Some brief Christian reflections to mark the birth of 5 million children by IVF

Over 5 million children have been born through IVF. The figure comes from a study, the first of its kind, into IVF statistics from countries around the world.

According to Bioedge, Researchers scoured government archives for information about how many women had used the procedure since its introduction and estimated that 900,000 children had been born after IVF in China alone.

Of all children in the world born by IVF, an astounding one-third of these children have been born in the past six years.

A lot of this has to do with increased success rates. IVF has enabled babies to be born to couples who would not otherwise have been able to conceive.

But on the other hand IVF has also opened what many regard as a Pandora ’s Box of genetic engineering, cloning, pre-implantation diagnosis, embryonic stem cell harvest and animal-human hybrids. 

The demand has also been fuelled by the rising levels of infertility which are exacerbated both by sexually transmitted disease (leading to tubal damage) and women delaying attempting to have children until such time as their natural fertility starts to drop off. Women wrongly assume that IVF is a good fallback solution when in fact the success rates are 40-50% for the under-35s, dropping to 20% for the under-40s and just 5% for women aged up to 43.

There are over two million infertile couples in the UK (one in seven) and infertility can carry real stigma. Infertility can result from defects in the production, release or transport of egg or sperm and successful treatment depends on accurate diagnosis. The range of treatments and their speed of development is bewildering, and not all couples need IVF: other common treatments include artificial insemination (AI), intracytoplasmic sperm injection (ICSI) and gamete intra-fallopian transfer (GIFT).

In IVF (in vitro fertilisation), sperm and eggs are brought together in a petri dish, and resulting embryos are then transferred into the womb. There is a high failure rate (75-85% per cycle overall) and the treatment costs of £2,500 per cycle will exhaust the resources of many of the couples who are unable to get NHS treatment. As highlighted just last week a couple is likely to have spent something of the order of £15,000 for the three cycles it is likely to have taken should they be fortunate enough to become pregnant. IVF heartbreak is real.

The emotional roller coaster of raised hope and dashed expectation is another important cost to be counted; but I believe the most important decisions Christians need to make involve honouring embryonic life and upholding the marriage bond. We should not seek a child at any cost (Romans 3:8).

Some IVF programmes involve the production of spare embryos, which are then used for research, disposed of, or frozen for future use. Freezing compromises embryo survival and there is a high chance that frozen embryos will never be used. Other programmes involve screening out embryos or fetuses with congenital disease either before implantation or later in pregnancy.

Our society thinks that because human embryos are small, weak and physically insignificant they are expendable. But this is at odds with the God’s loving grace, which sees even the weakest of human beings as precious, and worthy of wonder, love, respect and protection.

The other key question to consider is whether the use of donated eggs or sperm somehow violates the marriage relationship. Clearly using donor gametes does not involve sex outside marriage nor the cheating nor lust aspects of an adulterous relationship.

But marriage is a spiritual, emotional and physical union in which two become one and donor eggs or sperm inevitably introduce a third person that will be genetically related to the child, but play no part in their upbringing. And the child will be biologically related only to one, or perhaps neither of his or her parents.

So my own guidance is that prospective parents considering IVF should carefully count the economic and emotional cost and seek treatments that both respect the human embryo and also honour the marriage bond.

Some infertile Christian couples will go on to conceive, either naturally or with ethical infertility treatment, after a period of waiting. But this does not happen for all, and God in his wisdom has left some couples childless despite good treatment and patient prayer. 

Perhaps this is to ensure that there are couples with a strong desire to be parents, who can either adopt children, serve others’ children in some way or be freed up for some other special purpose which God has for them.

These comments are based on a longer article in Nucleus, which can be accessed here

Those wanting a more in depth review of the issues can’t do much better than Fertility and Faith by Brendan McCarthy (IVP, 1997, ISBN: 0851111807)

The Evangelical Alliance Home for Good campaign on adoption and fostering is well worth supporting. 

See also 'A new IVF milestone' by Philippa Taylor

Time lapse imaging of embryos – exciting breakthrough or just eugenics by another name?

