Death of Embryos
When I set out to write this blog, I jotted down my thoughts about the ethical dilemma of In Vitro Fertilization (IVF) and realized that, to treat the issue as thoroughly as I needed to, it would take… well, quite a few words. So, this will be the first of a series.
Before diving into the issue of IVF, I want to state unequivocally, that regardless of how a child is conceived, s/he is valuable and all children have equal dignity. Whether a child is conceived through IVF, some other reproductive technology or “naturally,” that child is of infinite worth. That is not a reality that’s up for question, as we’re entering into a discussion on the morality of IVF.
In vitro fertilization is available for almost any reason in North America, but it is generally used in cases where there are fertility issues, either explained or unexplained. It is also often used for procreation for LGBTQ+ couples and for couples who have a high likelihood of conceiving children with genetic abnormalities.
There are many variations in how IVF is employed, but the main process consists of three major components: egg retrieval, fertilization and embryo development, and transfer of embryos.
I) Egg Retrieval
First, eggs need to be retrieved for the process of fertilization. This is accomplished through ovarian hyperstimulation, where drugs are used to induce a woman’s ovaries to produce multiple mature oocytes. Once the cells are sufficiently mature, they are removed from the woman’s ovaries transvaginally. A needle is pierced through the vaginal wall and into the ovary, guided by an ultrasound. This needle removes the follicles and fluid.
II) Fertilization
After selection and preparation of the ova, the eggs are incubated together. After a few hours, the embryos are removed and cultured for a few days, before being implanted. Alternatively, eggs may be directly fertilized by intracytoplasmic sperm injection (this is when a sperm is injected directly into the oocyte to fertilize it). The resulting embryo would then be cultured as normal.
III) Transfer of Embryos
Once the embryos are ready (i.e. day 2-6 after incubation), they are sorted and graded based on quality. Selected embryos are either transferred to a woman’s uterus or frozen for future use. The transfer is a complex medical process which involves the woman taking drugs to prepare her body to conceive, followed by the transfer of the prepared embryos to the uterus, via a canula inserted through the cervix. Embryos that are not selected are generally destroyed. Embryos that are not implanted may be destroyed, frozen indefinitely or donated for gestation by another individual. [1]
The most obvious moral dilemma of IVF is the radically high proportion of embryos that die during the process. Death of embryos can occur intentionally or unintentionally. Obviously, in the destruction of excess (or genetically unfit) embryos, this is the intentional ending of embryonic human life.
Additionally, embryos may die spontaneously during culturation, die during the process of transfer, or die via miscarriage later on in the pregnancy. Of embryos that fertilize (which are a subset of the mature eggs retrieved), only %30-50 will reach the blastocyst stage[2] and be available for implantation. Doctors will often recommend that these embryos be genetically tested before implantation, so that the best embryos (those most likely to survive) can be implanted. With genetic screening prior to implantation, blastocysts that are graded as good quality had an implantation rate (leading to a clinical pregnancy) of %55.6 – the live birth rate was %46.8,[3] as a portion still died in miscarriage. That is, around half of embryos implanted will be miscarried.
So, broadly speaking, it can be a tiny portion of the embryos created (eggs that fertilize) that survive to birth. There are many ethical questions that come to mind in the context of this issue, but the most pressing from a prolife perspective are about the life and death of these very young human beings.
Are we justified in creating and intentionally destroying embryos lives?
The basic prolife case (the main argument used by the prolife movement, specifically against abortion) is quite simple:
1) It is wrong to intentionally end the life of an innocent human being
2) A human fetus/embryo is an innocent human life (from the moment of fertilization)
3) Therefore, it is wrong to intentionally kill a human embryo (from the moment of fertilization)
The basic application of this to IVF is obvious. It’s wrong to discard human embryos that are not wanted for implantation. It’s wrong to kill these human beings we’ve created.
As for those couples who opt for IVF, planning to use all the embryos created, this is a bit of a stickier situation. But, I think there’s an important consideration to be made before making that choice: do we want to participate in an industry that creates and intentionally destroys countless human lives on a regular basis? Do we want to pay people to help us conceive, when these same people would gladly end the life of our child on a whim?
These are questions that we need to take seriously. These are questions that we need to ask ourselves and that any couple should seriously contend with before making the decision to use IVF.
[1] In vitro fertilization (IVF) - Mayo Clinic
[2] Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage | Nature Biotechnology
[3] Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology? - Reproductive BioMedicine Online (rbmojournal.com)