Part 2 of a 2-part series. View Part 1 here.

Without Francis Schaeffer, the pro-life movement as we know it today would not exist. When the Supreme Court released its 1973 Roe v. Wade decision, most Protestants did not put up a fight. At that time, the abortion debate had largely been confined to the Roman Catholic Church. Even the Southern Baptist Church, among others, had entertained legislation in support of abortions in 1971, 1974, and 1977, and opposed constitutional bans.

All of this changed with Francis Schaeffer. Through his books, lectures, and films, he wielded considerable influence over the moral imagination of American evangelicals. Although he never assumed a direct leadership role within the pro-life movement, his efforts galvanized Protestants into a potent political and social force that swiftly elevated the protection of unborn life into a national issue. 

Decades later, this collective momentum elected President Donald Trump in 2016, which led to the appointment of new Supreme Court justices, and ultimately, the landmark decision to overturn Roe in Dobbs v. Jackson in June 2022.

Despite this pro-life victory, however, when it comes to the use of reproductive technologies like IVF and surrogate motherhood, Protestants once again find themselves at a crossroads. Much like in the 1970s, while some courageous leaders within Protestant churches are actively engaging their congregations on this issue, many still lack a clear position and are being blown around by the winds of the world. There remains substantial work to be done. 

It is past time for Protestant denominations to carefully examine the use of assisted reproductive technologies, namely in vitro fertilization (IVF) and surrogate motherhood. Biblical ambiguity or a lack of thoughtful teaching—particularly on issues related to the creation, gestation, and birth of human life—do a disservice to the church and lead people into confusion or sin.  

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In a previous piece, I delved into what protestant denominations teach about reproductive technology and offered a biblical and theological review of infertility and procreation. Here, I expound on this argument by providing practical examples of how to assess the merits of reproductive technology and offering some brief recommendations for how Protestant denominations may approach these issues. 

A Basic Review of Assisted Reproductive Technology

When a couple experiences infertility, doctors commonly rely on treatments within assisted reproductive technology (A.R.T.) to address the issue. Assisted reproductive technology refers to all infertility treatments that handle human eggs or embryos. This includes IVF, gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), and frozen embryo transfer (FET). In all, these treatments make up 99% of reproductive technology treatments. Each requires or is a variation of IVF. Notably, fertility treatments that only deal with sperm, such as artificial insemination and intrauterine insemination (IUI) do not fall under this definition. 

IVF, as it is commonly practiced, involves the creation of many embryos to increase the couple’s likelihood of conceiving a child. Given how time-consuming and costly a single round of IVF is—to the tune of $15,000-$30,000—most clinics prefer to create many embryos at a time. In many cases, couples find themselves with more embryos than they want or need. Once created, clinicians routinely practice preimplantation genetic testing to determine the health of a given embryo. This also reveals the sex of the child and other secondary features such as hair, eye, or skin color. From here, parents may choose to implant the embryo(s), destroy the embryo(s), or freeze them indefinitely. The presence of over one million frozen embryos and counting in the United States alone suggests that many parents find themselves in an unenviable position to decide whether their children live or perish. 

Among theologically orthodox Protestants, there is a divide between two groups. Some protestants approve of limited use of IVF, should the parents use their own sperm and egg and use all the embryos created without destroying, testing, or indefinitely freezing them. Conversely, others view IVF as a violation of the “package deal” of marriage, sex, and procreation, and thus oppose it under any circumstances. 

To parse through and judge the merit of these claims, it is necessary to understand the nature of technology itself. 

Technology and Personhood

When it comes to the study of technology, Christians can learn from thinkers such as George Grant, Marshall and Eric McLuhan, Pope John Paul II, Oliver O’Donovan, Jon Askonas, and Mary Harrington.

All these thinkers agree that technology may be understood as a material tool that humans use to build tangible structures and as a metaphysical force that shapes how human beings view the world. In other words, we shape our tools, and our tools, in turn, shape us. 

This is especially true of reproductive technology. 

One concern with assisted reproductive technologies is that it tends to treat nature as a raw material to be used for something. As John F. Crosby argues in his book The Personalism of Pope John Paul II, 

…there is also the modern passion to dominate the world and everything bodily by the means of technology. One looks upon the material world, and even one’s own human body, as nothing but raw materials for human making and manufacturing; everything in nature received its meaning only from what man chooses to do with it. As a result, we come estranged from our body, looking at it as an object over against us.

