IVF’s collateral damage

MYRNA BROWN, HOST: It’s Thursday the 24th of April.

This is WORLD Radio and we’re so glad you’ve joined us today. Good morning, I’m Myrna Brown.

MARY REICHARD, HOST: And I’m Mary Reichard.

First up on The World and Everything in It: the ethics of IVF.

This spring, lawmakers in Georgia and Tennessee passed bills to protect in vitro fertilization in law with overwhelming support. Even the few dissenters focused mostly on embryo selection and disposal.

BROWN: But even the conservative legislators seemed to overlook the deeper debate, especially among Christians: can IVF be done in a way that honors the sanctity of life from the very beginning?

WORLD’s Leah Savas introduces some of the arguments in this debate.

LEAH SAVAS: Dr. John Gordon is a Christian IVF provider in Knoxville, Tennessee. His colleagues in the industry tell him patients aren’t worried about ending up with more embryos than they can use. But Gordon regularly hears those concerns.

JOHN GORDON: I see so many patients who’ve asked their doctor, ‘Hey, I just don’t want to fertilize every egg. Can we limit how many eggs we fertilize?’ And they’re told, ‘No, you can’t.’

Gordon tells them they can.

For many IVF patients and providers, the more embryos the better. Each one increases the chances of bringing home a newborn. But Gordon and many of his patients are against discarding extra embryos because they see them as human life. He offers IVF protocols that stimulate the woman’s body to produce fewer eggs than in standard IVF, limiting the number of possible embryos.

One of the protocols is called natural cycle IVF.

GORDON: For a lot of the patients who do natural cycle, their concern is they don't want to do any embryo freezing at all.

Others are concerned about ending up with more embryos than they can realistically give a chance at birth.

But even Gordon’s careful approach can’t eliminate the loss of life inherent to IVF. On average, 50-70% of IVF-inseminated eggs stop growing in the days following successful fertilization. Gordon doesn’t see these losses the same as intentionally destroying an embryo.

GORDON: If you have a blastula-stage embryo, and you decide that you're not going to use it anymore, and you take it out and discard it from the freezer. Well, you've killed that embryo. But in this case, just because an egg fertilizes and doesn't continue to grow, I don't think that counts as embryos that are destroyed or lives that are lost through IVF.

Even in natural conception, an unknown number of embryos fail to implant or miscarry. Gordon sees natural IVF losses as comparable.

Christian IVF mother Sheila Brannan has a similar view. The two IVF cycles that resulted in her two daughters produced seven and five eggs each. She and her husband had them all fertilized. Both times, all but one stopped growing.

SHEILA BRANNAN: Even to this day, I cry for them. And I still think about them every day. Those embryos, to me, are life, and if they didn't grow or whatever the case may be, they still mean something to God and to me.

But Brannan doesn’t blame IVF for those lost lives.

BRANNAN: Why don't we look at it that God had a plan for those eggs that he didn't want them to grow. And yes I think believe they should be considered embryos, but I don't think that they are a victim of IVF. I just believe that that's God's plan.

But can we draw a one-to-one comparison between the losses of embryos in vivo—meaning, in the human body—and embryos in vitro—meaning, in glass?

PETRA WALE: We know that it's just no comparison between in vivo and in vitro.

That’s Petra Wale, president of the Fertility Society of Australia and New Zealand. She described the conditions tiny embryonic humans experience within their mothers’ bodies. It’s dark. The temperature is just right. So are the oxygen levels.

WALE: The embryo keeps moving. It gets released from the from the ovary and into the fallopian tube, and it keeps moving down and then settles in in the uterus. So it's moving into new nutrients and new environments and it’s moving away from what was there before it.

Meanwhile, new embryos in a lab mostly stay put in a petri dish. Atmospheric oxygen levels, light, the wrong temperature, certain compounds in the laboratory dishes, and the presence of perfumes and deodorants in the lab can all harm their growth. Even the act of transferring the microscopic embryos in pipettes can put physical stress on them when done too vigorously or too frequently.

Wale said the industry has gotten good at replicating the conditions in vivo. But there are still limits to what the industry knows and how closely science can copy the natural process. When an embryo stops growing, she says.

WALE: There's really no way of knowing if that particular embryo was exposed to unnecessary stress and that's what was the contributing factor.

Another factor causing embryo loss could be the low quality of many eggs harvested through IVF. Except in natural cycle IVF, providers use hormones to stimulate the female body to mature more eggs than it would naturally.

WALE: IVF brings along a large cohort of eggs, some of which probably would never have even got there in the first place. And then when they do become embryos, it's not surprising that they aren't, aren't able to continue to develop.

To Wale, these realities aren’t an ethical concern. But IVF opponents I talked to say the providers who fertilize these eggs—and the people who pay them to do it—are morally responsible for the resulting lives since they wouldn’t exist apart from IVF. They say that these lab-grown embryos don’t have the same chance at flourishing as naturally conceived embryos.

Matthew Lee Anderson is an ethics professor at Baylor University.

MATTHEW ANDERSON: I think they have heightened responsibility, because they know that … some number of embryos are going to be dead at the end of this process.

He adds that any improvements to IVF technology come at the expense of countless embryos that have died in the process.

Knoxville’s Dr. Gordon agrees that the IVF industry has its share of moral problems—many that he’s worked hard to avoid. He just doesn’t see the embryos that stop growing on their own as one of them. But he also understands that people must follow their conscience. If they believe IVF is a sin, they shouldn’t do it.

GORDON: I would say, for every believer, he has to decide, wrestling with their own conscience as to what they are called to do. I would never fault somebody who says I feel like these issues are just issues that I can't come to peace with.

Reporting for WORLD, I’m Leah Savas.

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