Thursday, December 11, 2008

Artificial Sex - The Whole Story

Warning: This post contains explicit information and frank discussion.

Some time ago, I posted this teaser and promised more on this subject. It is constantly on my mind, especially now as I currently have a baby to coo at and an active adoption discussion going on.

If you watch Discovery Health on cable at all, you will quickly be inundated with various baby-making alternatives to good, old fashioned sex. In vitro, artificial insemination, surrogacy, gay and lesbian parenting - everyone wants to have a baby of their "own" but nobody wants to eat the fruit born by, not trees....weeds (and I'm using that term loosely - anyone ever see Little Shop of Horrors? - I'm thinking more along the lines of that sort of vegetative beast). The most interesting thing to me is the church's silence on this issue. The Roman Catholics have the most to say publicly and for them I offer kudos but even they seem to merely whisper about these topics while screaming from the mountain tops about healthy marital relations, contraception and abortion. Abortion, you say? What does abortion have to do with any of this? Well, stick with me folks. This is plainly a Pro-Life issue in the broadest sense of the term. Anyone who cares about life at any stage of development should care about this issue.

I don't think any Christian would argue that God's original plan for conception, pregnancy and birth is one of beauty, wonder and awe. He clearly created a man and a woman to fit together - physically, spiritually and emotionally. The act of marital intercourse is designed for couples to be able to explore and enjoy nothing less than the inner life of the Trinity. Sex is more than a means to the end of producing a baby. It is the gift given to us by our Creator to share in the act of Creation. It is messy and wonderful and, most importantly, an act of love performed together, with the man and the woman equally involved in the process of creating life out of an act of love. Anything short of this, strips the spiritual from the clinical and demeans God's plan for marriage.

For Tad and I adoption was always an open discussion. I grew up with a spot in my heart that told me I would adopt children - with special needs. Tad grew up in a family formed by 3 homemade children and 2 adopted children. In his mind, that's how families grow - you birth some, you adopt some. Life was hard for us as a young, married couple. I was cycling through bi-polar phases at a rapid rate and in no shape to be a parent. Because of severe menstrual problems before we were married, I had been on a birth control pill to control my menstrual cycle and my moods, not to control conception. I didn't understand at that point the abortive effect of contraception. Nor did I understand the damage "the pill" can do to a woman's reproductive cycle.

As I began to heal emotionally and mentally we began to look forward to our first child. I went off the birth control pill and we began what would be an almost three year attempt to conceive. We took Natural Family Planning classes and were the only people I ever knew to fail them. My cycles were so off the charts that our instructor told me I was charting wrong when, in fact, she needed a better education in the issues surrounding infertility. When our foray into NFP produced no results except frustration, we ventured to a fertility "specialist" who tested us for such things as sperm motilitiy, count and viability and for me, hormone levels and the cycle of ovulation. At the end of it all we were told both of us had issues which would prevent natural conception. Diagnosis: Infertility.

We tried Clomid - an oral fertility drug - to regulate ovulation in my cycle. After about 3 months of that drug, it had only served to throw me back into an unhealthy mental state. At this point, we chose adoption. Neither of us had planned for infertility.
We had some grieving to do. While adoption was in our thinking, we had also hoped to be able to conceive children together. But, at the point when fertility treatments would have taken a turn towards the weird, we chose to build our family a different way. For whatever reason, God blessed us with a pregnancy when we clinched our decision to adopt. About 4 weeks after we brought home our first baby, JT, we found out I was 6 weeks pregnant with Ben.

All this to say that, yes, we do understand what infertile couples experience. I am not preaching from the side of inexperience, although the fruits of these questionable procedures speak for themselves no matter what your background.

Let's look at some of these techniques. The first course of action for an infertile couple is usually to try some regulating medications, such as the Clomid I took for a period of time. The idea here is that the body is hormonally out of whack due to inbalance of various body chemicals and the medication should kick start it all back into balance. This is a standard medical means of solving a problem. Diabetics are given insulin to control their blood sugar , we have thyroid medications, anti-depressants - all sorts of chemical solutions provided for us to help balance the body's natural functioning. It's when this fails to work that things get a little crazy.

After a few months' trial of these medications, couples are presented with the option of artificial insemination. For this procedure, the man's sperm is collected, "washed", separated and then implanted in the woman's uterus or fallopian tubes by a doctor. This is generally done if the man's sperm has a poor motility or a low count and, while still active and viable, may not be able to survive the trip through the woman's reproductive system. Most consider this as harmless as the medication route since it is a simple procedure, still uses the sperm and egg from both members of the couple and keeps the conception of a child within the mother's womb. How do those folks suppose, however, that the sperm is collected? The man has two choices - he can masturbate at home or he can do so in the back room of his fertility clinic.