Crosby’s concern, especially with IVF and surrogate motherhood, is that “the bodies of the man and woman are simply used as a source of biological materials” that may be extracted, built, rebuilt, and discarded as it is useful for the larger project. Here the view of the human person as worthy of inherent dignity and support is lost as children, and the purpose of all human beings, are treated as a means to an end. 

All that said, Protestants should be careful not to fall into a rejection of technology for its own sake. Neither should they, in their delight or distraction, tacitly embrace whatever technological advancements are thrust upon them. The outright rejection of technology is no more virtuous than the passive acceptance of it. Instead, the first step is to pay attention to it. 

Two Models on How to Assess the Merits of Assisted Reproductive Technology 

Drawing from Anglican ethicist Oliver O’Donovan and Canadian philosopher Marshall McLuhan’s frameworks for assessing the merits of technologies, we can begin to think more carefully about assisted reproductive technologies.

In Begotten or Made, ethicist Oliver O’Donovan argues that people should assess reproductive technology based on whether it restores or circumvents the body’s natural order. This analogy has its limitations, nonetheless, it is useful to consider here. 

For example, let’s imagine a couple experiencing infertility. There are two approaches a doctor can take. First, the doctor can address common underlying causes of infertility like endometriosis and polycystic ovary syndrome through medical treatments, such as hormone therapies or surgical interventions. This approach aims to restore the natural procreative function of the persons involved. 

If the couple is still unable to conceive, they may turn to reproductive technologies like IVF and surrogacy. Applying O’Donovan’s framework reveals that neither IVF nor surrogacy directly addresses infertility’s root causes nor do these treatments restore the body to its natural function. Both circumvent infertility by offering an alternative route to parenthood. 

Interestingly, when couples turn to IVF without first addressing the underlying cause of infertility, such treatments have much lower success rates, with much higher ethical costs, than basic treatments within restorative reproductive methods.

Imagine if a doctor took this one step further and used this technology to create and implant embryos for otherwise fertile adults. Who—for reasons such as their desire to select the best embryo, their fear of pregnancy, or their relationship status as a same-sex couple or single person—may choose not to bear children naturally. Such technology would not only circumvent their body, but it would reveal that such reproductive technology is a means of industrialized wish-fulfillment. 

A healthy use of technology empowers a person to achieve what is biologically natural and good. An unhealthy use of technology harms, dehumanizes, or rejects the embodied self. Such use is not determined by one’s intention, per se, but by an honest assessment of the technology itself. 

There are situations where O’Donovan’s framework fails to capture the complexity of the issue. When medical advancements, such as artificial insemination, intrauterine insemination, or uterus transplantation, don’t fit neatly within O’Donovan’s framework, a four-part question put forward by Marshall McLuhan, Canadian philosopher and author of The Medium is the Massage, is appropriate and useful. 

McLuhan argues that the medium is the message. This means that a given technology, in this case IVF and surrogate motherhood above, should be assessed not only by what it does (create embryos and gestate children for someone else), but by its “psychic and social consequences.” Using the example of the railway, McLuhan goes on to say, 

For the “message” of any medium or technology is the change of scale or pace or pattern that it introduces into human affairs. The railway did not introduce movement or transportation or wheel or road into human society, but it accelerated and enlarged the scale of previous human functions, creating totally new kinds of cities and new kinds of work and leisure… 

This fact merely underlines the point that “the medium is the message” because it is the medium that shapes and controls the scale and form of human association and action. The content or uses of such media are as diverse as they are ineffectual in shaping the form of human association. Indeed, it is only too typical that the ‘content’ of any medium blinds us to the character of the medium.

Armed with both the Bible and reliable medical knowledge, one can ask these four questions about any given fertility treatment: 

• What does it enhance or intensify? 
• What does it render obsolete or displace?
• What does it retrieve that was previously obsolesced?
• What does it produce or become when pressed to an extreme?

Each question prompts one to consider the ways a given technology shapes society’s moral imagination. Indeed, our use of reproductive technology can shape us in ways that are often contrary to our created good and detrimental to our spiritual health. For reference, a good example of this framework applied to the Pill may be found on Mary Harrington’s Substack. Given that IVF is a prerequisite for surrogate motherhood, I will consider them together. 

So, what do IVF and surrogacy enhance? 

• A person’s ability to create and bear children when experiencing infertility.
• A doctor’s (potential) ability to edit the genetic make up of embryonic life, including the child’s physical features, intelligence, and personality traits. 
• A person’s ability to conceive a child that they otherwise, given their choice of partner, medical sterilization, or relationship status, would be unable to naturally conceive (i.e. same-sex couples, transgender persons, or a single person).
• The ability to conceive, gestate, and raise multiple children simultaneously without the “delay” of waiting on one woman to conceive and carry a child for nine months and recover before going again (i.e. Andrew Tate’s comments on this topic or the family in Georgia who has 22 kids and counting, with 20 of them born over one year alone).