Various media outlets (including The Times (£), The Telegraph, BBC, The Independent and The Guardian) have published articles reporting on how fertility specialists from Nottingham have developed a radical technique that will ‘dramatically improve’ the chances of IVF couples having a baby.

The original research appears in Reproductive BioMedicine Online.

About one in eight couples have trouble having children through natural conception and around 48,000 women currently undergo IVF treatment each year resulting in about 12,200 IVF births, an overall success rate of 25%.

This failure rate of 75% causes immense emotional upset to affected couples, many of whom have paid between £5,000 and £10,000 for each treatment cycle.

However the new  procedure, which uses ‘time-lapse imaging’ to monitor the health of embryos by taking thousands of digital pictures to identify ones that are developing well, could raise the chance of a live birth to 78%, about three times the national average.

The new technique identifies the ‘best embryos’ to be implanted into the womb based on the time it has taken to develop between two key stages in the early life-cycle of the embryo.

Thousands of time-lapse pictures taken during the first few days of an IVF embryo's life are used to identify the time between the first appearance of the fluid-filled cavity, called the blastula (normally 97 hours), and the full blastocyst (122 hours).

In embryos at high risk of aneuploidy (extra chromosomes) these steps occurred about 6 hours later on average. Aneuploidy is the single biggest cause of IVF failure.

To test the system, the doctors ran the program on time-lapse images of 88 embryos that had been recorded previously for 69 couples at the clinic. Some 61% of the embryos ranked as low risk for abnormal chromosomes led to live births, compared with none of those ranked as high risk.

Around a dozen private and NHS clinics are currently using time-lapse embryo imaging. It costs around £750 in addition to about £3,000 for IVF.

The £750 cost compares favourably with the current cost of £2,500 for Pre-implantation Genetic Screening, an invasive test which removes cells from the early embryo for analysis.

If the new imaging test proves to be effective in larger trials it seems likely that it will be used much more widely.

What is singularly lacking from any media coverage of this research however is any discussion of the ethics.

Not only does it seem to be taken for granted that the improved success rates override any ethical objection. There is simply no ethical objection even considered.

But let’s think about what is actually happening here.

Embryos are being created in a laboratory and those with aneuploidy are being identified and discarded.

Some of these will have the commoner trisomies (three rather than two copies of a particular chromosome) – Down’s syndrome (trisomy 21), Edward’s syndrome (18) and Patau’s syndrome (13) – where affected babies are often born alive.

Some will have other trisomies (like trisomy 15, 16 and 22) and inevitably will either fail to implant or result in miscarriages.

So is it right to implant those embryos more likely to survive and throw away the others?

Well that surely depends on what these tiny organisms actually are.

They are undoubtedly individual human lives, but what status do they have? Are they potential human beings or are they human beings with potential?

Philosophers like Singer, Glover and Harris will tell you that they are alive but non-persons because they do not yet have functioning nervous systems.

But others, who would argue that human life from the time of fertilisation should be shown the utmost respect and afforded protection would say that every living human organism – no matter how young, old or disabled and regardless of its intellectual capacity – is also a human person with rights.

I know what I think, but what do you think and why? They are either persons or not persons. Which is it?

Is this new technique the 'most exciting breakthrough in IVF treatment in 30 years'? Or is it just eugenics by another name?

It makes all the difference in the world.

IVF for gay couples financed by the tax payer is actually the next logical step

The Telegraph this morning reports that more gay couples and women over the age of 40 are to be given fertility treatment on the NHS, despite claims that the health service cannot afford it (See BBC report here)

According to the Telegraph, under an expansion of NHS-funded fertility treatment, the National Institute for Health and Clinical Excellence (NICE) will recommend that lesbian couples be offered six cycles of artificial insemination and, if that fails, IVF.

There were just over 1,000 cycles of insemination performed for women in same-sex relationships in 2010, resulting in 152 babies. The number of cycles of IVF for this group rose from under 100 in 2009 to 561 in 2010, resulting in 215 babies. Most of these couples however paid for treatment privately, where a cycle of IVF can cost them £8,000.

