“Do you have any siblings?”
“Yes, I do.”
“How many?”
“Well, if you count half-siblings, I have five hundred to a thousand.”
While the numbers in that imaginary dialogue may sound like a joke, they are not—thanks to modern reproductive technologies. In the documentary Anonymous Father’s Day, viewers meet the man behind this story. His biological father was a sperm donor, and hundreds of humans are his father’s offspring—and thus his brothers and sisters—as a result.
Or consider the Donor Sibling Registry website. It was created in the year 2000 to connect people who are genetically related to one another as a result of others who gave away their sperm, eggs, or embryos. The largest group the website has brought together so far is two hundred half-siblings. One sperm donor linked up through that registry donated four hundred times in his lifetime, and since one donation can produce twenty-four vials, the fertility clinics he worked with could have sold as many as 9,600 vials. It is therefore. within the realm of possibility that this donor fathered hundreds, if not thousands, of biological children around the world. Currently, he is aware of twenty-two.
Stories like these raise this important question: Is it ethical to create human beings by science and not by sex?
In vitro fertilization (IVF) is one such procedure that makes children by way of science. With IVF, sperm and eggs are harvested from a man and a woman, combined in a petri dish where fertilization occurs, and the resulting human embryos begin their lives in glass (“in vitro”) instead of in their mother’s body. Ultimately, at least one, if not more, of the embryos will be transferred into a woman’s body.
Sometimes the sperm and eggs are the gametes of a husband and wife who are having difficulty conceiving naturally and enlist the help of science to establish fertilization in a lab. Other times, sperm and/or eggs are provided by third parties that are not the couple planning to parent. In some cases, the sperm is from one partner of a gay couple, but eggs are provided by a woman. Sometimes—and certainly this is the case with the latter scenario—surrogacy is pursued, where a woman is contracted to gestate a child in her womb and then relinquish the child at birth to the individual or couple who commissioned the baby’s production.
We are talking about tens of millions of human beings, at a minimum, who are directly impacted by this technology in some way.
Should IVF be embraced or rejected? Is it inherently good or inherently evil? Or, perhaps, is it something that is sometimes right and other times wrong, depending on the circumstances?
These are important questions to consider, because IVF is now widespread and international, affecting millions upon millions of people. Celebrities are increasingly divulging their infertility struggles and pursuit of IVF, including the Obamas, Nicole Kidman, and Céline Dion. These aren’t isolated cases. In 2018, CNN reported that since 1978, when Louise Brown became the first successful “test tube baby,” there have been a minimum of eight million children born around the world who were conceived through IVF and related technology. That number is only climbing, with estimates showing that more than five hundred thousand babies are born annually around the world as a result of IVF.
For every one embryo that successfully matures to birth, typically several others are created—sometimes ten or more embryos. IVF-conceived persons are in our families, churches, workplaces, and the general public. So are the people who attempted IVF, whether they were successful or not. We are talking about tens of millions of human beings, at a minimum, who are directly impacted by this technology in some way.
And the impact is not only on individuals; it is also on society as a whole, and it spills over into public policy. That became abundantly clear in 2024 when the Alabama Supreme Court came out with a ruling related to IVF that caused an uproar and led to debate across the United States. The case under consideration involved couples who sued their fertility clinic because their frozen embryos had been destroyed by a hospital patient who wandered into the room where their embryos were in the freezer. The patient removed them and dropped them, leading to the demise of the embryos.
The court ruled that embryos not within a womb were to be considered children under the law; in other words, Alabama’s Wrongful Death of a Minor Act applied to all preborn children, including the youngest of our kind: newly conceived embryos not yet inserted in a woman’s body. A justice wrote, “Unborn children are ‘children’ under the Act, without exception based on developmental stage, physical location, or any other ancillary characteristics.”
In response, IVF clinics in the state were hesitant to continue operating for fear of legal ramifications. Patients with scheduled appointments were devastated, many publicly sharing their stories of struggling with infertility, being on the cusp of an embryo transfer attempt, and being left in limbo about whether they would be able to access IVF in their state going forward.
Rallies and protests were held. Media coverage was extensive. Public figures on both sides weighed in as a national debate erupted. And Alabama legislators were quick to respond, passing a bill “to provide civil and criminal immunity for death or damage to an embryo to any individual or entity when providing or receiving services related to in vitro fertilization.” Even at a federal level, Senator Ted Cruz put forward legislation called the IVF Protection Act, which went so far as to propose that states that ban IVF access be denied Medicaid funding.
In light of such intense political and personal debate, this book aims to ethically evaluate the increasingly common practice of IVF, presenting arguments that are both sectarian and nonsectarian in nature. Although explicitly Christian appeals are made, a variety of information is offered to provoke deep thought and consideration, even for those who embrace a different religion or no religion at all. If we were to view the sections of this book like a house, part 1 lays the foundation with basic principles and ideas to guide our overall thinking on the topic; part 2 looks at the effects of IVF and identifies walls that should be in place; and part 3 is all about design: it proposes a blueprint for how to view sexuality, reproductive technologies, and life itself in this broken world. More than just an examination of IVF’s morality, this book shares stories of people who have endured the great suffering of infertility and offers a variety of hope-filled responses.
It also includes my own story. While some people have difficulty getting pregnant, in my case I’ve had difficulty sustaining pregnancies. In my first three years of marriage, I had four miscarriages, three of which were in a row. Never getting to cradle in my arms children I so desperately wanted was devastating. Losing child after child made me question whether I could emotionally handle getting pregnant again; even though I wanted more children, I feared more losses. Recurrent miscarriage is often listed as a reason to pursue IVF.
So is age. I didn’t begin trying to have children until I was forty, the age when the likelihood of pregnancy drops to a mere 5 percent each menstrual cycle. Even though my body has an unusual ability to defy the odds in that regard, my experience of many miscarriages aligns with another negative aspect of my age: miscarriage risk climbs to roughly 40 percent at age forty. My husband and I chose not to pursue IVF, although we were helped with the aid of Restorative Reproductive Medicine, explained in chapter 12.
Experiencing unmet desire, living through loss, finding hope in alternatives, and surrendering to a power higher than my own—all these helped form my perspective through difficult times, which I hope will help others as well.
This excerpt is a highlight of the introduction section of On IVF. In this timely volume in Word on Fire’s Dignity Series, Stephanie Gray Connors engages both the mind and the heart in answering increasingly urgent questions. Readers are drawn into the profound suffering of infertility and miscarriage, the difficulties and dangers of IVF, and the hope-filled alternatives that honor the dignity of human beings—both born and preborn.
