The human ovum was discovered in 1827. The ensuing 100 years was a battleground over contraception, abortion, and women’s rights, first the right to vote and then increasingly a demand for access to contraception and abortion.
While those events were developing, in 1878 Samuel Schenk in Vienna fertilized rabbit and guinea pig ova in vitro (“in glass”) in his lab. In 1934, Gregory Pinchus and Ernst Enzmann in the United States attempted “in vitro fertilization” (IVF) in a rabbit. The attempt was flawed by failure to understand the complexity of the process, and fertilization was shown to have actually occurred inside the rabbit. While many scientists turned their attention elsewhere for a while, Dr. Pinchus never lost interest in mammalian reproductive systems. In the 1930’s, scientists began to understand human reproductive hormones better.
In 1951, Margaret Sanger (Director of Margaret Sanger Research Bureau) and Abraham Stone (President of Planned Parenthood Federation of America) met with Dr. Pinchus to discuss an oral hormonal birth control technique. Initial research was encouraging, but Planned Parenthood showed little interest. Sanger met with her friend Katherine McCormick, philanthropist and heir to the McCormick family fortune, to discuss the project. In 1953, McCormick contributed most of the funding for Pinchus to develop the first birth control pill “Enovid,” which was approved by the FDA in 1960.
In parallel with these developments, advances were made in 1951 that lead to the first successful IVF in a rabbit in 1959. In the 1960’s and 1970’s, scientists concerned with issues of human female infertility made advances, but their attempts at human IVF were unsuccessful.
In 1976, Patrick Steptoe and Robert Edwards in England began working with an infertile couple, Lesley and John Brown. Lesley was infertile due to occluded Fallopian tubes. On July 25, 1978, Lesley gave birth to a healthy girl named Louise Brown who was promptly labeled the first “test tube baby.” As of 2018 (40 years later) about 8 million babies worldwide have been born after IVF, and it is estimated that 1-3% of births in the US and Europe annually are now by IVF.
The Catholic Church officially recognizes and speaks at length on compassion for couples wishing to have a child, and does not judge the use of technology to overcome fertility as wrong in itself. In 1987, a document on “The Gift of Life” proclaimed that methods which “do violence to the dignity of the human person and the institution of marriage” are immoral, but that “a medical intervention which helps or assists the marriage act to achieve pregnancy” may be considered moral. Therefore, IVF is decidedly considered to be immoral.
The simplest argument to explain this teaching is the fact that several eggs are fertilized in vitro which eliminates the marriage act of love between husband and wife. Furthermore, life of the embryo begins at the moment of conception, and it is at that moment that the embryo is a person who has a soul. Furthermore, the IVF procedure need not be completed with an egg from the wife or sperm from the husband, leading to many other social issues.
Finally, the doctrine goes on, “leftover” embryos are discarded, frozen, or relegated to experimentation. Moreover, it cannot be disputed from cases where thawed embryos have been brought to full term healthy babies who become adults that the embryos are real people, just undeveloped. As we shall see, this is also the subject of much debate and legal action.
Not every IVF attempt results in pregnancy. For one attempt about 45%, for three attempts about 50%, and for six attempts about 75%. The success rate can be improved by implanting several fertilized eggs, which risks multiple births. Multiple births result in more and more risk to the mother, and increasingly high risk of some of the babies dying before or shortly after birth when there are 3, 4, 5, or more. Therefore, in the 1980’s, doctors began the process of “selective reduction” of multiple pregnancies by injecting chemicals into the heart and killing all but one developing baby.
Typically, 15 eggs are fertilized giving rise to the issue of which embryos to implant. Most recently, doctors are using deep learning artificial intelligence software “to determine which embryo has the best chance to become a baby.”
Studies indicate that there is about a 30% chance of birth defects in children born by IVF over the general population, which seems to be related to the reasons for infertility in the parents. Whereas children born by IVF do not have cognitive or behavioral problems, long term studies indicate a higher incidence of such things as increased body fat, hypertension, impaired fasting glucose, depression, and binge drinking. It is not known if this is due to parental genetics or something in the IVF procedure.
At present only one or two eggs are typically implanted. But, some doctors have deliberately implanted more and made news when there were multiple live births. Some countries have enacted laws against implanting many embryos to prevent multiple births. Many states now require insurance companies to cover IVF which has lead to rules on how many eggs can be harvested and how many can be implanted.
What happens to leftover eggs that are not fertilized? What is done with fertilized embryos not implanted? Leftover eggs can be frozen and used later by the same woman or donated later to another couple to be fertilized by the man’s sperm. Leftover embryos are alive and have the potential to become babies, but they can be legally discarded as trash or designated for research and then killed. They can also be frozen and implanted in the same woman or another woman later. But, storage fees are costly. Some couples donate their embryos for adoption through agencies. Rather than going through the expensive IVF procedure or trying for years to adopt a baby, the receiving woman has a natural pregnancy and delivery. Currently there are over 1 million frozen embryos in the US alone.
It is now possible for doctors to use donated eggs and donated sperm to create a new living embryo. This new life can be implanted in a woman to become a baby who grows into an adult, or the embryo could be used for research and killed. This has produced intense debates over “the beginning of human personhood” and “the value of potential human persons.” This is the subject of political and ethical arguments over how to legally prohibit or regulate such activities.
In the meantime, in November 2018, it was announced that an illegal experiment in China has produced live human births from genetically altered embryos. Japan has also approved an experiment to implant human cells in animals to try to grow spare human organs to be harvested when needed.