What do IVF and surrogacy displace? 

• The “package deal” of marriage, sex, and procreation. Such technology decouples marriage from sex, sex from procreation, conception from pregnancy, pregnancy from motherhood, and biology from parenthood. 
• Motherhood. Motherhood is reduced to surrogate motherhood, and the surrogate mother is reduced to a nameless, sexless gestational carrier. 
• Childbearing. Childbearing becomes child-making. 
• Natural conception.

What do IVF and surrogacy retrieve? 

• Concubinage, or the reduction of another human into certain parts of their body (i.e. a woman’s womb, egg, or man’s sperm).
• The view of children as the property of their parents.
• A form of slavery, especially of women in foreign countries, who are subjected to invasive contracts—that usually include a “reduction of fetus” abortion clause and restrictions on lifestyle—for the purpose of providing a child. 
• Israel’s worship of Asherah, the goddess of fertility. Perhaps there is only a difference in kind between Israel’s fornication before Asherah and sperm-donation clinics where men are given pornography and cups to produce sperm for IVF cycles. 

What do IVF and surrogacy produce when pressed to an extreme? 

A detached and AI-driven assessment of which children are fit to live and which children are unlikely to “thrive” based on possible genetic illness, disease, or inconvenient timing.

Ectogenesis, such as artificial wombs, as a preferred alternative to natural childbearing and even surrogacy. 

Asexual reproduction. In vitro gametogenesis (IVG) enables scientists to reprogram adult skin cells into reproductive material such as viable egg or sperm, thus removing the need for egg and sperm “donation”.

A preference for pre-screening all possible human life prior to pregnancy to save money on future genetic therapies, treatments, or other medical care once the child is born.

The requirement that persons provide their genome sequencing or other genetic information to employers, health insurance companies, or to future spouses to assess whether their genes are acceptable or not. 

Considering the “psychic and social consequences” of IVF and surrogate motherhood in this light it is not hard to imagine the “Brave New World” possibilities that are already upon us. 

As the answers to the question above draw out, the use of IVF or surrogate motherhood, even with the best intentions, introduces a radical change in how humans think about childbearing. 

Given these inescapable concerns, protestant denominations should strongly consider putting limitations to reproductive technology in place. They have a strong scriptural foundation to do so. While the Bible does not deal directly with IVF as we understand it today, there are many examples where God encourages or limits the development of technology for the well-being of humanity. 

This is apparent in His intervention at the Tower of Babel. God is, it seems, a technological realist when it comes to understanding man’s fallenness and the need to limit technology.

And the Lord said, “Behold, they are one people, and they have all one language, and this is only the beginning of what they will do. And nothing that they propose to do will now be impossible for them” (Genesis 11:6, ESV)

God intervenes in mankind’s limitless pursuit of technological progress. He does so to protect them from idolatry and stagnation in a singular, but misguided, pursuit of heaven. Where humans desired to reach God and gain immortality, God promised to one day dwell among men and women to bring them everlasting life. To achieve this, however, God confused their language and compelled them to spread out and fill the earth; the very thing that God blessed mankind to do at the beginning.

Specific Guidance for Christians as They Navigate Infertility and Reproductive Technology

It is no longer sufficient for Christians to rely on broad or permissive guidance when it comes to the use of reproductive technology. Protestants need firm and well-articulated guidance that provides wisdom amidst a growing list of treatment options, comfort and clarity when treatments that promise to create a beloved child must be avoided, and courage to seek God’s honor and glory in how we use our bodies. 

2 Timothy 3:7 admonishes Christians who are “always learning and never able to arrive at a knowledge of the truth.” Ambiguity and open-mindedness are not the fruit of wisdom, especially when we’re talking about the creation of human life.  

My prayer is that this piece, and the one prior to it, spurns Protestant denominations onward in their own close study of this issue such that they may offer firm guidance that arrives at a sound knowledge of the truth.

Prioritize Marriage and Children

One aspect of this conversation that is unavoidable is the number of Christian couples who wait to have children until later in their childbearing years. For some, this is because they did not get married until later in life. For others, the demands of a career, caring for an older family member, sickness, or a desire to prolong the freedom and flexibility of childlessness filled their early years of marriage. 

