The conception-industrial complex: IVF and broken promises

The conception-industrial complex: IVF and broken promises

As Catholics we know the moral pitfalls of in vitro fertilization, but now it seems like the rest of society is catching up as well, finding mainly secular reasons why it may not be such a good deal for infertile couples.

Slate has a review of two new books on assisted reproduction and the problems they entail.

The fertility industry has been far better at inventing awe-inspiring technology—and selling it to the public—than it has been at counseling patients about the risks of procedures and how these technologies will shape families, sometimes in ways they didn’t anticipate.

One of the problems they present is that of multiple simultaneous births of twins, triplets, and quadruplets. While more children are not in themselves a problem—except insofar as a family might have trouble with a sudden onslaught of babies and the fact that multiples have more health problems—what often happens with multiples is “selective reduction”, i.e. aborting some of the babies.

It’s not easy to be clearheaded about life-altering decisions—and ask hard-nosed questions of your doctors—when the emotional stakes are so high. Then there’s the financial calculus, which pushes patients toward wringing the most out of every fertility treatment. IVF cycles typically cost about $12,000, and only a handful of states mandate insurance coverage. So, when a doctor asks a patient, 10 minutes before the embryo transfer, whether she wants to implant two or three or four embryos—-and she’s recently taken out a second mortgage to fund her pregnancy attempts—-it’s pretty tempting to choose the greatest number of embryos, thereby upping the odds of pregnancy, but also the risk of twins, triplets, and quadruplets.

Then there are the effects on husbands and wives, for whom the process becomes an end in itself, divorced from the unitive aspects of marital relations.

Birth defects and passing on infertility

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  • I must admit, that although I am firmly against assisted reproductive technologies of almost every kind (I exclude minor procedures that treat causes of infertility – stabilizing hormone levels etc…), I have a big place in my heart for the women who are faced with the decision. Although there are numerous women who turn to ART very early in the “trying to conceive” process in order to speed everything up or increase their odds, There are many women who are guided by the doctors they trust into an initially gray area, and then into a place where conception is completely divorced from the marital act and is accompanied by terrible moral ramifications.

    If you read a lot of infertility blogs, as I do, you see a pattern of women talking about how the line they won’t cross changes with each procedure. Yes there are couples and women who are very aware of the problems and issues and proceed anyway – but there are also so many who trust their doctor and are so desperate to conceive that they do not seek to know the possible negatives.

    Infertility can be a lonely place. For some women, their spouse is not supportive, or their family exerts great pressure. For some its just the feeling that you have failed in your primary role as a women. The supportive care of a doctor can be a very powerful influence, and I think some doctors take advantage of that (even if subconsciously) for financial gain.

    I especially feel for these couples when they get pregnant naturally after spending lots of time and money pursuing ART (IVF and related stuff). To go through the time and heartache and most of all the decisions that can be akin to selling your soul – only to find out it wasn’t really necessary – must be awful to face, even in light of the joy of a child.

    I put a great deal of responsibility on the doctors that lead couples down this path without the knowledge they need. There should be personal responsibility, but we should recognize the intense emotions that go into these decisions – it is important to pray for the completely innocent victims (children killed) as well as the not so completely innocent victims of IVF.

  • What you describe is not unlike what many women experience in abortion, i.e. being led down the primrose path by abortionists, boyfriends, husbands, family etc., until the only “choice” left to them is the one that benefits someone else.

  • Whenever I hear about people turning to artificial methods of conception, I have to think that these would-be parents have the wrong motives for parenthood.  If someone wants to have babies so they can love them and raise them and show them the world, then why not adopt?  There are children in need of parents, and adult couples who want children.  Seems like a perfect fit to me.  God bless the adoptive parents of the world!  (James 1:27)

  • I hear so much about people “suffering” with infertility and I suppose they do, but I can’t empathize.    Maybe it’s because I got pregnant on my honeymoon and went on to have two more bio kids so I’ve never walked a mile in their shoes.    However, as the mother of adopted children as well, I think there’s more to it.    I am blessed to know on every level there really is no difference in the love a parent has for a bio child as compared to an adopted one.

    There are millions of children available worldwide for adoption.  Think about it.  These children will grow up on the streets or in an overcrowded, underfunded orphanage while these couples spend tens of thousands for the chance to say they’ve given birth to their child.  The cost for being matched with a child who needs them through international adoption would be comparable to IVF, if not less.    The cost of fostering to adopt domestically is much less than fertility treatments although it is certainly more emotionally risky.

    I don’t want to pretend adoption is all roses, because it’s not, but every child, biological or adopted, comes with his own special challenges to his parents.

