I have been following media coverage internationally and reading public opinion, and find the conversation pivotal in respect to women’s rights, children’s rights, taxpayers’ rights and religious norms. If the U.S. government wants to regulate how many embryos are implanted in each IVF cycle, they should mandate that all private insurance cover the procedure. Or, government should limit the number of dependents any parent can claim in order to receive taxpayer funds. I find it amusing to read about people advocating for mental health screening of women undergoing IVF but I’ve read no one suggesting mental health screening for all women, regardless of current number of children, marriage status or income, before they chose to become pregnant. Truly, doesn’t all reproduction represent a facet of narcissism, whether parents have one or fourteen children?
I live in the South, have one child and worked for the Catholic Church. I continue to pay for COBRA benefits while now working elsewhere. I am in my early 30s and pay $446 per month for health insurance which covers no infertility diagnosis or treatment. I have already paid out of pocket more that $6,000 for diagnosis and treatment, without conceiving again. I have never taken birth control pills for the purpose of preventing conception. How many obese, diabetic, alcoholic or otherwise unhealthy people am I supporting monthly by my health insurance payment, who do not support me financially in my health challenges? I have no other regular medical needs, save periodic eye exams. Being raised Catholic and being one of an enormous family, it is devastating to be unable to become pregnant again naturally, especially as my son’s father is one of an enormous family himself. The entire experience has turned me away from the Catholic Church, in that it is so willing to advocate funding (private and public) for everyone else's children's needs, regardless of how many they have, how fit they are to act as parents, or whether they are contributing to providing for their own families, but I have been told by a prominent Catholic bioethicist that to conceive children through IVF is a grave evil, a sin for which I'd have to make a good confession. .” Does that sound Christlike? “Forgive me, Father, for I have sinned. I have procreated with my spouse using the only two embryos we created. And I'm actually happy about it.” It is also hilarious to read about how many Catholics are ignorant about IVF and believe that for any couple to undergo the procedure at least one embryo must be destroyed. And, it somewhat defies logic when the Catholic Church maintains that God would be more pleased with my parenting decision were I to adopt frozen embryos from people unrelated to me, and become parents to them, rather than procreate with the biological father of my child. And how many Catholics willingly give up the possibility of becoming biological parents, to follow “Church teaching” while how many others undergo IVF or other unnatural procedures but still fill the pews on Sunday? While we have our hope and change president in office, I hope he acknowledges, along with the thousands of women seeking to destroy their fetuses, the thousands of women in this country that could become loving, self-sufficient mothers but who lack $12,000 to randomly spend on repeated IVF cycles. Having worked for years advocating for the rights of the poor, and thus finding myself primarily in that income bracket, I have become more and more cynical about our country and how public funds reward irresponsible behavior, with women, and men, knowing they can naturally procreate on the governments’ dime without having to seek permission from anyone, while we stigmatize the mothers who pay out of pocket for infertility treatment and then find themselves in need of taxpayer assistance. (And how many government jobs are built upon people making poor choices, such as social workers and prison staff? How many more teachers could countries employ if they didn't have to pay for staff at welfare offices and prisons?) Personally, I think a new parent needing government assistance should have the right to choose guaranteed childcare over guaranteed housing and food, as with stable childcare, a parent prioritizes their child’s physical and developmental needs and stability over the parent’s comfort. And, we assume, most parents had something to eat, and somewhere to lie at night, before they became parents. While Suleman's case in many respects is tragic, it does bring to glaring light the desperation of women to become mothers through such an expensive procedure, and the reality of the basic injustice in advocating for taxpayer funding of abortions but not taxpayer funding of fertility treatments for women that meet certain basic requirements for health and income.

I am not religious or follow any particular belief but I am 'donor' conceived. Without getting into my own particular POV on all of this I'd like to bring to your attention this commentary by Dr. Margaret Somerville (a bio-ethicist whose insights and thoughts I greatly admire). I believe SHE has the (secular) answer to this growing global issue.

Source: http://www.mercatornet.com/articles/view/society_and_artificial_reproduction/

MercatorNet
Society and artificial reproduction
Should the state assist with conception where it would not approve an adoption?
Margaret Somerville
Tuesday, 17 February 2009

"Two cases -- one in California, the other in Calgary -- involving the use of new reproductive technologies have been the focus of intense media attention recently.

Nadya Suleman, a 33-year-old Californian single mother, just gave birth to octuplets. She already had six children aged seven years or under and says all 14 children were conceived through in-vitro fertilization with sperm donated by a friend. The octuplets were delivered prematurely by Caesarian section and will likely spend several weeks in a neo-natal intensive care unit, at a cost of hundreds of thousands of dollars.

Ranjit Hayer, a 60-year-old Calgary married woman, just gave birth to twin boys conceived from donated ova and her husband's sperm. She had been trying for decades, including using reproductive technologies, to have a child, but until now had been unsuccessful. Canadian physicians refused her access to IVF because of her age, so she underwent this procedure in India and returned to Canada for care during her pregnancy and giving birth to premature twin boys. Both required special care -- one, neonatal intensive care -- and serious medical complications ensued for Ms Hayer.

What ethical questions do these situations raise? And what insights or lessons might they provide?

First, we need to distinguish between natural conception and conception where there is reliance on technology. It is one matter, ethically, not to interfere with a person's decisions regarding conceiving a child when that is a purely personal and private decision as it is with natural conception; it's quite another when society provides its resources to facilitate that outcome and the institution of medicine is involved.