Given that the NHS is having to find £20 billion of efficiency savings over four years because flat-rate budget increases are not enough to cope with increasing demand, this means that local clinical commissioning groups, which make the final decision on fertility provision in hospitals, will be unable to afford the extra treatment without making drastic cuts to other services.

Does it strike you as odd that in a time of economic recession NICE is recommending that our tax money through the National Health Service, pays for a lesbian woman, who is suffering from no illness, is not infertile and wants to become pregnant but does not wish to have sex with a man, to have artificial insemination or IVF?

This latest move has, perhaps understandably, generated a lot of controversy, but in fact is the next logical step following from presuppositions that we have already accepted as a society.

Having turned our backs on the Judeo-Christian worldview and ethical framework, decisions in healthcare are increasingly now taking place in an ethical vacuum where the principle drivers are autonomy, technology, commerce and relativism.

Autonomy says ‘we want it’. Technology says ‘we can do it’. Commerce says ‘there are purchasers and providers’ and relativism says ‘why not?’

The Human Fertilisation and Embryology Act 1990 started from two ethical presuppositions.

First there was the assumption that human embryos are not human beings and so can be used as a means to an end – meaning that they can be experimented upon, frozen or destroyed.

Second was the belief that gametes (egg and sperm) need not be used only within the marriage bond but can be bought, sold, shared with and given to others.

If we combine these ethical starting points with the beliefs that marriage, gender and reproduction are simply arbitrary social constructs which can be reshaped and redefined by social consensus then human demand, economics and technology become the only limitations on what can be done in human reproduction.

Equality law will then ensure that everyone who wants a given technology, regardless of marital status, gender or even degree of infertility, must be treated equally.

If married women whose husbands are infertile can use donated sperm then why can’t single women or lesbians? If married women who can’t produce their own eggs (for whatever reason) can used donated eggs then why can’t single women or lesbians? Similarly why can’t gay men use both donated eggs and a surrogate to carry the baby? 

And if lesbian women, who are fertile, choose to use donated eggs and IVF, then what is to stop single and married women, who wish to avoid either sex or pregnancy from dong the same? And if married couples can have a certain ‘treatment’ funded by the taxpayer, isn’t it discriminatory to bar others, whether gay or straight?

As technology develops further, and egg and sperm can be artificially manufactured from ordinary body cells, it will be possible for lesbian couples to generate their own sperm and eggs and produce babies that are genetically related to their parents. And gay couples will be able to do the same with the help of a surrogate, or perhaps even transplanted, uterus. We should expect these extensions of practice now and not be surprised when they occur.

If these things alarm us, then rather than simply reacting to the latest developments we should be going back to examine the set of presuppositions that brought us to this point and examining those.

In this connection I have previously put forward a Christian framework for infertility treatment which I believe respects both the sanctity of human life and the integrity of the marriage bond.

But the other real questions we should be asking are about the real drivers of this new technology. 

Why are levels of infertility increasing so dramatically and why there are so few babies available to adopt? It's not rocket science.

Three parent embryos for mitochondrial disease – more media hype than real hope

The BBC reports this morning that a controversial fertility treatment which creates embryos from two women and one man to prevent life-threatening disorders is ethical. Children born through 'three-person IVF' would contain some genetic material from three people.

The UK's Nuffield Council on Bioethics has said the technique could free children from 'very severe and debilitating disorders'.

There are about 50 known mitochondrial diseases, which are passed on in genes coded by mitochondrial (as opposed to nuclear) DNA. They range hugely in severity, but for most there is presently no cure and little other than supportive treatment.

It is therefore understandable that scientists and affected families want research into these two related ‘three-parent embryo’ techniques (pronuclear transfer and maternal spindle transfer) to go ahead. But there are good reasons for caution.

This is not about finding a cure. It is about preventing people with MCD being born. We need first to be clear that these new technologies, even if they are eventually shown to work, will do nothing for the thousands of people already suffering from mitochondrial disease or for those who will be born with it in the future.

