In this continuing series on Values by the Catholic Medical Guild and Caritas Singapore, we examine if in-vitro fertilisation (IVF) is truly life-giving and ifit is the only solution for an infertile couple.

ANY married couples trying desperately to start a family will say something like this: "We love children. We want to have a baby but we are having problems conceiving. We have tried for three years now. We will do whatever it takes to have a baby. Adopting will be a last resort."

Indeed, the desire to have a child is one of the most natural human desires. When couples have difficulty having babies, it is common to seek medical help to conceive.

In-vitro fertilisation (IVF) is often regarded as a good option since it helps couples conceive. Not only does it deliver the happiness couples long for, but the goals of IVF also appear to be aligned with the Church's pro-life stance. In Singapore, it also aligns with the government's message of having more babies.

So how can IVF be anything but "God-sent"?


The miracle of life

To understand the moral dilemma behind IVF, we have to explore the miracle of life.

The procreative act that brings a child into existence is one in which the two spouses give themselves wholly to each other in love. The child is thus born as a fruit of that love and is in a relationship of love with his parents from the moment of conception.

In IVF, husband and wife contribute sperm and egg respectively to form the child, but the act which brings the child into existence is no longer an act of love of two people giving themselves to each other, but one that takes place through an elaborate laboratory process.

In a successful IVF cycle, the child is brought to life through the successful manipulation of "reproductive materials". Every parent would claim to love their child whether he is created through sexual intercourse or IVF, and rightly so, since he is a human person deserving of love and respect. Yet, the fact that the child was conceived through a mechanical process by the hands of doctors or scientists has already altered the parent-child relationship.

Instead of love and respect among equals, it becomes one in which the child relates to his parents as a product. This begs the question on new life: Can one claim, on the one hand, to love the child, but on the other hand, proceed to manufacture life in a laboratory as if it were a commodity?

The dark side of technology
Women who have experienced failed IVF cycles reveal a darker side of this technology. Many report frustration, anxiety, depression, or a lack of self-worth when the process fails for one reason or another.

In reality, the success rate of lVF is low - 72 to 84 per cent of IVF cycles fail. The low success rate, coupled with the high costs, contributes greatly to the cheaper, safer and equally or more effective treatments such stress experienced by couples already emotionally taxed by their difficulty to conceive.

There is also the dangerous side effect of the treatment known as ovarian hyperstimulation syndrome which occurs in 6 per cent of women who undergo IVF. The IVF process involves "hyperstimulating" the ovaries through hormonal injections. As a result, some women may experience severe headaches and vomiting, psychiatric disturbances, and sometimes even death.

Finally, it is a medical fact that huge numbers of embryos are destroyed in the IVF process. Australian data shows that only 3.6 per cent of embryos that are created by IVF survive to be born. Since human life begins at conception, this means that IVF kills 96 persons so that three others can live. This is morally unacceptable.

No IVF, but not the end of the road
There are alternatives for couples wanting to conceive which are safer, less costly, and more effective than IVF. One well-studied method is NaPro Technology based on the Creighton Model Fertility Care System (CrMS). It devotes medical and surgical resources to cooperate with the natural functions of the human reproductive system. A NaPro Technology centre in Ireland has seen more than half its patients achieve pregnancy.

The Billing's Ovulation Method is another natural method which has also been successfully applied. It helped more than 32 per cent of couples achieve conception in a large scale trial in China.

IVF may be popular and appear God-sent, but it comes with burdens of treatment that may far outweigh the benefits it brings.


IVF In A Nutshell

What lt Is

  • In-vitro fertilisation (IVF) is a method of assisted reproduction. The man's sperm and the woman's egg are combined in a laboratory dish where fertilisation occurs. The resulting embryo is then implanted in the woman's uterus (womb) to develop naturally. Usually, two to four embryos ore placed in the woman's uterus at one time (although more hove been tried in some centres). This whole process is usually known as one IVF cycle.


