Walking alongside childless couples is one of the most painful experiences I have known as a pastor. Few things cut as deep into peoples hearts as the unfulfilled longing for a child that for whatever reason fails to be conceived. In such circumstances, as well as prayer, medical help should be sought – but medical help quickly evolves into encouragement to pursue IVF, and it is at this point that any thinking Christian couple will want to ask some questions.

Reproductive ethics is a minefield, and when discussing these issues with a couple I would expect the conversation to last hours, not minutes. However, my overall feeling regarding IVF is cautious, to say the least, and the reasons for these cautions can be summed up fairly succinctly.

1. The personal toll
Scientists, by definition, always want to push at the boundaries of their knowledge and abilities and reproductive technologies are an exciting area of research. This means that medics have a bias towards pushing people towards IVF, sometimes without due consideration for the best overall interests of the couple: I’ve certainly counselled couples who have felt considerable pressure from medics to pursue IVF, against their will.

The reality is that IVF is an emotionally and physically demanding process, especially for the woman. The cycle of egg-harvesting is intrusive and unpleasant, and the emotional toll of waiting to see if the procedure has been effective is intense. Of course, many couples feel this a price worth paying if it results in a child, but the reality is that even while techniques improve, a large proportion of IVF attempts are unsuccessful. According to the HFEA, “The latest figures (2010) show that 25.6% of IVF treatments using a woman’s own fresh eggs resulted in a live birth.”

These factors cause me to urge any couple considering IVF to think very hard before proceeding with treatment.

2. The financial cost
I know I am treading on dangerous political ground here, but in talking through IVF with couples think it is worth talking about the financial costs of treatment. In the UK, women under 40 can be offered three cycles of IVF. This potentially represents a cost of about £15,000. Additionally, IVF tends to result in a high incidence of twins and triplets, premature births and other complications, and this puts considerable pressures upon neo-natal units, and thus increases the financial strain experienced by the NHS. (Not to mention the emotional pain for parents of going through this.)

Those of us who are Christians must recognise that children are a gift from God, not a right to be demanded. We must also recognise our responsibility to the wider community of our society, so I think it worth considering these financial issues. Of course, a couple can also expend considerable amounts on treatment personally if they fall outside the NHS’s provision, and the appropriateness of this also needs to be considered.

3. The problem of donated gametes
Very often a couple will be unable to conceive because one of them is infertile. In my pastoral experience this has invariably been due to a problem with the husband’s sperm. This is itself a difficult emotional issue to work through, as a man with fertility issues can easily feel his manhood is in some way questioned.

These personal and pastoral sensitivities are one thing, but the ethical position begins to become murkier if a couple investigate using donated eggs or sperm to help them have a child.

For me, the use of donated gametes is a no-go. This is because doing so involves a third party in the marriage and seems to me analogous to adultery. Sometimes people struggle to conceptualise what this means, so let me make it graphic: Grace & I have been very fortunate in experiencing no fertility issues; we know (and love) many people who do. It would be quite possible for me to ‘help’ one of these couples by offering to impregnate the woman – something that could be done quickly and ‘unemotionally’. Of course, were I to do this it would be rightly perceived – to use the appalling evangelical euphemism – as a moral failure: it would be adultery, and I would lose my job! Now, if rather than actually impregnating the woman myself I made a sperm donation which she used, what would be the real difference? I cannot see it as anything other than a difference in degree, not an absolute difference: something that would be made very tangible should a child result – a child that would be ‘mine’.

For Christian couples this is a caution that should be treated with the utmost seriousness.

4. The problem of ‘spare’ embryos
As fertility treatments are refined this will become less of an issue, but it remains a considerable one. If we are to maintain a consistent Christian ethic that life does indeed begin in some way at conception, it should trouble us if embryos are created as a result of IVF but then found to be surplus to requirements. What, in the end, will happen to such embryos?

In my experience it has been concerns about this issue that has most often prevented Christian couples I know from proceeding with IVF.

A better way
As I said at the beginning of this post, being unable to conceive is traumatic. Couples desperate for a child will often go to any lengths in order to conceive, but while I wouldn’t go as far as to say that IVF is always wrong (so much depends on the particular technique employed) I always counsel couples to look at other options.

In my church we have a considerable number of couples who have, or are in the process of, adopting. This is hardly a cost-free process itself: adopting is hard work. Yet I always encourage couples to explore adoption over and above IVF. Adoption is a redemptive act, which in so many ways parallels what God does for us. IVF is not always necessarily wrong, but it is always ethically complex and problematic in a way adoption is not. For a couple unable to conceive, through the tears that are shed and the pain that is felt, adoption offers a ray of hope – for them, and for the child in need of a home.