There are also already some alternative solutions available for affected couples including adoption and egg donation.

But apart from this I’m left with four big questions.

Will it work? I am sceptical. This technology uses similar ‘nuclear transfer’ techniques to those used in ‘therapeutic cloning’ for embryonic stem cells (which has thus far failed to deliver) and animal-human cytoplasmic hybrids (‘cybrids’). The wild claims made about the therapeutic properties of ‘cybrids’ by the biotechnology industry, research scientists, patient interest groups and science journalists duped parliament into legalising and licensing animal human hybrid research in 2008. Few now will remember Gordon Brown’s empty promises in the Guardian on 18 May that year of ‘cybrids’ offering 'a profound opportunity to save and transform millions of lives' and his commitment to this research as 'an inherently moral endeavour that can save and improve the lives of thousands and over time millions of people'. That measure was supported in a heavily whipped vote as part of the Human Fertilisation and Embryology Bill, now the HFE Act. But ‘cybrids’ are now a farcical footnote in history. They have not worked and investors have voted with their feet. Ironically, it was in that same Act of Parliament, that provision for this new research was also made.

Is it safe? No, each technique involves experimental reproductive cloning techniques and germline genetic engineering, both highly controversial and potentially very dangerous. Cloning by nuclear transfer has so far proved ineffective in humans and unsafe in other mammals with a large number of cloned individuals spontaneously aborting and many others suffering from physical abnormalities or limited lifespans. Also, as the Guardian noted last week, any changes, or unpredicted genetic problems (mutations) will be passed to future generations. In general, the more manipulation needed, the higher the severity and frequency of problems in resulting embryos and fetuses.

Is it ethical? No, there are huge ethical issues. A large number of human eggs will be needed for the research, involving ‘harvesting’ that is both risky and invasive for women donors. How many debt-laden students or desperate infertile women will be exploited and incentivised by being offered money or free IVF treatment in return for their eggs? How many thousands of human embryos will be destroyed? If it ever works, what issues of identity confusion will arise in children with effectively three biological parents? What does preventing those with mitochondrial disease being born say about how we value people already living with the condition? Where will this selection end? Some mitochondrial diseases are much less serious than others. Once we have judged some affected babies not worthy of being conceived, where do we draw the line, and who should draw it?

Is the debate being handled responsibly? No. The research scientists involved have huge financial and research-based vested interests and getting the regulatory changes and research grants to continue and extend their work is dependent on them being able to sell their case to funders, the public and decision-makers. Hence their desire for attention-grabbing media headlines and heart rending (but highly extreme and unusual) human interest stories that are often selective about what facts they present.

It must be tempting for David Cameron, like Gordon Brown before him, in a week when politicians are itching for good news stories, to make promises of ‘miracle cures’ in years to come which no one may remember. But I suspect it is much more about media hype than real hope.

This is being driven as much by prestige for government, research grants for scientists and profits for biotechnology company shareholders as anything else.

Let’s keep a cool head and instead concentrate on finding real treatments and providing better support for affected individuals and their families rather than spending limited health resources on unethical, risky and highly uncertain high tech solutions that will most likely never deliver.

Egg donation mania – probing beneath the journalistic hype

There are two stories about egg donation in the papers this week.

First is the HFEA’s drive to recruit sperm and egg donors. Apparently it is bringing together a National Donation Strategy Group to look at how to ‘raise awareness’.

The BBC gives an advertorial gloss to the story but the Daily Mail tells us that the payment to women donating their eggs for use in IVF has tripled from £250 to £750 this week and that the extra money on offer is said to have led to a five-fold increase in women approaching clinics to donate their eggs to infertile couples.

Under the change, egg donors will be given free treatment to retrieve the eggs plus a payment of £750 per cycle, no matter how many eggs are collected. Tempting during a recession and the question has to be asked, ‘how many of these women would choose not to take the risk if it were not for the money?’

It is noteworthy that the infertility industry in the United States has now grown to a multi-billion dollar business, its main commodity being human eggs. Young women all over the world are solicited by ads—via college campus bulletin boards, social media, online classifieds—offering up to $100,000 for their ‘donated’ eggs, to ‘help make someone’s dream come true.’