Other types of assisted reproduction include:

  • Intracytoplasmic sperm injection (ICSI) in which a single sperm is injected directly into a single egg in the laboratory and the resulting embryo is transplanted into the woman's body.

  • Artificial Insemination (AI) in which the man's sperm is artificially injected into the woman's body.

  • Gamete intrafallopion transfer (GIFT) is similar to IVF except that fertilisation takes place in the woman's body, instead of in the laboratory.


The Current Landscape

  • Globally, some three million babies hove been born through IVF since the treatment started in 1978.

  • In Singapore, the cost of IVF ranges from around S$7,000 to S$20,000 per cycle. In 2009, 3,271 couples underwent IVF treatments in Singapore resu ling in 778 births.

  • The success rotes for IVF decreases with each successive cycle, from up to 25 per cent for the first cycle, to about 5 per cent for the fourth cycle onwards.

Arguments For IVF

  • lt helps infertile couples to conceive. As such, it helps to fulfil an important human need of having children and raising a family.

  • lt brings about a human life. Can anything which is able to bring about such a cute and adorable little baby be considered undesirable?

  • lt helps to increase the national birth rate. A higher birth rate would hove much positive socio-economic impact for the country's future.

Arguments Against IVF

  • Embryos killed. If one regards the embryo as a human person who shares the some dignity as every other human person, then the killing of embryos is indeed a travesty.

  • Cheaper, safer and more effective treahnents avalable. IVF is an expensive treatment with a low success rote. There are cheaper, safer and equally or more effective treatments such as Billing's Ovulation Method and Napro Technology available.

  • Physical and emotional harm. Couples unable to conceive often feel inadequate. With low success rates, women undergoing IVF more often than not end up disappointed, frustrated and even depressed. The process of IVF involves hyperstimulating the woman's ovaries to produce more eggs. This is potentiolly harmful, with serious side effects including death.

  • "Made in Lab" problems. Taking the procreative act out of marital love-making and allowing it to be done in a laboratory engenders a kind of thinking which promotes the use of others as a product for one's own selfish motives rather than loving each other as equals. Furthermore, laboratory errors con result, such as the recent case in Singapore, where the child who was born was found to belong genetically to another father. lt also allows for surrogacy which has its own set of moral, social, psychological and legal dilemmas since a child could potentially have one set of genetic parents of different gestational mother, and another set of socially recognised parents.

What The Church Teaches

Embryos are human persons. Human embryos obtained in-vitro are human beings with rights: their dignity and right to life must be respected from the first moment of their existence. It is immoral to produce human embryos destined to be exploited as disposable "biological material". In the usual practice of IVF, not all of the embryos are transferred to the woman's body; some are destroyed. (Donum Vitae I, 6)

Freezing embryos violates human dignity. The freezing of embryos, even when carried out in order to preserve the life of an embryo - cryopreservation - constitutes an offence against the respect due to human beings by exposing them to grave risks of death or harm to their physical integrity and depriving them, at least temporarily of maternal shelter and gestation, thus placing them in a situation in which further offences and manipulation are possible. (Donum Vitae I, 6)

Fertilisation should not take place outside the body. "Fertilisation achieved outside the bodies of the couple remains by this very fact deprived of the meanings and the values which are expressed in the language of the body and in the union of human persons ... The one conceived must be the fruit of his parents' love. He cannot be desired or conceived as the product of an intervention of medical or biological techniques; that would be equivalent to reducing him to an object of scientific technology." (Donum Vitae II, 4 b-c)

IVF, even within marriage, is illicit. " ... from the moral point of view procreation is deprived of its proper perfection when it is not desired as the fruit of the conjugal act, that is to say of the specific act of the spouses' union .... the Church remains opposed from the moral point of view to homologous 'in vitro' fertilisation (where the egg and sperm are from married spouses). Such fertilisation is in itself illicit and in opposition to the dignity of procreation and of the conjugal union, even when everything is done to avoid the death of the human embryo." (Donum Vitae 11, 8, 4-5)

OUR SOCIAL MISSION
By Caritas Singapore Community Council

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