed: many Christian couples completed IVF treatment years ago and have embryos in frozen storage. What now? There is no comfortable answer. Continued storage postpones the question. Destruction is unthinkable if these are persons. Donation to research is the same thing with paperwork.

Embryo adoption, where another couple carries and raises the child, is the option most consistent with treating these embryos as human beings, and some Christian families have done exactly that. It is costly, complicated and rare, but it exists.

If you are in this position and reading it with dread, hear this clearly. Decisions made in good faith with incomplete information are not the unforgivable sin. There is forgiveness in Christ for what we did not understand and for what we did, and paralysis serves nobody. Seek counsel, act as faithfully as you now can, and leave the rest with God.

When it does not work

IVF fails more often than it succeeds. The cycles are physically brutal, financially draining and emotionally exhausting, and the disappointment after each one is sharper than the last because hope was raised deliberately. Couples need to decide in advance how far they will go, because in the middle of it there is always one more thing to try.

Scripture does not promise every couple a biological child. That is a hard sentence to write and a harder one to hear, and I will not soften it into something dishonest. What Scripture does promise is that God’s purposes are good even when they are not what we asked for, and that grief is permitted rather than shameful.

Adoption and fostering are not consolation prizes. They reflect something at the heart of the gospel, since we ourselves have “received adoption as sons” (Galatians 4:5). And fruitfulness in the New Testament reaches far beyond biology, into lives invested in the next generation in ways that outlast us.

How the church can help

Most congregations handle infertility badly, not from malice but from thoughtlessness. Mother’s Day services can be quietly devastating. The endless enquiry about when children are coming is asked by kind people who have no idea what they are pressing on. A couple in the middle of IVF treatment may be sitting through all of it while saying nothing.

So a few practical suggestions. Do not ask couples when they are starting a family. If they want you to know, they will tell you. Do not offer stories of someone who conceived the moment they stopped trying, which functions as an accusation however it is meant. And do not tell them that God has a plan, true though that is, as though it settled anything in the middle of the third failed cycle.

What helps is presence. Remembering the date of a scan. Asking how they are and then waiting through the pause. Praying with them and, when they cannot pray, praying for them. “Rejoice with those who rejoice, weep with those who weep” (Romans 12:15) is not complicated to understand. It is simply harder to do than giving advice.

So, now what?

IVF treatment is not a simple yes or no. The desire for children is God-given, and medical help is not a failure of faith. But every embryo is a human being, and any process that creates, freezes, screens or discards embryos has to be weighed in that light.

So go in with full information, a settled commitment to the life of every embryo created, clear limits agreed in advance, and genuine openness to God’s purposes even where they differ from yours. And if you are in a church with a couple walking this road, ask them how they are, then listen without offering solutions. That is worth more than you think. Related reading: when human life begins, what about contraception and family planning and reproductive choices.

“For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made.”

Psalm 139:13-14 (ESV)