Second is the news that scientists in Edinburgh are intending to seek permission from the HFEA to fertilise eggs grown in a laboratory from stem cells. The tests are understood to be aimed at eventually generating an unlimited supply of human eggs that could assist women to have babies later in life.

Stories like these of course make alluring headlines and journalists reproducing uncritical press releases from those with vested interests seldom ask questions about the deeper ethical issues around egg donation – such as the health dangers of egg harvesting, the huge numbers of human embryos destroyed in the process of refining new techniques and the problem of children with confused identities and parentage as a result.

Even less do they ask the ‘elephant in the room’ question of why there is such a huge demand for donated eggs in the first place, but it is precisely that which I want to shed some light on.

The primary problems driving egg donation are the rising incidence of infertility and the huge decrease in babies available for adoption.

Infertility is the most common reason for women aged 20–45 to see their GP, after pregnancy itself. It is estimated to affect around one in six or one in seven UK couples – approximately 3.5 million people – at some point.

Around 1.5% of all births and 1.8% of all babies born in the UK are the result of IVF and donor insemination and 45,264 women had IVF treatment in 2010. These women had 57,652 cycles of treatment, an increase of 5.9% on the previous year. There were 12,714 babies born in 2009 as a result of IVF treatment using women’s own fresh eggs.

There are of course many different treatments for infertility depending on the cause and only a small percentage of these use donated eggs but there were 1,506 treatment cycles with donated eggs in 2010 - and 593 children were born from donated eggs in 2009.

The latest figures (2009) show that 25.2% of IVF treatments using a woman's own fresh eggs resulted in a live birth but infertility in women is strongly linked to age.

The biggest decrease in fertility begins during the mid thirties. For women who are 35, 95% will get pregnant after three years of having regular unprotected sex. For women who are 38 the equivalent figure is 75%.

The following figures give the average success rate for IVF and ICSI treatment using a woman’s own fresh eggs in the UK in 2009.

•32.3% for women under 35
•27.2% for women aged 35-37
•19.2% for women aged 38-39
•12.7% for women aged 40-42
•5.1% for women aged 43-44
•1.5% for women aged 45+

Add to that the fact that women are delaying childbirth and having babies later and later and we see why there is such a high demand for IVF and donor eggs. In England and Wales, the average age at first birth was around 24 during the 1960s, compared with around 28 in 2009 (see graph of maternal age at birth in 2010).

Along with the increase in infertility there are fewer and fewer babies for adoption for two main reasons – abortion (which kills babies that might otherwise have been adopted) and state support for single parent families (which means that babies that would have previously been given up for adoption now are not).

There is currently only one baby adoption in the UK for every 2,235 abortions.

The new adoption tsar has tried so far unsuccessfully to promote adoption as an alternative to abortion but an in depth examination of UK adoption data reveals the following:

Total adoptions in England and Wales fell steadily from 22,502 in 1974 to 4,725 in 2009. Adoptions involving babies under one year fell from 5,172 in 1974 (23% of all adoptions) to just 91 in 2009 (2%). That is a huge reduction in baby adoption.

During the same period abortions on UK residents rose from 119,123 in 1974 to 203,444 in 2009.

The number of abortions on UK residents in 1968, the first full year after legalisation was 23,991. I can’t find an adoption number for that year but suspect it was considerably higher than 22,000.

There are also now three million children living in a single parent household (23% per cent of all dependent children).

Just over a quarter (26 per cent) of households with dependent children are single parent families, and there are 2 million single parents in Britain today. About half of these had their children outside marriage.

In 1971 just 8 per cent of families with children were single parent families but this had increased to 24 per cent by 1998 and 26 per cent by 2011.

So when you next read about egg donation, before jumping on the bandwagon and trumpeting it as a wonderful advance remember the deeper ethical issues (embryo destruction, health risks of harvesting, confused identities and commercial exploitation) and the societal changes (abortion, delayed childbirth and single parenthood) which have contributed to the demand.