With rare exceptions, such as the prohibition of incest or under-age sexual relations, when natural conception unassisted by technology is involved, personal autonomy and personal and family privacy must be given priority. In short, as Pierre Trudeau famously said, "The state has no place in the bedrooms of the nation."

When technology is involved in conceiving a child, we are, however, not in the bedrooms of the nation, but the laboratories, hospitals and clinics of the nation. And the creation of new human life is not an outcome of private love-making, but of actions undertaken by health-care professionals using research and facilities paid for with taxpayers' money. That means the state has ethical obligations, in particular, to ensure the protection and wellbeing of the future children who will result from those activities.

What are society's ethical obligations with respect to reproductive technologies? Despite the extensive work of the Royal Commission on New Reproductive Technologies in the 1980s and 1990s, and the passage of the Assisted Human Reproduction Act by Parliament in 2004, we still don't seem to have reached any working consensus in this regard. We have tended to equate the use of reproductive technologies to natural conception and birth and, more or less, to regard the former through the same ethical lens as natural conception.

Adoption as an ethical model

I suggest that is a mistake; natural conception and conception through reproductive technologies are more different than they are the same. Rather, I propose that our approach to adoption is a better model to guide the ethics of using these technologies, including because in both cases the resulting families are deliberately constructed with state assistance, rather than simply occurring naturally.

Adoption is a long-standing example, in which we have considerable accumulated wisdom, of society fulfilling its obligations to look after those of its members who are unable to look after themselves. The state is also complicit in adoption because it transfers legal parenthood from the biological parent(s) to the adopting parents. That complicity places obligations on the state."

Read full commentary here:
http://www.mercatornet.com/articles/view/society_and_artificial_reproduction/

As a scientist, who is Catholic, I am always surprised that in 2009 virtually no one has heard of natural family planning. It is completely natural, 2-4 times as effective as IVF (depending on the study) at a fraction of the cost, and based on cutting-edge knowledge of human endocrinology and physiology. I guess only making making technologies like IVF get much publicity .... One site to learn more would be http://www.fertilitycare.org/index.html

For many couples considering IVF as a method for conceiving children, natural family planning methods have proven ineffective. What answer does natural family planning offer to men who lack vas deferens or women with fallopian tube damage?

Until the Catholic Church comes out in full force in support of funding for research in reproductive organ transplant (not including ovaries or testes) the general public can assume The Church is not serious about supporting natural family planning for those who have reproductive challenges that prevent them from conceiving through sexual intercourse.

“The reproductive-technology industry is almost entirely unregulated.” (quote from article)

“Reproductive technology” is reproductive medicine, and the field of medicine is far from “almost entirely unregulated”. This field of medicine is just as regulated, licensed and overseen as every other area of medicine.

“Professional standards for the industry are primarily framed as guidelines and not enforced by law.” (quote from article)

This is similar to other areas of medicine. Guidelines are in place to set best practice standards in “average” cases, and also still allow doctors to treat patients as unique individuals with unique medical needs, and to not have to treat all patients the same without regard for their individual situations and needs. This is so that in most cases the patients gets the most appropriate care, not a cookie cutter treatment plan than might not be right for them. Are there times when individuals and individual doctors will make inappropriate choices and medical decisions? Yes, of course that will sometimes happen. People are flawed beings who make mistakes.

“Implanting multiple embryos, it has been believed, increases the likelihood that at least one will survive to birth.” (quote from article)

Embryos are transferred NOT “implanted” in the uterus during an in vitro fertilization cycle. There is a significant difference between these two things. Implantation is the biological process that needs to occur in order for a pregnancy to be established. Embryos are transferred in the hope that one will implant, and then continue the long journey to thrive and survive to a live birth. Multiple embryos are transferred to increase the odds of one of the embryos implanting. Most embryos (50-70%), through in vitro fertilization, OR in a “natural” cycle, are more likely to NOT implant and survive than to survive.

“I would like to see a healthy debate on a ban of the transfer of more than two embryos, as well as on “selective reduction.” (quote from article)

Banning the transfer of more than two embryos in any individual case is taking the autonomy of personal medical decisions away from individual patients, and restricting doctors from treating their patients as unique individuals with unique medical needs. Would patients in any other field of medicine be okay with their medical choices being severely and unfairly restricted in a reactionary ban due to a couple of high profile rare cases of poor judgment? It is highly inappropriate to restrict individual medical choices because there will be a few cases that are lacking in sound judgment (such as the Suleman case). There is no doubt that sometimes poor and questionable decisions are made in the field of reproductive medicine, but this is also true in all areas of medicine (and in parenting).

While to people who have never undergone medical fertility treatments, and do not fully understand in detail the entire medical process involved, restricting all embryo transfers to two embryos for every case likely sounds reasonable. Often it is a reasonable guideline and one that is followed. But there are times when it is an appropriate, reasonable and medically sound choice for a patient and their doctor to choose to transfer more than two embryos in an in vitro fertilization cycle.

Further to that, wanting to ban “selective reduction” is wanting to ban abortion. That is a complex issue that should not be quietly slipped into the in vitro fertilization discussion. While I think everyone is in favor of reducing abortions (and selective reductions), sometimes it is medically necessary, and beyond that, it is a very personal, emotional, and spiritual decision that needs to be kept as such.