    In my less charitable moments I think the drive to conceive through artificial means is the same drive that makes people research bloodlines before they buy a purebred dog.  I just don’t get it.

  • One quick story to show how love makes us forget the memories of a child’s origin, even for grandmoms.    When our Guatemalan son was recovering from surgery, the doctor had given us Tylenol with codeine for his pain.  My mother advised us not to give it to him since allergies to it “run in the family”.

  • Preface: I have no experience of infertility, I accept Church teaching in its entirety, and if anything I probably have too little ability to empathize with some who are infertile; extreme attempts to achieve some dream family on the would-be parent’s own terms don’t elicit emotional sympathy from me for anyone but the children.

    But I don’t think the arguments that immoral reproductive technologies are unacceptably selfish can begin with “There are children out there who were already born and need homes.” People who are not steeped in a Catholic understanding of marriage, sex, and procreation are likely to ask why this does not also apply to those who conceive through sex as a matter of course, or those who receive what the Church considers acceptable medical treatment to restore or aid natural fertility.

    I regularly see threads like this on the Internet about infertile people and lack of interest in adoption, but little similar comment on large expenditures for vacation homes, special training of children with big athletic or artistic dreams, etc. rather than sacrificing such dreams for the sake of others’ more basic needs. And it’s appropriate that there’s little comment on those prudential decisions, which might actually be selfish, but might also be people trying to use what they have to take care of those who are entrusted to them.  Don’t expect a couple to accept that spending the same amount of money to combine and pass on their family’s genes and to experience pregnancy and birth is somehow uniquely selfish because “There are children out there already who need homes.”

    The arguments really need to be about why specific technologies are immoral and disrespectful of the nature and meaning of marriage, recognizing why married couples need to be open to having children together and are not selfish to want to do so.

  • Eileen,

    Your comment about researching bloodlines isn’t that far from the truth.  It is very common to see adds on the campuses of top tier colleges (and in their papers) for egg donors.  There is also information available on male sperm donors so parents can pick the donor that best suits them. A recent article by a Harvard Business School faculty member indicates this and it is a gowing industry to produce IVF babies geared to going to Ivy League schools.

    I have to say I love the story about your mother and the pain medication.  It beautiful to see her so accept your adopted son to that point.

  • My favorite related stories are those of “infertile” parents who have finally adopted, and shortly afterwards conceived naturally! There are more of these than you’d suspect. And in each case I’ve heard so far, they do not begrudge the adopted child, but feel blessed for having adopted!

  • The egg donors are being sucked in, too.  My daughter asked me last year if I thought she should sell some of her eggs for IVF.  She was a freshman at Very Prestigious University, and was being wooed through campus newspaper ads offering money that would have paid her tuition if she would only help out a couple who wanted so badly to have a child.

    Needless to say, I set her straight, and the subject hasn’t come up again.  But it did give me some insight into the sort of exploitation that is out there.

  • Amelia, I understand what you’re saying and I agree to a point, but I do think there is a secular, practical argument to be made for choosing adoption over IVF. 

    IVF is not just a financial cost, there is a huge physical burden placed upon women.    Their bodies are loaded up with hormones and mood swings, post partum depression, and freakish amounts of multiples are all much more likely to occur with no guarantee a pregnancy will even “take”.  With international adoption and a reputable agency you are more or less guaranteed to become a parent, there is no physical toll on the body, and you’re not creating embryos that may not get used.

    We live in an area where people regularly make decisions for their families like the ones you are talking about (shore homes, top notch schooling and coaching, etc.).  We’re very familiar with the mentality and have struggled with it ourselves.  But the difference is if you don’t get your child the fancy lessons, he’ll be relegated to second best, and if you don’t buy that shore home, you’re putting your family at the mercy of hoteliers and landlords and probably losing out on a great investment.  Whether those decisions are selfish or not, the upsides for making them are clearly there.

    But an adopted child is not second best. 

    The belief that an adopted child is second best IS the main reason people choose the physical burdens of IVF over adoption.  As I look at my children and beam with pride over their accomplishments and rack myself with worry over their failings, I cannot for the life of me see a difference in the love I have for them and I know in my heart of hearts that how they joined our family is truly incidental.

  • I think that for some women it’s not necessarily that they think an adopted child is “second best,” but that there is a deep rooted drive to bear children within them. I understand that drive very well – My husband and I would have loved a honeymoon baby, but instead took a year to conceive only to miscarry early on. Now, another year later, I am 19 weeks pregnant and very happy. We conceived without any medical aid, just careful tracking for me to determine exactly what was going on with my body – in those 2 years I ovulated less than 4 times. However, we would have considered some medical treatment before approaching adoption. There is a procedure where they check for a fallopian tube blockage that also tends to clear minor blockages in some women. I would also have considered Clomid (considered…I’m not sure if i would have taken it). There are also some minor hormone regulating drugs and procedures that may have come into play.

