The arguments for in vitro fertilization are terribly practical. That’s an expression I borrowed from C.S. Lewis. “Terribly practical,” that is. Prescient as Lewis was, I don’t think he ever delved into the ethics of IVF. Actually, I take that back. His 1945 conclusion to the Space Trilogy foresaw a time when human beings would “learn how to reproduce [themselves] without copulation”—and that is precisely what IVF offers. I do not say that in vitro fertilization is a terribly practical procedure (the old way of getting pregnant is far simpler), but the arguments supporting IVF certainly are. And therein lies the difficulty. To be terribly anything—be it clever, funny, or attractive—is to carry at least a hint of something dangerous. “Terribly” is an intensifier that toes the line between the amoral and the immoral, which is the same line toed by IVF.

Earlier this year, the Alabama Supreme Court garnered intense national criticism for ruling that human embryos—even the in-vitro variety—would be recognized as children under the law. As a result, several IVF clinics in the state paused services. But why would they do that? What threat could this ruling pose to their operations? As ever, the devil is in the details. At the technical level, in vitro fertilization is expensive and difficult and prone to failure. To mitigate these difficulties, more eggs are gathered and fertilized than can be reasonably implanted. This is because, according to the Cleveland Clinic, only about 70% of harvested eggs are successfully inseminated, and only about half of these will survive to implantation. Success rates vary according to the age of the mother, but live births are the exception for mothers of all ages. Hence the freezing and stockpiling of embryos. If at first you don’t succeed, try, try again.

The Free Press published a piece recently by Olivia Reingold titled, “How Abortion Became ‘the Defund the Police of the GOP’”—which is a clever way of asserting that Republican opposition to abortion is political suicide. Legal abortion, apparently, is as essential to our nation’s future as reliable police protection. But Reingold didn’t open her article with an anecdote about abortion. She began instead with IVF, and introduced to us a woman intended to embody everything wrong with the Alabama verdict. But it would be hard to overstate how incongruent this woman’s moral reasoning is. If you want to see cognitive dissonance in action, she’s it.

Allow me to set the scene. Kelley Stafford is a 37-year-old Alabama mother whose young son was conceived through IVF. Reingold describes her as a lifelong Republican and Christian. When Stafford first read that the Alabama Supreme Court had ruled “frozen embryos [would be considered] ‘children’ under state law,” she was elated. She described her reaction to Reingold like this: “Being pro-life, I’m like, ‘Great, they’re just viewing those as our babies,’ because you do kind of feel that way when you’re going through IVF, that this is my baby, even though it’s not in my womb yet.” So far, so good, but then things start to unravel. Reingold continues: 

Later that night, when [Stafford] read more about the ruling, she learned that her eight embryos, which are still in a freezer at the University of Alabama at Birmingham, would no longer be treated as her property. Instead, the state now considered them living children. And disposing of them could, in theory, lead to criminal charges.

“I think it’s ridiculous that anyone would say that an embryo is a child, even though I love my little ‘embabies,’ ” [Stafford declared]. “But I just don’t see how anyone could say it’s the same as my son that’s sitting in my house right now.”

Her original plan was to donate her remaining embryos to science, but now, she worries that doing so could be considered a form of manslaughter. At the same time, she’s beginning to wonder if the pro-life movement that she’s supported her whole life has gone too far.

In case you missed it, Stafford’s second statement entirely contradicts her first. She went from saying that her son was her baby, even when he was an embryo in the Petri dish, to calling it “ridiculous” to view an embryo as a child. She went from rejoicing that her frozen embryos would now be recognized as children under Alabama law to lamenting that she might be prevented from donating them to “science.” Huh?! Does Stafford not understand what it means to donate an embryo to science? Does she not realize that the lives of the tiny “embabies” she purportedly loves, would thereby be terminated for their cells? And even if that sounds noble to you, NBC News reported in 2019 that there is such a glut of excess embryos in America that not even “science” wants them anymore. “We have 18 percent of our patients telling us they want to donate their embryos to science,” a longtime clinic operator told the outlet, “but I can’t find anyone to take them.” 

