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October 12, 2008

Facing infertility: A journey of faith, hope and love

By Mary Louise Kurey

CONTRIBUTOR

As the church in the United States marks Respect Life Month, we explore the tough issues surrounding conception

October is Respect Life Month. For many years, the U.S. Conference of Catholic Bishops has dedicated October to promoting the sanctity of human life from the moment of conception until natural death. Abortion and euthanasia involve the deliberate killing of innocent and vulnerable human beings. They are direct attacks on the foundation of justice and therefore are at the focus of the bishops’ concerns.

Other life issues addressed during Respect Life Month include: embryonic stemcell research and human cloning, vaccines derived from the tissue of aborted babies, capital punishment, artificial reproductive technologies and the promotion of chastity, post-abortion healing, and morally acceptable fertility treatments. The Respect Life Office of the Archdiocese of Chicago addresses these matters through education, public policy involvement, prayer and pastoral care programs.

Infertility, defined as the lack of conception after at least one year of unimpeded intercourse, touches about 1 in 5 couples in the United States. The causes of infertility are varied. Men cause or contribute to about 30 percent to 45 percent of infertility cases. Their issues are primarily related to low sperm count or motility. “Female factor” infertility is generally more complex. One woman may have several overlapping causes, including endometriosis, ovulation defect, blocked fallopian tubes, hormone dysfunction, limited quality cervical mucus or polycystic ovarian disease.

From personal experience, my husband and I have learned that facing infertility is truly a journey of faith, hope and love. We must have faith that God is always abundantly generous, even if our deepest desires go unfulfilled. We continue to hope that the incomparable, precious gift of a child might be given, or if that is not God’s will, that another vocation of love will be revealed. As a married couple, our love has grown, because infertility tests a couple’s love, and can bring them together or drive them apart.

For those who don’t experience infertility, it can be difficult to understand how to reach out to suffering couples. Without intending to, people can make insensitive comments. Well-meaning people have said, “I’m glad we didn’t wait too long,” or “We did in-vitro fertilization, you should too.” These comments can cause unintended wounds. They also can mislead and pressure couples to make treatment choices that are physically and spiritually unhealthy.

All too often, fertility clinics conduct a few minor tests before concluding that a couple has “unexplained infertility.” They are then rushed into a lucrative procedure like in-vitro fertilization. Feeling there is no alternative, couples often get involved in artificial reproductive technologies without understanding the health risks or the moral consequences.

The Catholic Church offers a morally enriching framework for evaluating fertility treatments. Morally sound treatments that respect human life and dignity are also more effective than artificial reproductive technologies, and are better for women’s health. As a woman experiencing infertility, I’m grateful for the wisdom of the church in this confusing arena of bioethics, and am eager to share with other couples one of the church’s best-kept secrets.

Aligned with God’s design?

The marital act has inherently unitive and procreative meanings that must not be separated. While artificial contraception claims to provide “sex without babies,” artificial reproductive technologies attempt to provide “babies without sex” – the other side of the coin. Even from a worldly perspective, both fail to achieve what they promise. The basic analysis for assessing the morality of a particular fertility treatment is to ask, “Does this treatment assist the marital act, or replace it?” Couples using a treatment that assists the marital act are acting in cooperation with God’s plan. Technologies or treatments that render the marital act unnecessary or incidental to creating a new human life are opposed to God’s plan.

Some may think that this question is “splitting hairs,” but in fact, it’s a thoughtful and important distinction. Treatments that assist the natural outcome of the marital act respect the conjugal love between spouses and respect the dignity of the child, who deserves to be conceived through the intimate, unitive act shared exclusively between a loving father and mother.

Some mistakenly equate the church’s pro-life legacy with being “pro-getting-ababy.” But this is a false caricature of the church’s teaching that diminishes the child’s human dignity. A child is not a product to be obtained or “gotten.” Certainly, children who are generated through IVF are equal in dignity to other children, because every human life is precious regardless of how he or she is brought into the world. But as stewards of human life, we have a responsibility to ensure that we are not, for lack of a better term, manufacturing people. Just because we can do something doesn’t mean that we should.