Moreover, the long-term use of hormonal contraceptives and IUDs can often contribute to a woman’s difficulty getting pregnant once she stops using them. These factors, in turn, drive the demand for IVF or other invasive fertility treatments. When we delay, by our own volition or out of necessity, the normal patterns of nature, many unexpectedly find that conceiving a child later in life is much more complicated than they previously thought. Unfortunately, IVF does not provide a reliable alternative. For example, according to the Centers for Disease Control and Prevention, IVF is only successful 10% of the time in women 40 and older. 

While recognizing that some situations are indeed outside of a couple’s control, Churches would do well to actively encourage their congregants to go on dates, pursue marriage, and have children sooner rather than later. One non-denominational Church in Washington, DC where many of our friends attend boasts a high percentage of single men and women in their 20’s and 30’s. After hearing one of my friends who attends this Church complain about the dating options in DC, I asked her how often the Church had encouraged young people to prioritize and pursue marriage. She could not think of a single instance. 

Christians need to learn how to be an attractive prospect, but we also need our Church’s extolling the joys and benefits of marriage and childbearing in such a way that it encourages people to actively pursue these things. 

The integrity of human life.

Protestants affirm that life begins at conception, not merely at the implantation of a fertilized egg. Even at their most vulnerable stage, these undeveloped human beings are created in the image of God (Job 10:9–11; Ps. 41:5; 139:13–17; Jer. 1:5; Luke 1:41–44). Because of this, any procedure or treatment that destroys or violates the dignity and life of an embryo is morally and theologically abhorrent; such things should not be found among Christians (Deuteronomy 18:10-14, Ephesians 5:3). 

This unwavering commitment to protect embryonic human life is a necessary but insufficient stance for Protestants to take in their use of reproductive technology. IVF and surrogate motherhood pose much larger moral quandaries beyond whether doctors destroy or preserve nascent human life. Indeed, these technologies reshape our moral imagination in ways that must be accounted for in our theology and biblical counseling.

IVF and surrogate motherhood, as expounded upon here and here, routinely destroy or violate embryonic human life. Further, with the little we know from studies now, children born from IVF have higher rates of autism, cancer, minor physical deformities, and other chronic illnesses. Not to mention the rampant loss of a biological or social mother or father that accompanies these practices. 

As bioethicist Oliver O’Donovan argues, “There is a world of difference between accepting the risk of a disabled child (where that risk is imposed upon us by nature) and ourselves imposing that risk in pursuit of our own purposes.” 

Marriage, Sex, and Procreation are a package deal. 

Marriage, from Genesis onwards, is set apart in the Bible by its unity and exclusivity between one man and one woman. From within and through this bond, Christians may observe the threefold purpose of marriage—the procreation of children (Psalm 127:3), mutual comfort (Genesis 2:18), and protection from temptation (1 Corinthians 7:9). 

Further, key passages throughout the Old and New Testament further emphasize this biblical vision of marriage, sex, and procreation as an unmediated “package deal.”

For example, Malachi 2:15 ties each together saying, 

Did he not make them one, with a portion of the Spirit in their union? And what was the one God seeking?  Godly offspring. So guard yourselves in your spirit, and let none of you be faithless to the wife of your youth.

Malachi describes marriage, sex within the bounds of marriage, and godly offspring together as a singular but multifaceted vision of what God intends. Further, passages such as Genesis 1:27-28, Genesis 2:23-24, Mark 10:7-9, and Luke 20:27-40 each discuss marriage, sex, and procreation altogether in their consideration of what a natural and godly marriage consists of. 

Sin, which separates and divides what God ordains together, introduces a break in this unity if couples experience infertility. Nonetheless, infertility is a byproduct of sin entering the world and does not redefine God’s vision for the package deal of marriage, sex, and procreation. Indeed, it was only when reproductive technologies such as the Pill, IVF, and surrogate motherhood entered the picture that it became normal or understandable for marriage, sex, and procreation to be severed from one another. We shape our tools, and our tools, in turn, shape us. 

The very use of reproductive technologies such as IVF and surrogate motherhood, which circumvent and reinvent natural fertility, disrupt this “package deal” of marriage, sex, and procreation. This unmediated vision is one that the Bible both prescribes and describes. As McLuhan’s questions for technology reveal, IVF and surrogate motherhood reimagine childbearing and human nature itself. 

This is why the church accepts, and even encourages, adoption. It is not a treatment for infertility, but an act of charity toward a child whose biological parents are unable or unwilling to care for him or her. 