Kelley Stafford is held out as proof that the pro-life movement—which she’s supported her whole life!—has gone too far, but she’s a strange proxy for pro-life Christians. Nothing in the Free Press article leads me to believe that Stafford was ever pro-life. Not in any meaningful sense. People who view the embryos they want to keep as babies but the embryos they want to discard as “property” are not pro-life. The charitable description for them is “pro-choice.” If you feel it’s unfair to question her pro-life credentials, here’s something else to consider. When asked whether she would ever vote for the Republican jurists behind Alabama’s recent ruling, Stafford responded without hesitating that she would never vote for “those people.” Those people being the ones who oppose the death and dismemberment of unborn human beings. Perhaps it’s just me, but I’m skeptical of the notion that any true abortion opponent would flip their vote to the Democrats in protest over IVF.

It’s not that I suspect Stafford of being intentionally duplicitous. I just don’t think she has the proper framework in place to be consistently pro-life. And she’s certainly not alone. It’s easy to self-identify as a pro-life Christian and just as easy to be deceived on both counts. If you yield to external pressure whenever your moral convictions become sufficiently inconvenient, you probably never held them in the first place. The fundamental reason to oppose abortion is because it kills an innocent human being. And not just any innocent human being. It kills precisely those human beings with the least capacity to defend themselves and the most of their lives left to lose. This is true of abortion, and it’s true of IVF as it operates in the main. So the case against both practices is essentially the same. Those who call that going too far simply misunderstand the principles in play.

Following the Alabama Supreme Court ruling, former President Trump issued a statement declaring his support for IVF and calling upon the Alabama legislature to act quickly to ensure its continued availability. “The Republican Party should always be on the side of the miracle of life,” he said, “(and) IVF is an important part of that.” What Trump fails to articulate in his statement is that the only reason the court ruling has any bearing on IVF treatments is because of the way the IVF industry has chosen to practice its trade. In other words, the point of contention isn’t IVF itself. It’s the fact that millions of excess human embryos are being created in the process—only to be frozen or destroyed. So the real question is, why should we expect the court to accommodate the preferred practices of the IVF industry rather than expecting the IVF industry to accommodate the declaration of the court? The reason, of course, is a terribly practical one. Forbidding the IVF industry from destroying innocent human life would make IVF treatment even more expensive and less successful than it already is—which isn’t something a $5 billion industry takes lying down. 

Even before the Alabama Supreme Court verdict, American IVF clinics already had a crisis on their hands. Namely, what to do with their burgeoning collection of frozen embryos—particularly those belonging to AWOL parents. Dr. Craig Sweet, whose Florida fertility clinic has assisted with thousands of pregnancies in three decades of operation, estimates that almost a quarter of their frozen embryos have been abandoned—which means the parents can no longer be reached and are no longer paying for storage. Though nobody knows how many American embryos are in cryogenic freeze at the moment, the number could well be in the millions. Dr. Christine Allen, another longtime IVF practitioner, puts the number of abandoned embryos in this country in the “hundreds of thousands.” At least. So, apparently, “science” doesn’t want these embryos and neither do large swaths of parents.

The problem of embryo abandonment has been described as “an unanticipated, and unwelcome, byproduct of the considerable advances made in assisted reproductive technology,” but it’s not an inexplicable phenomenon. One mother profiled by NBC, who has given birth to two sons conceived through IVF, believes the financial burden of ongoing storage costs may be leading women to “quietly abandon their embryos.” But her own story reveals something deeper. Upon realizing that she was done bearing children, there were three options before her. She could authorize her frozen embryos to be destroyed, sign them over to the clinic “for research,” or donate them to another woman for implantation. After months of agonizing, this particular mother opted for the “research” option because she couldn’t stomach the idea of her children being raised by a stranger. It’s easy to criticize her decision—and fair to wonder if there’s actually any difference between the destroy option and the research option, but we should all be able to agree that none of the choices are good ones. I’m pro-adoption, and love my adopted son more than life, but that doesn’t mean I’d want my own children to be raised by someone else. Adoption, by definition, is a tragedy. 