When Tad and I were undergoing our fertility treatments we were completely unprepared for this part. Of course a sperm sample needed to be produced and I, for one, hadn't really thought through how that would happen. For the testing, we were sent to a room way in the back of the clinic where we found a treatment chair, a collection cup and a collection of pornographic magazines. No matter how you look at it, sperm are always required for conception to occur and, outside of intercourse, this can only be obtained through masturbation. Since masturbation itself poses no physical health threat, the threat here is purely spiritual and emotional. I'll leave that to your own judgement but I can say that being placed in a back room, with a rack of pornography, for a sex act performed by my husband which did not require my presence, left me to dip my toes into rather murky ethical waters. That feeling was enhanced when we walked up the hallway bearing our used collection cup and were met halfway by a nurse, who grabbed the cup from Tad's hands, tsk-tsked us for not leaving it in the treatment room and quickly ushered us out a back door into the parking lot.

So now the sperm sample has been collected and it needs to make it's way into the woman's uterus in order for fertilization to occur. I have never witnessed a doctor perform this procedure on a woman but I have seen a farmer perform it on a cow - up close and personal - and that just isn't pretty. At this point, the loving act of intercourse is replaced by a doctor and some sort of medical instrument. Essentially, the doctor assumes the role of the man in the act of conception, up to our ankles now in rather murky waters.

When this procedure fails to produce a viable embryo, the next step is in vitro fertilization which takes on many subtle variations. The word in vitro refers to the fact that fertilization is taking place outside of the womb, generally in a petri dish or on some sort of live culture - thus, the colloquialism "test tube babies". In the best case scenarios the sperm are collected from the husband, the eggs from the wife, they are combined using a couple of various techniques then reinserted as an embryo (fertilized egg - in other words, a viable human being) into either the woman's fallopian tubes or directly into the uterus. The exception to this would be Gamete Intrafallopian Transfer (known as GIFT) in which case the egg and the sperm are placed side by side in the fallopian tubes and allowed to fertilize themselves. I shudder at the thought of a human being being created in a shallow glass dish on a sterile laboratory table. Stripping the spiritual from the clinical to create life puts us on par with a base, animal, instinctive method of simply maintaining our population. The act of love has been morphed into a clinical procedure. Where are we to go from here?

As with artificial insemination, a third party - the doctor - is now involved in the act of procreation between a husband and wife. The waters muddy even more when the sperm or egg of the baby-seeking couple are provided by a donor. Egg and sperm donations are collected by the same means from third party donors and frozen until they can be used by the couple. Continuing to descend down this slippery slope, this looks to me an awful lot like adultery. The woman now has an egg and/or a sperm from a donor who is not her husband within her womb. In this case, of course, the child who grows from one of these embryos will have the physical traits of the donors, not the couple having the baby. If a woman's egg is combined with a donor's sperm the resultant child will have the same physical characteristics as if the wife had had intercourse with another man. At this point, I'm thinking...why not adopt?

Instead of adoption, however, a couple whose eggs and sperm are plenty good enough to conceive, but for whom the woman's body is not equipped to carry a baby, this whole procedure can be performed with a surrogate uterus. Egg and sperm are harvested from the husband and the wife, fertilized in vitro and then planted within the body of another woman who carries and delivers the baby and hands the child over after birth.

But wait, it gets even more complicated than this. While a normally fertile couple would conceive a single baby - perhaps against high odds twins or even triplets - multiple births are more normative with in vitro procedures. This is because the survival rate of the embryos is fairly low, so several embryos - as many as 6 or 7 - will be implanted in the woman with the hopes of maybe 1 or 2 surviving. If you agree that life begins at conception - that a fertilized egg, or embryo - is fully a human being - then you have to face what is happening with these tiniest of babies. They are being created - outside of the marital embrace, outside of the woman's body even - and then given little chance to live. In fact, extra embryos are intentionally created knowing that several of them will in all probability die before birth. Life is created in order to be sacrificed for the life that may or may not survive. The more morally conscious parents who use this procedure for conception, then, will insist on only creating as many embryos as they are willing to parent and will implant all embryos that are created. This is simply moral smoke and mirrors. If we pump enough smoke into our line of vision we can avoid the truth. Whether or not a couple is willing to parent triplets does not make it any more or less true that three embyros are being formed rather than one in the hopes that one will survive.

The descent into full darkness happens when couples want to create as many embryos as possible but only are willing to implant a few at a time. The remaining embryos are frozen, to be thawed and implanted if and only if the first round of in vitro fails to produce a viable fetus. If round one works and the happy couple now has babe in arms, those remaining embryos become a problem for them. Embryo storage facilities charge money to keep the embryos frozen until the couple may or may not desire to try again down the line (and give birth to a twin 2 or 3 years later?!). Many couples are not willing to pay these storage fees. Those couples have their embryos thawed and disposed of. This is a clinical abortion - the destruction of an embryo. Again, though, there are those who fashion themselves more morally conscious and so choose to place their embryos for adoption. Embryo adoption has become the pro-life solution to this rather convoluted problem. An adoptive couple is chosen by the embryo's "parents" (generally the term used in adoption would be birthparent but in this case the parents have not given birth to the baby) and the embryo is adopted according to procedures similar for regular adoptions. The adoptive couple then has the embryo implanted in the wife's body and gives birth to the child/ren with all the rights and responsibilities of an adoptive couple.

