On 25 July Louise Brown, the world’s first baby born via in-vitro fertilisation (IVF), celebrates her 40th birthday.
40 years after her birth it is estimated that more than seven million babies have been born as a result of IVF and other assisted reproduction treatments. Around 2.4 million assisted reproductive technologies (ART) cycles are estimated to take place each year world-wide, with about 500,000 babies born as a result. If rates stay at current levels, then an estimated 157 million people alive at the end of the century will owe their lives to assisted reproductive technologies (1.4 per cent of the global population).
40 years ago it was generally assumed that IVF would remain rare. However there has since been an explosion of assisted fertility services: intracytoplasmic sperm injection (ICSI), gamete and embryo freezing, gamete and embryo donation, embryo genetic diagnosis and surrogacy, to name some. The most common fertility treatment now is ICSI, accounting for around two-thirds of all treatments worldwide, with conventional IVF around one-third (proportions that vary across countries).
Infertility is deeply distressing and can affect every area of life for those struggling to conceive – as many as one in six couples. The Bible views childlessness as a painful, personal tragedy (Samuel’s mother Hannah’s anguished prayer illustrates the stress of infertility, as does Rachel in Genesis 30) while the Psalmist praises the God who ‘gives the barren woman a home, making her the joyous mother of children’ (Psalm 113:9).
IVF can provide couples with a child they desperately want. And it has brought many precious new lives into being, and real happiness to millions of parents.
Therefore, many now think IVF is the answer to infertility.
But it is not. While the IVF industry and media focus on and market the success stories, the average delivery rate from ART treatments are around just 19 per cent per cycle – a global IVF cycle failure rate of around 80%. In the UK, the Human Fertilisation and Embryology Authority reports a ‘success’ rate of 26.5% . This ‘success’ rate actually means that 73.5 % of cycles do not lead to a birth.
Success rates for IVF diminish rapidly after 35 years of age for women, largely because of loss of ovarian follicle reserve and oocyte quality with age. Even a woman under 35 years has less than a one in three chance of having a baby per embryo transferred, using her own eggs and partner’s sperm. A woman in her early 40s only has about a one in ten chance of having a baby per embryo transferred. And the success rate drops to a mere two per cent for women over 44. This is highly relevant in a time when more and more women are delaying childbirth to concentrate on jobs and careers. When celebrities in their 50s become pregnant, what the media do not tell you is that it is almost always with a donor egg (indeed, 59% of women over 44 years used donor eggs in their treatment).
IVF heartbreak is real. IVF is no guarantee of success, despite all too often being touted as such. Added to this is the significant financial, emotional and physical toll that IVF can have on women.
Yet still, with one in six couples experiencing problems conceiving, the fertility industry is thriving. It is estimated to be worth over £600 million in the UK alone, with one cycle of IVF costing up to £5,000 or more.
There are some very troubling aspects of the fertility industry.
For instance, the number of babies born with health challenges (see here and here too), the use of medically unproven techniques and ‘add-ons’, poor regulation, the shocking commercialisation and exploitation of women’s wombs and eggs (see here too) and the change to ‘traditional’ notions of family structure and biological parenthood, through gamete donation (which can bring much heartache to the offspring) and surrogacy. A dead or dying person can have their reproductive tissue removed to enable someone else to have a child – even a grandmother.
IVF has also opened what many regard as a Pandora ’s Box of genetic engineering, cloning, pre-implantation genetic diagnosis (screening out of embryos), embryonic stem cell harvesting, research on three parent babies and animal-human hybrids. Many IVF programmes involve the production of spare embryos, which are then used for research, disposed of, or frozen for future use. Between 1990 and 2013 over two million were allowed to perish, according to a Parliamentary answer. Now, over 170,000 IVF embryos perish every year. Embryos are experimented on, donated to other couples, frozen indefinitely … or even turned into jewellery.
The last 40 years of IVF and ART have given many couples happiness but even more couples, dashed hopes. The next 40 years will undoubtedly bring even more possibilities for the fertility industry, but what is possible is not always right.
What should we think as Christians?
Some biblical reflections on infertility treatments can be found in a CMF Nucleus article here and are summarised in a blogpost. Central to our response should be upholding the marriage bond and honouring embryonic human life. If these principles had been followed over the last 40 years many of the difficult issues that have come out of the fertility industry’s Pandora’s Box would not have happened.
I have also written a booklet with Dr Jason Roach which provides both information and guidance on some of the ethical dilemmas IVF raises for Christian couples considering IVF, and considers how we might seek treatments for infertility in line with God’s character and commands. We included two personal testimonies from Christian couples who both considered IVF and decided to take different courses of action.
A moral vision, especially one shaped by a Christian understanding of the person and family, has to be prepared to say ‘no’ to some exercises of human freedom and to turn away from technology that is possible but unwise. With fertility treatments, while we can and should use our God-given skills to help alleviate infertility we should also be prepared to acknowledge that there may be suffering we are free to end, but ought not to, that there are children who might be produced through artificial means, but maybe ought not to be.
Peter Saunders reflects in a blog here that some infertile Christian couples will go on to conceive, either naturally or with ethical infertility treatment, after a period of waiting. But this does not happen for all, and God in his wisdom has left some couples childless despite good treatment and patient prayer.
So this IVF anniversary could serve as our reminder to recognise God’s sovereignty, acknowledge we live in a fallen world, serve the childless with compassion, uphold marriage and honour all life.