Nevertheless, if the only available options are destroying your offspring or entrusting them to another, shouldn’t the appropriate course of action be obvious? King Solomon certainly thought so, but we’ve developed a double standard when it comes to unborn humans. The same moral calculus that plagues aborting mothers is bleeding over to IVF mothers as well. In both contexts, adoption is considered a fate worse than death. That’s how Planned Parenthood, according to their just-released annual report, is able to perform 228 abortions for every one adoption referral. But there’s an additional layer of complexity in the realm of IVF. Most women who have abortions didn’t set out to get pregnant. IVF mothers certainly did—which makes the prospect of then placing for adoption that much harder to reconcile. These are not poverty-ridden girls desperate to make ends meet. These are women who often lay out forty, fifty, or even sixty thousand dollars to get pregnant. To turnaround and place their embryos for adoption might well feel beneath their dignity. What do they do instead? Large numbers of them, it seems, simply disappear. Rather than commit to the evil of destruction or the agony of adoption, they seek solace in abdication. In the absence of a single good choice, they absent themselves from making any choice—as if that excuses them from moral culpability.

To those within the IVF industry, embryo abandonment is a problem to be solved—a nuisance that costs them time and money. But I’m inclined to see it as a more fundamental indictment. If even the most successful IVF outcomes leave its participants in an inescapable moral quandary, isn’t that indication that something wrong is baked into the system? I’ve already referenced C.S. Lewis’ dystopian vision of the future. Nearly 80 years ago, That Hideous Strength warned of a time in which “[men] are so [insatiable] in their dreams of lust” that “real flesh will not please them.” Lewis may not have specifically foreseen a world of streaming pornography or AI sex bots, but he certainly had the gist of it right. He could envision a future in which real sex would be forsaken for a more stimulating and obscene fiction. In that world, Lewis wrote, children would be “fabricate[d] by vile arts in a secret place.” You see, for C.S. Lewis, the thought of creating children in a laboratory was sinister and grotesque—and yet that is what IVF does. Granted, children conceived through IVF are still grown in a human womb, but is our lack of moral repugnance towards this exceedingly unnatural procedure a sign of progress or decay? Carl Trueman recently observed the following to Andrew Klavan:

We have technology that can stop nature in its tracks, and we would say that’s a good thing. The question, of course, is where does the stopping of nature in its tracks [cease] being a good thing and become a bad thing? And I think to make that judgment, you have to have a normative understanding of what it means to be a human being. So, if you think that human beings normatively have two legs and a human being is born with one leg, I have no problem in providing that human being with a second prosthetic leg. We are restoring something that should be there but isn’t there. The question comes when you cross the line, I would say, from (the) restoration of true humanity into transformation to something that isn’t humanity. And that’s a difficult line to draw, I think. But we stand no chance of drawing that line unless we have some way of understanding what normative humanity is. And that’s a theological question. That’s not a scientific question. Science can tell you how. Theology tells you what.

Trueman was addressing transhumanism in general, but his remarks still apply to the more narrow “life enhancement” offered by IVF. On the one hand, IVF is restoring a normative human function—the bearing of children—to women who might not otherwise be able to conceive. On the other hand, it often transgresses normative human limitations in order to do this. The point Trueman is making is that though science tells us what we can do, it does not tell us what we should do. It can’t. Only God can do that—but if there is no God, then there is no “should.” That’s the point. Either there is a Creator who expects his people to uphold established moral standards. Or there is empty biology, where nothing is out of bounds. It’s no surprise that those who reject the existence of God would see nothing wrong with terminating the lives of tiny human embryos—be it through abortion or IVF. Why should we consider a microscopic human being to be more sacred than a grown cockroach? It’s all just a matter of scale and development. If there is no overarching purpose or plan, there is only possibility.