As a radical pro-lifer I have considered embryo adoption simply to do my part in allowing a frozen embryo to enter into the fullness of life. However, this brings up the same objections mentioned earlier to surrogacy and the use of donor sperm/egg. Another moral dilemma arises when we consider if giving an unborn baby the chance at life is balanced by the fact that doing so only perpetuates the creation of even more embryos to be dealt with later as couples use the option for a moral crutch.

Let's be brutally honest about what motivates this whole issue. I have had many friends tell me that once diagnosed with infertility, they were immediately referred for some sort of treatment. One couple I know even had the doctor on the phone with their insurance company before they were even given the opportunity to answer whether or not they'd like to pursue this route. That couple left quickly and eventually became adoptive parents. The doctors in this business stand to lose their livelihoods if people suddenly recognize the moral darkness woven through their line of business. Baby-making is literally their business and they don't intend to be out of work anytime soon.

For the couple, the motivation to go through all this is the opportunity to have a child of their "own". Those who have considered adoption gravitate toward infertility treatments out of a fear of the unknown. They may lose a child in process, they may adopt a child with needs they hadn't anticipated, and on and on and on. I have heard couples say that going through the hormone shots and all the other shenanigans necessary to maintain an in vitro pregnancy was the highest act of love they could give their spouse. Sadly, these couples are masking fear and selfishness with a convoluted idea of love. God gave us his model of love - marriage and the marriage bed. He also gave us a model for adoption should the sickness of humanity prevent child-bearing from the marriage bed. If we are not able to conceive in spite of what we "want" then perhaps God, in his mercy, has another plan for us and our family. In order to avoid the grief of a closed womb we choose to bypass it through the swamp of infertility options. It only muddies our shoes and dirties our hands and souls. Unfortunately our me-based culture has glorified those who make these decisions by granting them fame, fortune and bragging rights. John and Kate are probably wonderful people, but setting them up as an example to the nation of self-less parenting is misleading and dangerous.

I am thankful that God has seen fit to grant us children both through adoption and through the fruits of my own marital embrace. I am calling those who will never conceive to a higher calling than I myself have experienced but I challenge you to consider letting God stay in control of the baby-making business.


Pasifik said...

One thing missed on your post is your big family pictures....

Happy blogging,

Female Fertiliy|Infertility

Anonymous said...

I know exactly where you're coming from. My husband and I tried for four years to conceive with no luck. We did not feel comfortable with IVF because of many of the reasons you mentioned. We did, indeed, leave it in God's hands even thought we were distraught and saddened.
Eventually, and by God's grace, we ended up conceiving naturally and now have 4 children (two of which are identical twins).

magda said...

After finishing reading your post, I was struck by all the couples in the Bible (and even in fairy tales) who desperately wanted to have children, and could not until God granted them a child. This reminds me of my mother's story of how babies are made: "A man and a woman loved each other very much (and so they got married) and they asked God for a baby. And God said, 'Yes.' " This opened to me at an early age the immense idea that I was created by God's intimate part in the decision to make me. If we are asking science for children instead of asking God (Who is still necessary), when will we listen to His voice?

Mairs said...

Oh, Magda, what a wise woman your mother must be! I love her way of explaining it so simply.

Anonymous, I truly respect your willingness to enter into the pain and grief rather than bypass it and do what you wanted. Hopefully your story will be a witness to many of God's ways at work. And, I bet your twins were actually born on the same day!

Anonymous said...

Overall, good post. However, I would like to add that your comment about "The act of marital intercourse is designed for couples to be able to explore and enjoy nothing less than the inner life of the Trinity" is not 100% in accordance with the mindset of the Orthodox Church. Yes, there are some liberal theologians who ascribe to this theory but a Patristic understanding of this will lead you to another conclusion.

Mairs said...

Thanks, Anonymous. I do admit to being heavily influenced by Pope John Paul's Theology of the Body (much research done from the perspective of our pre-Orthdox experience). Dh and I are trying to look into a more Orthodox view of this and he's gotten slightly further on it than I. Have any good references from the church fathers and their Orthodox apologists? We would very much like to be aligned with the Orthodox mindset.

Gina said...

Thanks for this post. It confirms a lot of my thinking. We will probably adopt, since I think my body is not going to cooperate with a pregnancy.

The intuitive often works better here than overthinking things. I was recommended to go on BCP for health reasons, and after a couple weeks of taking them, stopped. I could feel that it was wrong. I'm sure there are women with more severe problems who are grateful for some regulation, but I'm an advocate of natural methods for more reasons than one.