Given this discussion, it is important to note that the covenant of marriage is made between God, the man, and the woman. Even if God withholds the gift of children, the couple’s marriage is complete in the eyes of God and the church. Marriage is not an end in and of itself but the gateway through which such men and women pursue God’s calling in their lives. Children are certainly a blessing, but they are not a requirement if God leads the couple to a different set of gifts and responsibilities.

People are stewards, not owners, of their children.

Children are not products to be bought, sold, or designed. The fertility industry—unlike organ donation or adoption—is a highly lucrative business. Big Fertility is rife with flagrant human rights violations. Few regulations govern the use of IVF and surrogate motherhood in the United States; notably, this is at odds with the laws in most developed nations. As many activists and legal rulings have noted, the industry functions as a form of commercialized and contractual baby selling. 

For example, if a man purchases the egg, the womb, and the necessary paperwork, the line between a legitimate commercial surrogacy agreement, driven by unfortunate health circumstances, and outright baby selling dissolves. As Matthew Lee Anderson put it in his preface to Oliver O’Donovan’s Begotten or Made?, “to describe reproductive medicine and research as the industrialization of human fertility is not to invoke a metaphor, but to name a reality.”

Of course, it’s not wrong to pay for medical services that aim to heal or restore the human body. There is a big difference between paying for legitimate medical treatments and using medical technology to artificially create and birth human life outside of the bonds of marriage, sex, and procreation. In part, the fight against gender ideology has revealed a similar situation when doctors use medical treatments to transmogrify the human person. 

Protestants should think carefully about the message that IVF and surrogate motherhood send future generations. Children, who are first and foremost a gift from God, ought to be loved and accepted as they are, not because they fit the mold of a given parent’s desirable child. 

Children are not an act of the will, nor is reproductive technology a means of wish fulfillment. A culture that values and protects life is one where parents submit their own wishes to the wellbeing of children. That includes children who do not exist yet. Parents must faithfully steward all the good gifts God gives them, including children. 

Restorative Reproductive Methods

Thankfully, God is a God who loves to work in and through His creation. While not all cases of infertility can or will be resolved, Protestants have access to incredible methods to treat the underlying causes of infertility such as NaproTechnology (natural procreation technology), restorative reproductive methods, and the Creighton Model. 

>>> Exploiting the Vulnerable

Each of these rapidly growing approaches recognizes that infertility is not an ailment in and of itself but a term that doctors use to describe any number of issues within a man or woman’s body. The Centers for Disease Control and Prevention list many examples, including polycystic ovary syndrome and endometriosis in women and low sperm motility in men. By addressing the underlying causes of infertility, these methods achieve unparalleled success in healing the human body and enabling men and women to naturally conceive and bear children. 

For some women, who turned to these methods after multiple failed rounds of IVF, they were able to naturally conceive and birth a child in less than a year. 

Protestant denominations should embrace these methods that aim to heal rather than circumvent the natural body and God’s “package deal” of marriage, sex, and procreation. I have spoken to several couples in the Church who are understandably wary of IVF, and yet are equally hesitant to seek out natural restorative methods with a specially trained doctor. Christians would benefit immensely, it seems, from hearing testimonies of couples who pursued natural methods and having resources readily available from pastoral staff in the Church. Christians should pursue health and restoration of their bodies, not feel as though any such intervention is a form of “playing God.”  

The “What About When” Exceptions… 

I am sure that by this point a few examples have come to mind that make you wonder, are there any exceptions to these approaches? For example, what about a young woman who is diagnosed with ovarian cancer in her early 20’s (either before marriage, children, or both)? In these instances, freezing her eggs and using IVF to create embryos with her husband may be her only chance of having children. Or, what about the husband who, in preparing to deploy into a combat zone, freezes sperm in case a future injury prohibits him from naturally conceiving children with his wife? 

These situations require the utmost sympathy and pastoral care. Here, I will call upon theologians and Church leaders to make it a priority in their dedicated study of these issues, to consider how to respond in a way that is consistent with their larger approach to reproductive technology and with what the Bible says about marriage, sex, and procreation.  

It is time for Protestant denominations to pay serious attention to reproductive technology and invest in the hard work of subduing and taking dominion over it. Reproductive technology, whether we like it or not, is an inescapable part of the human experience. Moreover, its presence and widespread use shape the way that men and women think about children, whether they use the exact technology or not. Because of this, faithful Protestant denominations must employ wisdom and a firm commitment to God’s vision for procreation, sex, and marriage in their guidance on reproductive technology.