The IVF industry operates on the assumption that there is nothing immoral  about the mass destruction of tiny, genetically-distinct human beings. The only reason they’re reticent to destroy abandoned frozen embryos is because they fear legal trouble down the road. In theory, this part of their practice could be done away with. Even industry insiders criticize the wanton practice of inseminating 40, 50 or 60 eggs. “With the technology we have,” Dr. Allen says, “creating a large amount of surplus embryos is completely unnecessary.” But the IVF industry also operates on the assumption that there is nothing problematic about separating procreation from sex. That’s a premise that few of us have ever bothered to consider. Ostensibly, IVF was developed to help couples overcome fertility problems, which seems like a good thing. But it’s morphed into a means for single women and women in same-sex relationships to also have a baby. Is that a good thing? At the very least, it’s less good for the children raised in such contexts than if they’d been raised by their mother and father alike.

What percentage of IVF treatments are performed on women without a husband? Either nobody knows or nobody is saying. But we do know that IVF, along with intrauterine insemination (another sexless means of procreation) is explicitly marketed as a means for single women and women in same-sex relationships to bear children. A 2020 study published by Fertility and Sterility reports “a significant increase in single women undergoing IVF over the past twelve years.” These women “were significantly older than the general IVF population”—which hints at a whole separate problem. Women who forsake marriage and childbearing when they’re young often try to undo that decision in the end. As of 2018, heterosexual couples in the UK still made up 90% of all fertility treatments, but during the decade prior, IVF usage increased by 572% among same-sex women and by 160% for women without a partner. So you can see how things are trending. In China, which historically forbid unmarried women from undergoing IVF treatments, they are now so desperate for children that they’ve opened the procedure up to all women.

The number of human embryos who’ve been destroyed as a result of IVF is another unknowable number, but we can at least make an educated guess. It’s reported that somewhere between 8 million and 12 million children have been born as a result of IVF around the globe. We’ll go with 10 million. The likelihood of a successful live birth varies wildly by age, but USA Facts puts the overall likelihood at 37%. If we generously assign that percentage to the entire globe, that means somewhere around 27 million IVF treatment cycles have taken place. But how many embryos are being created for each cycle? That’s another number nobody seems to know or be willing to disclose, but Reproductive Medicine Associates (RMA) gives us some framework. Twelve mature eggs, they say, “are usually enough for one normal embryo.” As a rule of thumb, “the more eggs you have retrieved, the higher your chances of success.”

Twelve mature eggs, RMA reports, will lead to a live birth in 65% of all cases. This indicates that each egg increases the chance of success by roughly 5.4%. Since the average success rate in our model is 37%, that equates to something like seven eggs per cycle. So let’s multiply 27 million by seven. That gives us 189 million eggs. According to the Cleveland Clinic, only 70% of these will be successfully fertilized—which takes us down to 132 million embryos, minus the 10 million who were born. Some number of these embryos are still “alive” in cryogenic freeze, where they may be able to survive for 100 years. But only an estimated 75% will survive the thawing process. Other embryos were unintentionally lost during implantation, but this still leaves a staggering number. For every one child born through IVF, something like 12 “siblings” were lost to the process. Collateral damage. Biologically, these were not potential human beings. These were human beings, and they certainly weren’t part of any mother’s body since a majority weren’t even in a mother’s body when they met their demise. An entire industry has emerged, embryo adoption, because of the fact that embryos can survive independently of their biological mothers.

One hundred and thirty two million lives created; 122 million lives lost (or frozen). That is the secret, sinister cost of IVF. But since the perceived benefits are so terribly practical, we barely even notice. We look at the pragmatic advantages of being able to get pregnant without having sex and have sex without getting pregnant, but we fail to consider what is lost—or even destroyed—in the exchange. And I don’t just mean the embryos. Is it possible that there are metaphysical dangers to fundamentally altering the relationship between sex and reproduction? Is it possible that our blind sprint towards a sexless, childless future is not in our best interests? We cannot give IVF a moral pass for the simple fact that it sometimes leads to successful births. Rape does that too. I’m not saying that IVF is the moral equivalent of rape. I’m simply pointing out that we can and do draw distinctions between the justifiability of an act and its various outcomes. The value and legitimacy of a person’s life does not depend upon the circumstances in which they were conceived, but the mere fact that something results in a good outcome does not mean that the thing itself is good. As in everything, we must count the cost of our assisted reproductive technologies—and at least allow for the possibility that C.S. Lewis may have been right all along.