Suzanne is a forty-year-old mother of two who recentlyattended an Evangelical women’s Bible study in a suburb of Chicago. At thisparticular gathering the topic was infertility. The church had brought in twoguest speakers. One spoke of how she and her husband had spent yearsunsuccessfully trying to conceive before they decided to adopt. The otherrelated that she and her husband also had experienced fertility complicationsbut that, after many years of trying, they were finally blessed with a child oftheir own. She had been so overcome with gratitude at having given birth thatshe was now serving as a surrogate mother of twins for another couple desperatefor children. Both women were hailed as models of how to turn privatesufferings into public goods, and as strong Christian witnesses for how to faceone’s own infertility with courage and grace. That response suggests that we’vefailed to reflect deeply enough about the moral significance of reproductive technologies.
Infertility is a painful reality for many couples, yet mostChristian congregations have been reticent in response. Meanwhile, assistedreproductive technologies remain increasingly popular options for infertilecouples desperate to conceive. Historically, the Judeo-Christian tradition hasheld fertility in high regard, taking seriously the command to “be fruitful andmultiply.” But the modern advent of reproductive technologies now forces us toask what boundaries or lines should be drawn.
The modern-day fertility industry can trace its origins backto 1884, when a doctor in Philadelphia inserted the thawed sperm of a strangerinto a woman who nine months later gave birth to a child whom she believed wascreated from her husband’s sperm. This incident would give rise to the nowwidely accepted phenomenon of anonymous conception, perfected a century laterthrough in vitro fertilization (IVF) when Sir Robert Edwards engineeredthe birth of Louise Brown, the world’s first test-tube baby. While Louise wasthe product of her mother’s egg and father’s sperm, it would not be long beforeconception via third-party donor egg or sperm, or both, and the eventualimplementation of the embryo into a third-party surrogate. In short, theemergence of assisted reproductive technologies has allowed us to alter foreverthe idea of procreation, with sex no longer a prerequisite for reproduction.
Yet while these technologies had originally resulted from apurely scientific interest in the problem of infertility, they soon became thecenter of a lucrative enterprise. Their most common form relies heavily on thebuying and selling of eggs—often euphemistically called “egg donation.” Youngwomen, commonly on university campuses, are lured by the prospects of receivingas much as tens of thousands of dollars for their eggs, paid for by affluentinfertile or homosexual couples eager to have a child.
This emergent baby-producing industry has dark sides. Theprocess of removing eggs from women is medically questionable—there have beenno long-term scientific studies done on the health risks involved, and the mostserious risk, ovarian hyperstimulation syndrome (OHSS), already shows links to variouscancers and can in rare cases even lead to death. There are also emotionalrisks involved, to the egg donor, the couple on the receiving end, and thechild conceived.
The practice of surrogacy at its simplest takes place byinserting sperm into a fertile woman who is able to serve as the child’s birthand biological mother. The story of Abraham, Sarah, and Hagar shows us thatthis is an ancient practice. A second method, increasingly more common, isknown as “gestational surrogacy,” in which a previously created embryo isimplanted inside the surrogate mother, who can then deliver a child notgenetically related to her. According to recent data from the American Societyfor Reproductive Medicine, more than a thousand children were born throughsurrogacy in 2011. That number indicates an almost 100 percent increase fromthe 530 babies reported born in 2004. While the psychological, emotional, andphysical challenges of gestational surrogacy are similar to those of IVF andanonymous sperm donation, because this method is relatively new, we have littledata on children born this way.
In his 1972 essay “Making Babies—the New Biology and the OldMorality,” Leon Kass, the distinguished physician and ethicist, cautioned thatscientists were then on the cusp of creating children outside the womb. Justhow it would affect these children would have to be determined years later.Sensing that all might not be well, Kass warned that “infertility is arelationship as much as a condition—a relationship between husband and wife,and also between generations too. More is involved than the interests of anysingle individual.” In many discussions of infertility, the emphasis will betypically centered on the deep longing for a child. Yet, Kass notes, this cannever be a one-directional matter: We must also give consideration to thechildren and their desires, their rights, their pain, and their suffering.
The unregulated aspect of the baby-producing industry (whichof course also includes the more common use of anonymous sperm to impregnatefertile women) makes it difficult to fully grasp or analyze the experience ofchildren created from third-party reproduction. In 2010, the Institute forAmerican Values, a nonpartisan think tank, released the report “My Daddy’s NameIs Donor: A New Study of Young Adults Conceived Through Sperm Donation.” Theirdata, while not focused exclusively on gestational surrogacy, provides astarting point for understanding the experiences of these children.
Looking at children produced through artificialinsemination, the report found that “sixty-five percent of donor offspringagree, ‘my sperm donor is half of who I am.’” Similarly, it found that “donoroffspring are more likely to agree, ‘I don’t feel that anyone reallyunderstands me.’” This has typically led this population to struggle with theirmothers and their social fathers, with over half of the respondents agreeingwith the statement “I have worried that if I try to get more information aboutor have a relationship with my sperm donor, my mother and/or the father whoraised me would feel angry or hurt” and another 70 percent agreeing that “Ifind myself wondering what my sperm donor’s family is like.”
This raises questions about reproductive technology thatcurrently remain unanswered in our public policy: Is it right or even lawfulfor parents to deny children information about their genetic parents? Shouldsperm and egg banks be required to keep records of the individuals who donate orsell their eggs and sperm? Should there be a limit on how many times anyone cansell eggs or sperm? Why do we make a legal distinction between the selling oforgans, 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 theologicaldebate that exists has largely remained in the classroom or in theconfessional.
Today a successful IVF cycle can cost as much as $100,000.Surrogacy pushes this cost higher when the costs of nine months of medicaltreatment are combined with the fees paid to the surrogate mother. And whileanonymous sperm conception is relatively inexpensive, egg donation is not.Moreover, the exchange of money between the donor and the recipient inevitablycarries with it the feeling that children are being bought and sold. Thiscommodification of life is something that donor children themselves seem to belamenting. 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 “achild of their own”? For Christians, the notion of a child of one’s ownis both shortsighted and dangerously individualistic. When parents choose topursue third-party reproductive technologies, an automatic asymmetry isdeliberately established. IVF, surrogacy, or anonymous gamete donation—theseall become individual projects, rather than a joint collaboration between bothspouses as co-creators of their future child.
Even more worrisome is the potential objectification of thechild who is so desperately longed for by the mother or father. As GilbertMeilaender observes, as we remove the creation of new life further and furtherfrom the natural reality of male and female sexual union, children become “ourproduct, our project, or our possession.” Years later, when the child learnsthe details of his conception, he may react against the idea of how great aneffort had to go into it. In an age in which people are as transient as theyare now and when even local family units drift apart, biological ties remainunalterable. We ignore them at great risk of harm to these children.
We are still only in the nascent stage of reproductivetechnology. To this point, we have proceeded speedily in the hope of rectifyinginfertility, which is on its surface a goal worthy of joy and celebration. Yetthe stories offered to us by the children conceived from these methods mustgive us pause for more reflection. It is often remarked by parents that theirchildren become their greatest teachers in life. If this is the case, then thelesson being taught by the children conceived via IVF, anonymous sperm and eggconception, and surrogacy is one that urges caution.
Jennifer Lahl is the founder and president of the Centerfor Bioethics and Culture and producer of the documentary film Eggsploitation.Christopher White is the director of education and programs at the Center forBioethics and Culture.
Image by Wayne Evans licensed via Creative Commons. Image cropped.