Pre-implantation genetic diagnosis is too high a price for a perfect baby

Last week the European Society of Human Reproduction and Embryology (ESHRE) held its annual meeting in Stockholm, Sweden on 3-6 July.

Not surprisingly we had a number of stories from the papers presented at that meeting filtering into the media, the most notable of which was the Aberdeen study of the link between abortion and premature birth which I commented on last week.

However the BBC also ran a story which I initially missed titled ‘Gene dilemma to prevent next generation cancer’ reporting on the use of Pre-implantation Genetic Diagnosis (PGD) to screen IVF embryos for genetic disorders.

You may have noticed that Germany have just made it legal to use PGD to screen out embryos carrying disorders which are fatal to the baby during pregnancy.

However in the UK our policy is much more liberal and was liberalised even further by the Human Fertilisation and Embryology Act 2008. PGD has been offered by the NHS for more than a decade for serious diseases that come early in childhood (like Cystic Fibrosis, or Tay Sachs) but it is now also available for much less serious diseases. The first child born free of the breast cancer genes BRCA1 and BRCA2 by PGD was born only in 2009 but screening is now increasingly commonplace.

There are over 6,000 genetic disorders of varying severity and age of onset. Some result almost universally in miscarriages (eg. some of the trisomies), some are fatal in childhood (Tay Sachs), some fatal in adulthood (Huntingtons), others result in life-long disability (Down’s Syndrome) and some genes simply give you a high possibility of contracting a certain disease like cancer later in life (eg. BRCA). The problem is that Britain is moving rapidly down the slippery slope seemingly to screen out embryos with less and less serious conditions.

There is a huge moral difference between, on the one hand, testing prospective parents to see if they have particular genes and then advising them of the risk of having an affective baby (which if high enough might lead them rather to opt for adoption), and, on the other hand, searching out and destroying affected individuals either at the embryo stage through PGD or later in pregnancy through chorionic villus biopsy (at 8-10 weeks) or amniocentesis/ultrasound at 18-20 weeks.

Search and destroy techniques in the UK are increasingly common. Apart from the growing number of PGD cases there were almost. Statistics released just last week, revealed that between 2002 and 2010 there were 17,983 abortions on the grounds that there was a ‘substantial risk’ that the babies would be ‘seriously handicapped’ — known as ‘Ground E’ abortions. The overwhelming majority of these were for abnormalities compatible with life outside the womb.

The article describes a teacher from South Shields, Daniel Stanley, who lost his sister Natasha to breast cancer at the age of 28. Having been tested and found that he carried the same gene he and his partner Danielle were opting for PGD to screen out any affected embryos. Daniel is reported as saying that ‘having watched his sister, preventing that kind of suffering is almost a kind of duty’.

However there is a huge moral difference between on the one hand preventing or managing suffering in an affected individual, and on the other hand destroying that individual because it might suffer in the future.

The key question is, ‘is it better to live with the disability or have your life ended before you have lived at all?’ The overwhelming majority of disabled people would say that they would far rather have lived with their disability than not lived at all. So how can we presume to make that decision for others?

It seems that we have now reached the situation where we as a society are making the decision that human beings conceived with disability should not live either because we do not want them to experience suffering, or because having to care for them in their suffering would be a burden to others and society in general.

These cases of course raise serious questions about the status of the embryo and the nature of suffering.

My own view is that human embryos are human beings with potential worthy of the utmost respect, protection, empathy and wonder. The only difference between an embryo and you and I is nutrition and time. It follows that we should not be ending the life of a person with disability (or serious disease) before birth anymore than we should be doing it after birth.

The Christian ethic as exemplified beautifully in the life of Christ is that the strong make sacrifices for the weak or even if necessary lay down their lives for the weak. We are encouraged to bear one another’s burdens recognising that there are stages in the lives of all of us when we are deeply dependent on the love, care and support of others.

It would be wonderful if the Christian community could model this care for the sick and disabled, not just after birth but also for the most vulnerable of human beings before birth. But we need to begin by recognising that these principles apply even in the most serious conditions at the very earliest extremes of life.

