You’re not just another, who’s struggling with infertility.

Because of: 1) the controversy spurred by President Trump’s executive order, 2) my unanticipated fertility detours, and 3) my friends, who have traumatic infertility experiences, IVF is top of mind. I’ve listened to influential thinkers regarding IVF, and this article differs. Well-known commentators seem to choose between extremes: either as fervent IVF advocates without admitting a unique member of the human species is created or preaching IVF is ethical refuse. I agree IVF may force seminal ethical choices, but IVF can be used for good.

What This Article Isn’t

This article doesn’t address same-sex couples and IVF or surrogacy. This article is limited to IVF for biological parents.¹ Without discussing these topics, you may think I weakly opted for a weightless intellectual workout. I think examining IVF only in the context of controversial parental issues requires less intellectual muscle. I’d like to focus on couples with fertility imperfections, not natural genetic impossibility (two eggs or two sperm). IVF is an option, where unsolved fertility issues have prevented, perhaps, the most rewarding human experience: loving and raising a child.

I suspect, although I could be wrong: for most male and female couples, IVF is not the first choice. The testing, hormone shots, intense monitoring, invasive procedures, and no guarantees (not to mention, thousands of dollars) isn’t ideal. Natural pregnancy is worlds easier – much more fun, no cost, no drugs (I really hope), no shots, no intense monitoring, no invasive medical procedures.

For healthy pregnancy and parenthood, I eagerly encourage both parents to investigate the root cause of infertility, as well as do the hard, inconvenient work of changing lifestyle (practice financial discipline with breathing room for a child, remove toxins and hormone disrupters in your home and food, be conscious of what you eat, workout, etc.). IVF will be more successful, if sperm are healthier and the female reproductive system is optimally functioning. However, science and doctors aren’t omniscient; they haven’t solved all fertility issues, and in my experience, they completely misdiagnosed mine.² With these caveats, here’s my unconventional view of IVF.

Ethical Concerns of Technology

Technology spawns good and bad choices. The nuclear bomb saved and killed. The internet supports free speech and easier access to porn. Social media encourages connection and addiction. You can use a phone to call your wife or your mistress.

Technology, in isolation, usually isn’t the evil; a person’s use of technology is to blame. What about AI? AI presents a new dilemma: it’s humanlike technical function, operating detached from direct human control or morality. If AI independently makes human choices without morality, AI could be a problem.

But, IVF isn’t a technology isolated from human control. IVF can’t operate without human decision and commitment. IVF requires a new mom to endure increased (sometimes, pain-inducing) hormones, demanding monitoring, and invasive procedures … without any guarantees. Infertility and IVF can cause strain and stress on each spouse and the marriage. In the heartbreak and desperation to have a child, along with the physical, mental, and financial toll of IVF, couples can’t evade IVF’s momentous ethical considerations.

Common Ethical Questions for IVF and Practical Solutions

For example: how many embryos should a couple create? What if there are extra embryos? Should we adopt them out (my friend did this and visits her biological daughter, out of state!), donate them to science, or discard them?

My IVF doctor averted my ethical impasse by assuring me: my egg count was too low; we most likely wouldn’t have extra embryos. I guess, thank you?

I’ve heard the argument: IVF without enough embryos is financially unviable. As a believer in informed consumers and free markets, I reject this. Each couple has the right: 1) to ethical informed consent that embryos are part of the human species, and 2) the right to choose how to value the youngest forms of human life. Couples should be advised of all sides of the ethical implications of unused embryos. A human is part of the human species, no matter age or capacity for medical independence or development.

Free markets have a role. Restrictive IVF costs should be investigated. For example, investigate requirements of genetic counseling. For me, I didn’t consent to genetic counseling, due to an error on the clinic’s side. But, my fertility clinic required genetic counseling before treatment. Since I didn’t consent, the clinic waived the fee. It seemed to me like genetic counseling is an illegal tying agreement, used against vulnerable couples. Genetic testing and counseling, and their cost, shouldn’t be required for IVF. Of course, couples should also be advised of risks without genetic information regarding IVF success.

Embryos should be protected and valued, because they’re human, even if an embryo relies on a mother for full development. I reason: parents should take responsibility for unused embryos, since embryos are part of the human species.

I think the best way to avoid grave ethical choices with IVF is: create only the amount of embryos a couple will use. This may result in extra embryos, true, if the couple has an unexpected issue. Couples should be encouraged (before deciding how many embryos they create) to adopt unused embryos, if the couple can’t raise the youngest form of humanity they created.

The Problem Isn’t IVF

With IVF, I don’t think the problem is technology or method. It’s the definition of humanity. As long as abortion is celebrated as a sexual right, instead of a damaging medical procedure (for both mother and baby), ethical IVF via limiting embryo creation and encouraging embryo adoption is a loser. The best ethical solution is to culturally win this debate.

As long as motherhood is viewed as second-rate, unglamorous³, unrewarding, and disempowering, women will probably continue to wait longer to have children. IVF is more in demand, when there’s not much time ticking on the biological clock, or that clock has run out.

IVF requires ethical heavy lifting, but if culture values the youngest form of humanity, the ethics of IVF can be clarified and carried by admirable moral courage.

1. One of the objections to surrogacy is testing for chromosomal abnormalities, which promotes abortion. Even with natural pregnancy, doctors offer testing for chromosomal abnormalities, without the ability to fix them, purely for an abortion. Therefore, I don’t agree with this distraction of an “argument”. ↩︎
2. My experience eroded all confidence in corporate medicine and doctors; part 1 of my 3 part series is here. ↩︎
3. Ironically, I think the unglamorous realities of motherhood – diapers, cleaning poop, well, cleaning everything, caring for sick children, carrying and protecting new life – transform it into the most powerful role. A little one relies on a mother to enter the world, for initial survival, nurtured care, and to cultivate a loving home. People may envy gorgeous celebrities (including me) and influential CEO’s, but the emotional and spiritual mark of a mother lasts long after the glitz or authority of any moment. A mother is remembered for a lifetime. She sacrifices, 24/7, for the weakest and most vulnerable, which should be the most treasured role. ↩︎