In the last half-century or so we have experienced what might well be called a revolution in reproduction. We are likely to describe it as a technological revolution, and it surely is that. But it is also—and perhaps more importantly—a revolution in our way of thinking about the relation between parents and children. Which came first—a changed way of thinking or technological development—is not easy to say. But however exactly we tell the story, a commitment to the use of technologies of assisted reproduction is increasingly common in our society and in many other societies throughout the world.
Whether we make use of these technologies or not, their very presence affects how we think about parents and children. Even if we decide to make no use of such technologies, we still have to decide. And that makes a difference. Moreover, although the goodness of such technologies is often taken for granted—and even commended—by many Christians, such approval may be grounded more in a desire for genetic connection than by Christian teaching. We can probe a little more deeply into this issue if we first consider briefly where the reproductive revolution has brought us and then, second, examine it in the light of Christian belief.
The Rapid Rise of Reproductive Technology
Artificial insemination has, of course, been used for a long time in animal breeding, and its use among human beings is more than a century old. The more far-reaching technological breakthrough came, however, with the procedure of in vitro fertilization (IVF), in which both sperm and ova are externalized and then joined in the laboratory, where fertilization takes place. The resulting embryo (or, more likely, embryos) can then be transferred to a woman’s uterus in the hope of achieving a pregnancy. The first child known to have been produced by means of IVF—called at that time in a formulation that now sounds a bit quaint, the first “test-tube baby”—was born in 1978. Now, approximately four-and-a-half decades later, it is estimated that at least 400,000 children are born worldwide each year by means of IVF.
IVF was first developed in order to assist married couples struggling with infertility. Certainly, however, the technology has now developed (and will continue to develop) in such far-reaching ways that to think of it simply as help for infertile couples is to miss what is significant about the reproductive revolution. In fact, in the minds of many people it has little connection to the institution of marriage—that is, to the desire of a husband and wife to see their marriage express itself in a child who incarnates their one-flesh union. Rather, it is about individual desire to experience a certain kind of fulfillment.
IVF can and often does involve much more than simply taking sperm from a man and an ovum from his wife, uniting them in the laboratory, and then transferring the resulting embryo to the wife’s uterus. IVF can also be a way to produce children free of certain defects or children of a desired sex. A couple or an individual desiring a child may commission others to fill some of the necessary roles. Thus, the sperm or the ova (or both) may come not from the commissioning parent(s) but from “donors” (as they are usually called, although often they have sold rather than donated their gametes). The embryo(s) produced in the laboratory—whether from one’s own or acquired gametes—may be transferred not to the woman who has commissioned the reproductive project but to a surrogate, who agrees to gestate the child and then give it after birth to the couple or the individual desiring a child.
Because more embryos may be produced in the laboratory than can safely be transferred to a woman’s uterus, the commissioning couple may decide to freeze the remaining surplus embryos. They may use them at a later date to try again to conceive a child, or they may never use them, leaving the embryos frozen indefinitely, or discarded, or perhaps made available for use in research. Such frozen, unimplanted embryos now number in the hundreds of thousands, and our society seems willing to permit that number to continue to grow.
Many of these frozen embryos will never be needed or wanted by those who produced them in an effort to achieve a pregnancy. What, then, is to be done with them? There is no satisfactory answer to that question. As long as we permit, and even encourage, freezing of embryos, we create for ourselves a moral problem for which there is no good solution. Leaving embryos frozen indefinitely seems unsatisfactory, but using them for research—which will inevitably involve their destruction—would be wrong. They have already been used once as a means to someone else’s reproductive project; surely once is enough.
Embryo adoption, in which a woman gestates someone else’s frozen and now unwanted frozen embryo, has appealed to some Christians. But we can hardly recommend it when we remind ourselves of the millions of orphaned and abandoned children in the world who need a familial home. If we are searching for children in need of adoption—children who need but lack a family committed to their wellbeing, children who are likely to suffer continued harm unless they find such a family—these children are all around us in our society. If we have the resources and the ability to adopt, it seems better for us to direct that energy toward children already born who need a place of familial belonging.
Closely connected to the practice of IVF is the use of genetic testing. Our society has by now come to regard genetic testing of fetuses in utero as almost routine. Of course, at least at the present time, no treatment is available for most of the conditions that can be detected by means of prenatal screening of fetuses in utero. The only “treatment” that can avoid the birth of a child who will suffer from disabilities and genetic defects is abortion, which eliminates suffering only by eliminating the sufferer.
Preimplantation genetic diagnosis (PGD)—that is, genetic testing in the laboratory of the unimplanted embryo—moves the testing process back still further, prior even to the establishment of a pregnancy. It is now possible to identify in an unimplanted embryo hundreds of disease mutations as well as its chromosomal makeup. This allows the commissioning parent or parents to select only some of the embryos for implantation, avoiding in particular any that may have genetic defects (and, of course, any of what they may regard as the “wrong” sex).