If the price of a perfect baby is screening out and destroying embryonic humans with ‘special needs’ then that price is too high. It is far better to choose to remain childless, or to adopt, or to be prepared to provide a lifetime of care for a person with special needs rather than to go down that route. It is better, if your intention is ‘search and destroy’, not to be testing at all.

New advances in embryo testing may result in higher success rates for IVF but at what cost?

Two new embryo screening tests have been recently developed that researchers believe will increase success rates for women having a health baby after IVF treatment.

At present only about 30% of women under 35 have a baby following IVF and this percentage drops with age falling to 10% by age 40.

The new tests enable abnormal embryos to be indentified five days after fertilisation and before being implanted in the womb.

If embryos judged unlikely to survive are not implanted, it follows that the chance of a pregnancy reaching term is higher.

The first new test involves measuring the uptake of glucose by early embryos. Glucose is an energy source essential to growth and its low uptake is therefore a marker of poor growth in the early embryo.

Researchers at the University of Melbourne in Australia have developed the technique.

Their research involved 50 patients undergoing IVF. 32 of the women had a positive pregnancy test after embryo transfer and 28 babies were born. These 28 babies resulted from the embryos which had the highest glucose uptake. Controversially the method also has the potential to predict the gender of an embryo prior to implantation, as female embryos appear to take up more glucose than males.

The second new test involves determining the number of chromosomes in the developing embryo. The BBC has run the story this morning apparently after receiving a press release from specialists at CARE Fertility in Manchester. This will probably make it big news. However the story is not new and was covered by the Daily Telegraph and Bionews (amongst others) over a week ago. Those interested in knowing more about the technique will far more usefully spend their time examining these accounts.Tony Rutherford, chair of the British Fertility Society, expects the test will take two to three years to develop.

Aneuploidy (read more here)– an abnormal number of chromosomes – is responsible for a high percentage of pregnancies that spontaneously abort and is increasingly common with age.

But fertility specialists in the US state of New Jersey are claiming to be able to double IVF success rates by selecting out embryos with either too many or two few chromosomes. A Denver specialist has explained why the test is of particular importance to women over 35. He said, ‘By the time you’re in your mid-30s about 50 per cent of embryos are abnormal; by 40, 75 per cent are; and by 42, 85 to 90 per cent are’.

Fertility drops off rapidly after age 30 probably mainly for this reason. So it appears that the demand for this technology will be greater the more women, for whatever reason, delay trying for a baby.

So what of the cost?

The NHS currently provides funding for one cycle of IVF for women who have met the clinical definition of infertility, providing they have an identifiable cause to their infertility. After that couples have to pay. According to the Human Fertilisation and Embryology Authority (HFEA) the average cost of one cycle of IVF including drugs is between £4,000 and £8,000.

Preimplantation genetic diagnosis (PGD) – determining if the embryo is genetically abnormal before implantation – currently costs between £1,000 and £2,000 but it is likely that these new embryo screening tests, should they become commercially available, will cost considerably more. Cheaper options overseas will no doubt fuel more IVF tourism in future. Regardless, in an era of shrinking health budgets this is technology that is increasingly going to be only the reserve of the rich.

But money is only one part of the cost of IVF. There is also the emotional cost of being on the emotional roller coaster of a treatment for which results are not immediately obvious (confirming a successful pregnancy takes time) and where there is still a high probability of failure. 30% success rates are also 70% failure rates.

And finally there is the moral cost. This new technology is essentially eugenic. It involves identifying and discarding (or not implanting) embryos that are judged to be abnormal. It might be argued that many of these would not have survived pregnancy anyway - embryos for example with trisomy 16 inevitably do not survive pregnancy – but a significant number do.

These include babies with Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18), Patau Syndrome (Trisomy 13) and Turner’s Syndrome (XO), who carry disabilities varying in form, number and severity. Some of these are treatable and some aren’t.

Are we therefore saying that embryos which can not look forward to a life without disability should not be given the chance to live?

