Biomedical Issues III

Artificial Insemination

There are two forms of artificial insemination: by the husband (AIH) and by a donor (AID). There seem to be no valid moral objections from a Christian perspective to the former. [It seems that] it is morally permissible to correct impediments to fulfilling God’s command to propagate life. (Christian Ethics by Norman Geisler)

[The cost of AID is $300-$500 per attempt].

If the married couple is having a problem getting pregnant and artificial insemination is recommended by a doctor, then it is acceptable under the following conditions. Only the sperm and egg of the married couple are involved. Fertilized eggs are not intentionally lost or destroyed. As long as both the egg and the sperm are from the same married couple, then I can see no problem with this process.  After all, both the egg in the sperm belong to the married couple and there is no intrusion of seed from outside that marriage bond. In addition, if the process of artificial insemination involves the fertilization of many eggs with only one being implanted in the womb of the mother, this is not acceptable since the other fertilized eggs must then be discarded.

(CARM.org)

 

[ Is it ok to correct imperfections in our body? Well, there were countless healings both in the Old and New Testaments. Jesus made the blind to see, the lame to walk, and the deaf to hear. God allowed the barren womb to bear. If God can do this, might it not be ok for us to?…]

Some object that [AID] is adultery by proxy. This objection is a bit far-fetched, since no sexual act with another is involved, nor need there be any lust entailed. Others consider the so-called ‘one flesh’ principle to be opposed to AID, but simply because the conception was not born of sexual intercourse between husband and wife does not mean they are not ‘one flesh’ in their marriage. Actually, ‘one flesh’ is possible without sexual intercourse; it refers to the intimacy of marriage (Gn 2:24). Stil others object that in AID the baby is not really the husband’s child, only the wife’s. But if this is pressed, it would also be an argument against adoption, where the child is neither the husband’s nor the wife’s.

 

Finally, some object because of the use of an autosexual act in obtaining the sperm necessary for the insemination. However, if [this is done] in the context of his own marital relationship, the objection loses its force. Inside a marriage, the act need not be autosexual.

 

The morality of artificial insemination within the bounds of marriage does not automatically extend to the unmarried. Children need a father and a mother; the Bible bemoans fatherlessness.

(Christian Ethics by Norman Geisler)

Surrogate Motherhood

(The following is taken from the Yale – New Haven Teacher’s Institute; by Grayce P. Storey)

Ten to fifteen percent of married couples are unable to have children.

A surrogate mother is a woman who carries a child, usually for an infertile couple. Making a decision to become a surrogate mother or hiring a surrogate requires a lot of planning, thought, and preparation.

There are two types of surrogacy, traditional and gestational. The traditional type of surrogacy involves the surrogate mother being (AI) artificially inseminated with the sperm of the intended father or sperm from a donor when the sperm count is low. In either case the surrogate’s own egg will be used. Genetically the surrogate becomes the mother of the resulting child.

 

In case of a sperm donor, cryopreserved sperm may be used. This process involves placing the sperm in liquid nitrogen and storing in an insemination facility. The sperm is thawed just prior to being used. For a better pregnancy rate the sperm collection is usually placed into the uterus or fallopian tube rather than into the cervix.

How long a sperm can remain cryopreserved is uncertain, but success has been recorded over 16 years.

The intended father’s name is put on the birth certificate. The couple will have to consult a lawyer and the wife will have to do a stepmother adoption in order for both spouses’ names to be put on the birth certificate. Laws vary from state to state and a knowledgeable lawyer will make the transition easier.

In gestational surrogacy, the surrogate mother has no genetic ties to the offspring. Eggs and sperm are extracted from the donors and in vitro fertilized and then implanted into uterus of the surrogate. This is an expensive procedure. Again, the unused embryos may be frozen for further use if the first transfer does not result in pregnancy.

[This in vitro fertilization is known by the common name, ‘Test-Tube Babies’. It is estimated that there have been some 5 million test-tube babies born since the first one in 1979.]

There are three types of mothers, the genetic mother (provides the egg), the gestational mother (she carries the fetus inside her body), and the social mother (contributor to the raising and care of the child). Each is important for the well-being and development of the child.

 

In order to become a surrogate, the individual undergoes a series of tests prior to the planting of the egg, sperm, or both. Some of these tests include.

  • Hysteroscopy/HCG, this procedure determines the fallopian tubes are clear and the size and shape of the uterus

  • Infectious disease test, to ensure there are no contagious diseases present

  • A mock cycle, to see how the uterine linings will react to hormone replacements (estrogen)

  • Pap smear to check for a healthy uterus

  • A physical, to see if there are any physiological impediments that would hinder the surrogate in carrying the baby

  • Trial transfer, to check the length of uterus to find out how far to insert the catheter, which will be loaded with embryos

  • Psychological testing, to check motivations, attitudes, and commitment

Once all of the testing is completed and out of the way, the surrogate and/or egg donor are both usually given a birth control pill to synchronize their cycles and then a subcutaneous injection of Lupron, a steroid, which will shut down the production of hormones to control the cycles. Hopefully this process will ensure that the surrogate’s uterus is ready to receive the embryo. Since the surrogate’s cycle is a week or more ahead of the Egg Donor it will make the uterus more ready to receive the fertilized eggs. Once the cycle starts the Lupron dose is decreased and estrogen replacement is added.

The egg donor starts on fertility hormones on day three to stimulate her ovaries to produce more eggs than the norm. A shot of HCG is given, which includes a (LH) lutinizing hormone surge causing the eggs to mature at a rapid pace. The drugs given to stimulate the ovaries produce more than enough eggs for a single implantation. After thirty-six hours have passed, the eggs are retrieved and fertilized with waiting sperm. The fertilized eggs are then incubated for 2-5 days. When the fertilized embryos have developed to their proper stage they are loaded into a special syringe with a flexible catheter and inserted through the cervix into the uterus. Usually 3 of the 2-day-old embryos are used and the others are frozen. After the transplant has been completed, a 3-day bed rest is usually required.