We stand, therefore, on the brink of a world in which we will hardly know how to name some of the relationships produced by technological reproduction. A woman can give birth to her own “grandchild” by gestating a fetus produced in the laboratory from gametes taken from her child and his or her spouse. People can “have children” posthumously if their frozen embryos are implanted and gestated in someone else after their death. A woman lacking ovaries can receive an ovary transplant from an aborted fetus, in which case that fetus could become the genetic “mother” of a child born to the woman.
By means of eggs made in the laboratory from induced pluripotent stem cells (iPSCs) it may soon be possible to avoid the costly and medically burdensome process of retrieving eggs from women. And given that sperm are readily available, this would mean that an individual or a couple could produce many embryos from which to choose. Perhaps even—it is too soon to say for certain—researchers may be able to use iPSCs to make sperm from a woman’s cells or ova from a man’s cells, meaning that a child could be produced using sperm and egg derived from cells of the same “parent” (as has, in fact, recently been done with mice). And it is not impossible to imagine that—as has already been done with a lamb—a child could be gestated entirely in an artificial womb—thereby producing a child with no mother.
This is what we have accomplished in the last half century or so. But these are only the bare facts. Into what larger story shall we place this reproductive revolution in order to think more carefully about it? Two competing narratives are present in our society.
Blessing or Project?
One story, deeply embedded in Christian teaching and belief, understands the child as a blessing given to a man and woman who have given themselves in love to each other. Aiming to express their love for each other as fully and completely as they can, they sometimes find that, in the providence of God, their love-giving has also been life-giving. Then they receive the child not as a product of their aims and intentions, but as a gift and a mystery, springing from their embrace—a blessing love gives into their arms. They might well say what the biblical writer says of Hannah after the birth of Samuel: “The LORD remembered her.” Within this story the erotic desire of a man and a woman for each other is also a desire to give birth, to turn outward as a couple. The body is not an instrument that we use to produce desired outcomes; it is the place in which we are personally present to each other in friendship and in love.
This story has its basis in the mystery of God’s own creative work. The opening chapter of the Gospel of John is clear that our world was created in and through Jesus, the One who is God’s Word of love to us. So also our own procreation, growing out of the giving and receiving of love between a man and a woman, can image the mystery of God’s creative work.
According to the other, competing narrative, a story that has become increasingly influential in our culture, parents are simply people who undertake what we might call a reproductive project. The purpose of that project is to produce a child of their own—that is, one who satisfies their desire for a child to rear, a desire that they feel must be satisfied if their lives are to be fulfilling and complete. If for one reason or another they are unable or unwilling to produce a child through sexual intercourse, they can have recourse to technological means of assisted reproduction to accomplish that goal.
If we think only in terms of results, we may suppose that they have simply found another way of doing the same thing that others do through ordinary procreation—namely, have a child. In fact, however, although a child may result from both sexual intercourse and various forms of assisted reproduction, these are not simply different ways of doing the same thing. If we tell the first story, we think of the child as a blessing given sometimes to those who give themselves to each other in love. If we tell the second story, we think of the child as a product we have made—and, quite possibly, made to meet desired specifications.
Nevertheless, if we are committed to the truth of the first story, we cannot ignore the sadness caused by infertility. Sometimes, within the providence of God, love-giving between husband and wife is not life-giving. Although this is often a source of great sadness, Christians have good reasons to resist the desperate desire for a child of one’s own. In the first place, we should be clear that there is for Christians no continuing obligation to have children. It is not a mitzvah for Christians, as it is for Jews. To be sure, the one-flesh union of husband and wife should always turn outward, and a child is the way in which that most naturally happens. But it is not the only way. Insofar as the divine word “be fruitful and multiply,” spoken at the creation, is a command, it has been reshaped and transformed in the history of redemption. Because The Child has been born—that is, the promised Child in whom human life has been created anew—we have no need to produce generation after generation of children.
Moreover, those who are unmarried or childless, whether that state is deliberately chosen or an accident of one’s personal history, have an important role in the life of the church. In their singleness they remind us that the wedding feast of the Lamb is something quite different from the restoration of our earthly marriages; in their childlessness they remind us that the church grows not because of our natural capacity to give birth but through the grace of adoption as God’s children. Theirs is a special vocation in service to the whole church.
The antidote to a desperate search for a child of one’s own is given us in baptism. There we learn to take seriously that, as St. Paul writes, “flesh and blood cannot inherit the kingdom of God.” There we relinquish any claim to a child of our own and, having given it up, receive the child back as one before whom we now stand as the representatives and mediators of God's covenant love and care. Therefore, it is neither biology nor genetics that is at the heart of parenthood; rather, it is the lifelong commitment to be a parent to the child whom God has adopted as his own and now places into our arms. Knowing ourselves to be God's children only by adoption, we can rejoice in the truth that, whether our children have been given us through natural birth or through adoption, they are not our possession but a trust given us by God. And we can look with the eyes of faith toward the promised redeemed creation in which all of us—husbands and wives, parents and children—will share as brothers and sisters in the wedding feast of Christ and his Bride, the church.