Interestingly the Pope is quoted in the Hindustan Times just yesterday on this very issue. He said, ‘it is indispensable that new technological developments in the field of medicine never be to the detriment of respect for human life and dignity, so that those who suffer physical illnesses or handicaps can always receive that love and attention required to make them feel valued as persons in their concrete needs.’

He added that the number of people with Down syndrome ‘has declined mostly because a good number of them are eliminated before they are born.’

In December 2008, the Vatican issued a document affirming the ‘dignity of the human embryo’ which listed biomedical techniques considered ‘illicit’ by the Roman Catholic Church. These included in vitro fertilisation, cloning, the therapeutic use of stem cells, producing vaccines from embryo cells and the ‘morning-after’ pill.

Such practices go against the ‘fundamental principle’ that the dignity of the person must be recognised from conception until natural death, it said.

Quite!

Some brief Christian reflections on infertility treatments to mark Robert Edward’s receiving the Nobel Peace prize in medicine

The decision to award the Nobel prize in medicine to Robert Edwards(pictured), the British scientist who developed IVF, has met with a mixed reaction. On the one hand there have been 4 million babies born to couples who would not otherwise have been able to conceive. On the other IVF has opened what many regard as a Pandora ’s Box of genetic engineering, cloning, pre-implantation diagnosis, embryonic stem cell harvest and animal-human hybrids.

I’m not intending to comment on the appropriateness of Dr Edward’s award or weigh the perceived benefits of his research against its downside but rather to use the occasion for some brief Christian reflections on infertility treatments.

There are over two million infertile couples in the UK (one in eight). Infertility can result from defects in the production, release or transport of egg or sperm and successful treatment depends on accurate diagnosis. The range of treatments and their speed of development is bewildering, and not all couples need IVF: other common treatments include artificial insemination (AI), intracytoplasmic sperm injection (ICSI) and gamete intra-fallopian transfer (GIFT).

In IVF (in vitro fertilisation), sperm and eggs are brought together in a petri dish, and resulting embryos are then transferred into the womb. There is a high failure rate (75-85% per cycle) and the treatment costs of £2,500 per cycle will exhaust the resources of many of the couples who are unable to get NHS treatment. The emotional roller coaster of raised hope and dashed expectation is another important cost to be counted; but I believe the most important decisions Christians need to make involve honouring embryonic life and upholding the marriage bond. We should not seek a child at any cost (Romans 3:8).

Some IVF programmes involve the production of spare embryos, which are then used for research, disposed of, or frozen for future use. Freezing compromises embryo survival and there is a high chance that frozen embryos will never be used. Other programmes involve screening out embryos or fetuses with congenital disease either before implantation or later in pregnancy. Our society thinks that because human embryos are small, weak and physically insignificant they are expendable. But this is at odds with the God’s loving grace, which sees even the weakest of human beings as precious, and worthy of wonder, love, respect and protection.

The other key question to consider is whether the use of donated eggs or sperm somehow violates the marriage relationship. Clearly using donor gametes does not involve sex outside marriage nor the cheating nor lust aspects of an adulterous relationship. But marriage is a spiritual, emotional and physical union in which two become one and donor eggs or sperm inevitably introduce a third person that will be genetically related to the child, but play no part in their upbringing. And the child will be biologically related only to one, or perhaps neither of his or her parents.

So my own guidance is that prospective parents considering IVF should carefully count the economic and emotional cost and seek treatments that both respect the human embryo and also honour the marriage bond.

Some infertile Christian couples will go on to conceive, either naturally or with ethical infertility treatment, after a period of waiting. But this does not happen for all, and God in his wisdom has left some couples childless despite good treatment and patient prayer. Perhaps this is to ensure that there are couples with a strong desire to be parents, who can either adopt children, serve others’ children in some way or be freed up for some other special purpose which God has for them.

These comments are based on a longer article in Nucleus, which can be accessed here

Those wanting a more in depth review of the issues can’t do much better than Fertility and Faith by Brendan McCarthy (IVP, 1997, ISBN: 0851111807)