An IVF Primer

By: R.J. Snell and Public Discourse, originally published September 23, 2024, Public Discourse

These essays are not provided out of callousness or a lack of empathy, but if we are to be responsible, we must be well-informed so that we can judge and choose in keeping with the truth of things.

I’ll admit I was not expecting in vitro fertilization (IVF) to be a major issue in this election, let alone that the Republican candidate for president would support free IVF coverage while claiming to be a “leader” in that support, or that his so-called “Statement on Life” would describe IVF as “beautiful.”

There is significant confusion on the morality of Assisted Reproductive Technology, including IVF. More than a few people who consider themselves “pro-life” on abortion consider IVF “pro-life” since it allows “people to start their family or add to their family if they want to,” in the words of Senator Josh Hawley.

The desire to have a child is understandable, praiseworthy, and infertility is too often a cause of frustration, sadness, and pain. We can sympathize with a couple’s desire to have a child and their delight at a procedure that allows for this, and we certainly view each and every person, however they were conceived, as having dignity, worth, and value equal to all other people.

At the same time, the morality of IVF is not self-evident, and there are multiple issues and problems to consider.

VF separates the unitive and procreative goods of sex, a separation that is not morally neutral. IVF can treat humans as a product, the sort of being it is right to produce or manipulate. At times, although certainly not always, IVF raises additional questions about the morality of surrogacy or of having donor-conceived children. If multiple embryos are implanted, the option of “selective reduction,” that is, abortion of some of the unborn children, might occur. And often, far too often, excess embryos are used for scientific research—that is, embryo-destructive research—or are frozen and never implanted. There are occasional controversies about “ownership”—if a couple divorces, the embryos are “marital property” involved in a “custody” dispute, of sorts.

According to some calculations, more than one million embryos are cryopreserved—frozen—in the United States alone, with others estimating fewer, perhaps 400,000. Whatever the number, if one trusts the science, as I do, that means that hundreds of thousands of human beings are in stasis. (Since the advent of modern embryology, we have known—this is not a philosophical, religious, or moral question—we have known the embryo to be a genetically distinct, alive, biologically self-directed human being.)

In other words, if one were pro-life, one would take a long pause before claiming that IVF was pro-life. Certainly, if one were consistently pro-life, one would not treat IVF merely as a political opportunity to win votes.

With that in mind, we offer this short primer on IVF from the Public Discourse archives. I don’t claim these essays offer all the answers, let alone ask all the relevant questions. I certainly do not presume these essays resolve the frustrations and longings of those struggling to conceive—not at all. These essays are not provided out of callousness or a lack of empathy, but if we are to be responsible, we must be well-informed so that we can judge and choose in keeping with the truth of things.

I hope these essays are useful for those who wish to understand more adequately, and for those who wish to live responsibly and well.

R. J. Snell, Editor-in-Chief

IVF: A Second Front in the Cause for Life

Stephen W. Austin

IVF and its related technologies inevitably treat children not as people but as the objects of manufacture. At every step of the process, embryos are processed and graded with the goal of quality control. Embryos that don’t make the cut on this human assembly line can be easily discarded.

Read the full essay.

IVF, Designer Babies, and Commodifying Human Life

Daniel Kuebler 

Viewed in this manner, the leftover embryos become just one more commodity to be manipulated. Since most of the excess embryos will be discarded in some manner, the idea of donating them to research seems to many to be a humane practice. In fact, a majority of Americans support this practice. It is the presence of excess embryos that has fueled research on embryonic stem cells, and it now appears that it will fuel research into the genetic modification of humans.

Read the full essay.

An Absurd Fate: What Happens to Abandoned Embryos?

Jennifer Lahl

Human life was not meant to be created in the lab, put on ice, and left for years and years. Many frozen embryos do not survive the thawing process. As Paul Ramsey explained back in 1972, freezing human embryos would “constitute unethical medical experimentation on possible future human beings, and therefore it is subject to absolute moral prohibition.”

Read the full essay.

The In-Vitro Catch-22

Phillip Reed

Ethical objections to IVF, of course, extend beyond the pro-life concerns about leftover embryos or selective reduction. One prominent strand of thought objects to IVF in principle because it shows disrespect for the dignity of the human person in the very act of creation. On this understanding, IVF amounts to a dehumanizing form of technical manufacture of children outside a conjugal act. Other objections similarly show concern about the assertion of choice and will in the process of reproduction. The IVF user must decide: How should the gametes be obtained? Should a third party’s gametes be used if mine fail? Which third party should I choose? How many eggs should be fertilized? Which embryos should be selected and on what basis? How many embryos should be selected? What should be done with the remaining embryos? Should a surrogate be used if I can’t get pregnant? Which surrogate should I choose? Should I continue to carry all of the fetuses that have implanted? With so many difficult “elective” choices, it is not hard to see why some have thought the whole thing should just be shelved.

Read the full essay.

The Embryo Orphanage: A Cautionary Tale

Ana Maria Dumitru

[I]n reality parents play a more active role in consigning their children to scientific research by donating or selling their embryos. They may be motivated by a desire to justify an IVF or abortion procedure by contributing to scientific advancements, or they may view embryos as “products of conception” rather than as living human beings. Like the orphans, these vulnerable embryos contain all the same root capacities for mature human life. Yet because they are not able to consent or protest, they are often disregarded or assigned a status lower than that of an extrauterine person.

Read the full essay.

It’s Time to Regulate IVF

Margaret Brady

Practices like these are devastating for the dignity of everyone involved. The bodies of egg and sperm donors are treated as valuable raw material to be harvested for industrial purposes. Embryos themselves are subject to a degrading quality control process, which calls to mind a USDA livestock inspection. And their parents’ desperation to have children has been turned into a lucrative opportunity for investors who realize pain can be profitable. Can we question the angelic purity of licensed medical professionals and venture capitalists? Troubling news from the world of Silicon Valley fertility start-ups says we probably should. Without meaningful regulation, the human family in our country risks becoming just another tech product.

Read the full essay.

R.J. Snell is Editor-in-Chief of Public Discourse and Director of Academic Programs at the Witherspoon Institute.

Public Discourse is the online journal of the Witherspoon Institute, which seeks to enhance public understanding of the moral foundations of free societies by making scholarship of fellows and affiliated scholars available and accessible to a general audience.