    My point in this, is that even though an adopted child would not be second best to us, I felt a deep drive to bear a child myself – to experience everything that goes with it. If faced with complete infertility, we would have pursued adoption without reservations. All I would lament is the loss of the experience of being pregnant.

    But there are couples on both sides of this – some would prefer to adopt and some would prefer to bear children. Neither position is immoral as long as the openness to life is present. It is difficult to have a deep desire for children and to be unable to fulfill it. Personally, I have felt a vocation to be a mother – in some way – since i was a teenager. To be unable to conceive, unable to adopt, unable to mother a child, would be very upsetting to me emotionally and spiritually (thankfully I have 12 nieces and nephews, so there is “mothering” fulfillment to be had, even if as an aunt)

    My main point is this – I judged the decisions of others regarding children a great deal…until i faced difficulty conceiving. I asked new couples when they were going to have children; in my mind I condemned people who pursued ART (assisted reproductive technology); I got annoyed at people who adopted instead of bearing children…In all these instances I assumed motives and circumstances. I assumed that the adoptive parents could bear children but chose not to for vanity or for picking the perfect baby; I assumed the newly married couple could conceive if they wanted and just weren’t trying; I assumed the couples pursuing ART had the same moral compass I did and were well-informed on the ethical quandary they were entering into.

    Adopted children being second best is not the main reason that many or I would even say most couples pursue ART. For some this is true, but to say it is the main reason is an unfair generalization. I urge you not to assume the circumstances and motivations behind the decisions of others…especially those that are not intrinsically immoral. It is immoral to pursue certain assisted reproductive procedures for many reasons, however, there are some procedures in that category that are morally neutral. It is not immoral to have a desire to bear children stronger than that to adopt, nor is it an indictment of adoption to strongly pursue bearing children – just as pursuing adoption more strongly than bearing children is not immoral (as long as openness to new life is present). It is not even immoral to not really want to have children…as long as you are still open to God’s will and not attempting to circumvent nature.

    I mean to harshness towards to opinions previously expressed in these comments, but I want to make a firm point: We do not know the strength that others posses, the moral compass, the common sense, the trusted guidance. Decisions and reasoning that make sense to you, do not necessarily enter into the minds of others. It is our duty to pray for others, lead by example, teach and witness where we can, and by all means have compassion for others even when we feel they are on the wrong path or disagree with what we perceive their motives to be.

  • syntax clarification…I should qualify one thing i said:

    Adopted children being second best is not the main reason that many or I would even say most couples pursue ART

    I did not mean structure that sentence to sound as if adopted children are second best, rather I was addressing the perception that adopted children might be considered second best by women wanting to conceive.

  • Betsy,

    Well put. Thank you for your salient comment.


    I agree with everything that Betsy said.

    I’d like to share my experience and feelings as well.

    I have a 1 year old daughter and recently had a miscarriage. After that miscarriage, I was diagnosed with uterine cancer and told I would have to have a hysterectomy. This diagnosis was later reversed; but for the space of about a week, I was almost certain that I would never bear a child again.

    I knew with a part of my mind that we would eventually consider adoption and that I would love any adopted child just as much as I love the daughter I bore in my womb for nine months. But the loss of my ability to bear children was still a loss. I mourned, sobbed on my husband’s shoulder, pleaded with God to let this cup pass from me. I am very blessed that He answered my prayers; but had he not, I would have also accepted his will for my life.

    It’s not that I had any notion that adopted children are second best. I know well that they are just as much gifts from God as the children we bear. And I had a strong sense in prayer one night that any child I adopted would just as much have been chosen for me to mother as any child I bore. But at the same time, I was aware that conceiving and bearing children is a special gift from God. The wonder of participating with God in his creation of a unique human being is not something we should undervalue. Bearing children is imaging God’s own life-giving love and is an irreplaceable experience.

    Also, I think adoption is a special vocation. Not all parents are called to it and not everyone is capable of handling the unique challenges that come with adopted children. I would add, however, the caveat that an a priori rejection of adoption could be rejecting God’s call and perhaps a form of not being open to life.

    Infertility is a cross and I think it is cruel to minimize the suffering of those who must bear it. Every night I pray for those couples who are suffering from infertility because I know just how much they need those prayers.