Surrogacy has been around a long time and dates back to biblical times. An interesting bible scenario is Sarah, the wife of Abraham. Sarah could not have children in the beginning. She gave her handmaid, Hagar, to her husband Abraham to produce them a child. The method used was copulation. The outcome in this arrangement did not prove to be a productive one and ended in disaster. In this scenario the spouse became jealous, the surrogate became proud and refused to give up the identity of the child and consequently the spouse had both her and her child ousted.

It was the practice of her native country where there was no hope in bearing children for the spouse to give her maid to provide an heir for the family. This was one of the legal codes of Mesopotamia. The wife determined the rights of the offspring.

The situation of the Egyptian maid could very well be mirrored today. Being a surrogate gave Hagar an elitist feeling and she became pompous and proud. Hagar would not consent to the plan to turn her child over to the mistress. Her question was, why should her child be passed off as the wife’s son? She had second thoughts and this still happens today. Biblically the very bitter dissension between the offspring’s of Sarah and Hagar is so intense until the repercussions are felt in the modern world today. Sarah’s descendants, the Jews, and Hagar’s descendants, the Arabs, are still contending for the possession of the Holy Land. [And all this from surrogacy!]

Another issue that should be considered in sperm or egg donations are the feelings of surrogate. How does the husband or wife feel about a third party being involved in the conception of their child? Is their privacy being invoked? When, if ever, will the recipient parent tell the child about the manner of his or her conception?

[What about when ‘gay’ couples desire to have a child? The perfect option for them is ‘surrogacy’. And what about that baby’s future? Being raised by two sexual deviants!]

The surrogate is usually paid $10,000.00 for her services upon completion of her contract. If the contract is not fulfilled she gets nothing (if she backs out). If the pregnancy results in a miscarriage, the surrogate receives partial payment. If for any reason [the payment] is out of order [(unethical)], it is looked upon as baby selling (reproductive prostitution, baby trade, selling body and parts, prostitution, renting uterus) by the pregnant woman.

Frozen embryos are costly and should be addressed in the last will and testament of infertile couple. Methods of disposal can be controversial and should be addressed. The methods commonly used are: donate to unknown couple (separate consent is preferred and the parties may wish to screen each other), disposal (thawed embryos degenerate and cease to grow), and tissue donation for medical research. [All three methods are ethically controversial.]

 

Surrogacy is not a simple arrangement; it is extremely complex. The relationships can be stressful, overwhelming, and intense. Patience and perseverance are a must. [And, there are many ethical and legal complications that could arise.]

What are the pros and cons of using unused embryos for medical research?

Is there anything wrong with disposal of unused embryos leaving them on the counter to thaw and degenerate?

What if the surrogate decides to maintain her privacy?

What if the surrogate decides to keep the baby?

What if the surrogate demands to visit her child?

Is there anything wrong with a surrogate giving her unused embryos to someone else?

Is handing over a child after delivery for a fee “baby-selling”?


(The following is taken from Christianliferesources.com)

“Certainly, surrogate motherhood for convenience is wrong. Motherhood should not be ‘for hire’ or ‘rent’ any more than wifehood should be. In this regard, surrogate motherhood is no better than harlotry. [God has designed everything very well, and surrogatehood was not part of that design; Genesis explains that it is between a man and his wife; if they are barren, then that is most likely by God’s design (barring any damage done by the environment).] Perhaps there are babies to adopt, or maybe God wants us to help with the care of the fatherless and not to have our own.” (Norman Geisler)

“Leave parenthood out and turn to test-tube creations for experimental purposes, and ethical questions arise that go to the heart of our outlook on life itself. The thought of anyone playing God in the laboratory, shaping the genetic material to whim and theory, raises visions of selective breeding, chance monsters, or what have you. And at the end of the road sits the specter of “social eugenics,” the creation of the ideal society of ideal human beings. What is there to stop this sure progress of bio-engineering?” (Arkansas Democrat, Little Rock, Arkansas, August 3, 1978)

Theologian William Lazareth of the Lutheran Church in America‘s Department of Church and Society stated:

“Christian ethics cannot be determined by medical technology. The ethical significance of the use of any medically sound method within a covenant of marital fidelity depends chiefly on the motivation of the users”. He pointed out that “human beings do not actually create life, whether inside or outside of test tubes. Ultimately, God remains the sole Creator of the egg or the sperm, and the sovereign author of the miracle of life”.

Director James McHugh of the Catholic Bishops’ Pro-Life Committee said priests should warn against anything that “would tend to mechanize the marriage act” (Christianity Today). He added: “It is not necessary to have a child. People can have a certain confidence and reliance on God’s will. If God’s creative act doesn’t take place, it is not to be”.

Another concern must be that if sperm and ova are borrowed from others than the prospective parents, what happens to the concepts of parenthood?

“In the case of the Brown couple,” [(those involved with the first test-tube baby in 1979)] wrote Vatican Journalist, Benny Lai, in the Florence daily, LaNazione, “sexual relations were missing, and thus the birth of Louise must be taken to be morally illicit”.

All those who believe that life begins at conception must oppose IVF. One of several fertilized eggs is chosen for implantation, which means that others will be discarded. “If man can strike the spark of human life in a glass laboratory dish, how casually may he extinguish it?” (Detroit Free Press, Detroit, MI, July 28, 1978) And who bears the responsibility for the loss and waste of embryos. Having been informed of the procedure before hand, is not the egg donor? Is not the sperm donor? Is it not the doctor who unites them, implants them, or discards them?