There are many morally acceptable fertility treatments, including hormone therapy, surgery to remove endometriosis and tubal occlusions, vitamin supplements that improve mucus quality, drugs such as Clomid that assist ovulation (but can cause multiples) and naprotechnology, a cutting-edge science that addresses the underlying causes of infertility for women and men. Immoral techniques that replace the marital act include in-vitro fertilization, artificial insemination or intrauterine insemination, intracytoplasmic sperm injection and surrogacy.

Why is IVF wrong?

Examining the process of in-vitro fertilization makes clear the church’s wisdom that this procedure respects neither human life nor human dignity.

1) The manner in which human life is generated. Multiple ova from the woman and sperm from the man are combined in a test tube. Several people outside of the couple, such as laboratory technicians, are involved in this process. Their job is to produce, through a series of procedures, multiple human beings. Instead of being brought into the world through an intimate act of love by the mother and father, these new human beings are generated – manufactured – in a laboratory, by people whom they will never know.

2) The manner in which human life is discarded. The embryos are rated for their quality. The C-quality human beings are discarded, while some of the A and B quality human beings are implanted in the woman’s womb. Some or all of these might not be viable and will be miscarried. If many were implanted and all of them are viable, a new problem is presented, because multiples are risky for the mother and the unborn children. Some clinics recommend “selective reduction” to abort one or more of the children. A man once told me that he and his wife had “gone through” 13 embryos in IVF and didn’t have a living child. Other couples have shared with me that they generated 23 embryos or more in failed IVF attempts. Only about 25 percent to 27 percent of couples who undergo IVF have a living child at the end of the process.

3) The manner in which human life is preserved. Remaining good-quality embryos that are not implanted in the woman’s uterus are cryogenically preserved, frozen for later “use” by the couple. More than 400,000 human embryos are frozen in fertility clinics across the country, dwelling in “concentration cans,” as described by neuroscientist Father Tad Pacholczyk. Parents of “leftover” embryos have called me with a dilemma, because the mother is unable to carry another child to term. There are no easy answers. Embryo adoption is gaining popularity, although the church is still discerning whether adopting abandoned embryos is morally licit.

In addition to the moral concerns, the potential health risks for women are significant. Mild to severe Ovarian Hyperstimulation Syndrome (OHSS) affects 3 percent to 5 percent of women undergoing IVF, causing bloating, vomiting, abdominal pain and even death. Some of the drugs used to hyperstimulate the ovaries, such as Lupron, are used off-label. No studies have been conducted to assess the long-term health risks to women. Suzanne Parisian, former director of the Food and Drug Administration, said of women who undergo egg harvesting for fertility treatments or egg donation, “She is nameless. She doesn’t appear in the medical literature, and there is no government oversight. She is gone.”

Real Solutions

However, there is great hope for most couples facing infertility. Naprotechnology, or natural procreative technology, is a science that focuses on finding and treating the underlying causes of infertility, rather than applying a “band-aid” approach of attempting to circumvent the causes through artificial means.

Naprotechnology improves our health as women, because its goal is to cure the health issues that prevent pregnancy. Thomas Hilgers of the Creighton University School of Medicine pioneered this approach. He has assisted tens of thousands of couples in having children, and has trained more than 300 doctors in the U.S. and internationally.

Naprotechnology not only can cure infertility, but also multiple miscarriages, repeated preterm births, premenstrual syndrome and post-partum depression. The book “In Their Own Words: Women Healed” contains the testimonies of women who have been cured through naprotechnology.

Its rate of effectiveness is remarkable. The general success rate of IVF is 25 percent to 27 percent, while the general success rate for naprotechnology is 74 percent. For women with endometriosis, IVF is 21 percent effective, compared with 56 percent for women treated with naprotechnology. Women with tubal occlusions have an IVF success rate of 27 percent, compared with 81 percent for women using naprotechnology. And because naprotechnology is about healing the woman, it is usually covered by insurance. For couples who must pay outof- pocket, naprotechnology is more affordable than IVF.

So the next time someone shares with you that they have the sadness of infertility, listen compassionately, and if it’s the right time, share with them the good news of naprotechnology. It’s beneficial to women’s health, more effective than artificial reproductive technologies, usually covered by insurance, and is aligned with God’s plan. Let’s not keep it a secret any longer.

Kurey is director of the Respect Life Office of the Archdiocese of Chicago.