Suzanne is a forty-year-old mother of two who recently attended an Evangelical women’s Bible study in a suburb of Chicago. At this particular gathering the topic was infertility. The church had brought in two guest speakers. One spoke of how she and her husband had spent years unsuccessfully trying to conceive before they decided to adopt. The other related that she and her husband also had experienced fertility complications but that, after many years of trying, they were finally blessed with a child of their own. She had been so overcome with gratitude at having given birth that she was now serving as a surrogate mother of twins for another couple desperate for children. Both women were hailed as models of how to turn private sufferings into public goods, and as strong Christian witnesses for how to face one’s own infertility with courage and grace. That response suggests that we’ve failed to reflect deeply enough about the moral significance of reproductive technologies.
Infertility is a painful reality for many couples, yet most Christian congregations have been reticent in response. Meanwhile, assisted reproductive technologies remain increasingly popular options for infertile couples desperate to conceive. Historically, the Judeo-Christian tradition has held fertility in high regard, taking seriously the command to “be fruitful and multiply.” But the modern advent of reproductive technologies now forces us to ask what boundaries or lines should be drawn.
The modern-day fertility industry can trace its origins back to 1884, when a doctor in Philadelphia inserted the thawed sperm of a stranger into a woman who nine months later gave birth to a child whom she believed was created from her husband’s sperm. This incident would give rise to the now widely accepted phenomenon of anonymous conception, perfected a century later through in vitrofertilization (IVF) when Sir Robert Edwards engineered the birth of Louise Brown, the world’s first test-tube baby. While Louise was the product of her mother’s egg and father’s sperm, it would not be long before conception via third-party donor egg or sperm, or both, and the eventual implementation of the embryo into a third-party surrogate. In short, the emergence of assisted reproductive technologies has allowed us to alter forever the idea of procreation, with sex no longer a prerequisite for reproduction.
Yet while these technologies had originally resulted from a purely scientific interest in the problem of infertility, they soon became the center of a lucrative enterprise. Their most common form relies heavily on the buying and selling of eggsoften euphemistically called “egg donation.” Young women, commonly on university campuses, are lured by the prospects of receiving as much as tens of thousands of dollars for their eggs, paid for by affluent infertile or homosexual couples eager to have a child.
This emergent baby-producing industry has dark sides. The process of removing eggs from women is medically questionablethere have been no long-term scientific studies done on the health risks involved, and the most serious risk, ovarian hyperstimulation syndrome (OHSS), already shows links to various cancers and can in rare cases even lead to death. There are also emotional risks involved, to the egg donor, the couple on the receiving end, and the child conceived.
The practice of surrogacy at its simplest takes place by inserting sperm into a fertile woman who is able to serve as the child’s birth and biological mother. The story of Abraham, Sarah, and Hagar shows us that this is an ancient practice. A second method, increasingly more common, is known as “gestational surrogacy,” in which a previously created embryo is implanted inside the surrogate mother, who can then deliver a child not genetically related to her. According to recent data from the American Society for Reproductive Medicine, more than a thousand children were born through surrogacy in 2011. That number indicates an almost 100 percent increase from the 530 babies reported born in 2004. While the psychological, emotional, and physical challenges of gestational surrogacy are similar to those of IVF and anonymous sperm donation, because this method is relatively new, we have little data on children born this way.
In his 1972 essay “Making Babiesthe New Biology and the Old Morality,” Leon Kass, the distinguished physician and ethicist, cautioned that scientists were then on the cusp of creating children outside the womb. Just how it would affect these children would have to be determined years later. Sensing that all might not be well, Kass warned that “infertility is a relationship as much as a conditiona relationship between husband and wife, and also between generations too. More is involved than the interests of any single individual.” In many discussions of infertility, the emphasis will be typically centered on the deep longing for a child. Yet, Kass notes, this can never be a one-directional matter: We must also give consideration to the children and their desires, their rights, their pain, and their suffering.
The unregulated aspect of the baby-producing industry (which of course also includes the more common use of anonymous sperm to impregnate fertile women) makes it difficult to fully grasp or analyze the experience of children created from third-party reproduction. In 2010, the Institute for American Values, a nonpartisan think tank, released the report “My Daddy’s Name Is Donor: A New Study of Young Adults Conceived Through Sperm Donation.” Their data, while not focused exclusively on gestational surrogacy, provides a starting point for understanding the experiences of these children.
Looking at children produced through artificial insemination, the report found that “sixty-five percent of donor offspring agree, ‘my sperm donor is half of who I am.’” Similarly, it found that “donor offspring are more likely to agree, ‘I don’t feel that anyone really understands me.’” This has typically led this population to struggle with their mothers and their social fathers, with over half of the respondents agreeing with the statement “I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt” and another 70 percent agreeing that “I find myself wondering what my sperm donor’s family is like.”
This raises questions about reproductive technology that currently remain unanswered in our public policy: Is it right or even lawful for parents to deny children information about their genetic parents? Should sperm and egg banks be required to keep records of the individuals who donate or sell their eggs and sperm? Should there be a limit on how many times anyone can sell eggs or sperm? Why do we make a legal distinction between the selling of organs, which is banned, and that of sperm and eggs, which is not? To date, little public-policy attention has been given to these questions, and the theological debate that exists has largely remained in the classroom or in the confessional.
Today a successful IVF cycle can cost as much as $100,000. Surrogacy pushes this cost higher when the costs of nine months of medical treatment are combined with the fees paid to the surrogate mother. And while anonymous sperm conception is relatively inexpensive, egg donation is not. Moreover, the exchange of money between the donor and the recipient inevitably carries with it the feeling that children are being bought and sold. This commodification of life is something that donor children themselves seem to be lamenting. When asked, 45 percent of sperm-donor-conceived children agreed that “it bothers me that money was exchanged in order to conceive me.”
How are we to respond to couples who so desperately seek “a child of their own”? For Christians, the notion of a child of one’s own is both shortsighted and dangerously individualistic. When parents choose to pursue third-party reproductive technologies, an automatic asymmetry is deliberately established. IVF, surrogacy, or anonymous gamete donationthese all become individual projects, rather than a joint collaboration between both spouses as co-creators of their future child.
Even more worrisome is the potential objectification of the child who is so desperately longed for by the mother or father. As Gilbert Meilaender observes, as we remove the creation of new life further and further from the natural reality of male and female sexual union, children become “our product, our project, or our possession.” Years later, when the child learns the details of his conception, he may react against the idea of how great an effort had to go into it. In an age in which people are as transient as they are now and when even local family units drift apart, biological ties remain unalterable. We ignore them at great risk of harm to these children.
We are still only in the nascent stage of reproductive technology. To this point, we have proceeded speedily in the hope of rectifying infertility, which is on its surface a goal worthy of joy and celebration. Yet the stories offered to us by the children conceived from these methods must give us pause for more reflection. It is often remarked by parents that their children become their greatest teachers in life. If this is the case, then the lessons being taught by the children conceived via IVF, anonymous sperm and egg conception, and surrogacy is one that urges caution.
Jennifer Lahl is the founder and president of the Center for Bioethics and Culture and producer of the documentary film Eggsploitation. Christopher White is the director of education and programs at the Center for Bioethics and Culture.