The Case Against In Vitro Fertilization

On April 1, 2025, The New York Times published a profile of Noor Siddiqui, the founder of a healthcare startup aiming to “reinvent reproduction.” The profile's cover featured an image of a baby next to a sign indicating the child had been screened for gender and health using in vitro fertilization (IVF). Although IVF has traditionally offered a solution for those unable to conceive naturally, Ms. Siddiqui envisions a future where all humans are conceived in vitro and subsequently screened for gender, genetic predispositions such as obesity or autism, and other characteristics. She asserts that this approach prioritizes infant health, remarking, “Sex is for fun, and embryo screening for babies,” and adding that “it’s going to become insane not to screen for these things.” 

Twelve days later, TechCrunch announced a $16 million seed funding round for Cofertility, another startup that enables healthy women to freeze their eggs for future procedures, provided these eggs are also available as potential donations to other couples, thereby creating a marketplace for both egg donors and recipients. Fifty two days later, another startup, Nucleus Genomics, announced a “genetic optimization”  software platform designed to bring longevity to embryos. The program, designed for couples undergoing IVF, screens multiple embryos for factors ranging from genetic diseases to intelligence and height, assigning them a “risk score.” Clients of the service would be able to rank and even name embryos. These new ventures, characteristic of the burgeoning $20 billion fertility market, promise human empowerment, genetic enhancement, and ultimately, greater control over reproduction. Such startups seek to medicalize and mechanize procreation, offering enhancements at every stage—from egg collection to embryo screening and freezing. 

These companies build upon IVF, a technology that enables human conception in a biomedical setting, and promises control over reproduction. In her book Fearfully and Wonderfully Made, Dr. Megan Best notes that IVF was originally conceived to bypass the fallopian tubes in conception, simply allowing sperm and egg to meet without the need for fallopian tubes. However, the intention of  IVF began to turn from simple remediation of the reproductive system to a replacement to the reproductive system: “Doctors are now employing procedures that go beyond just fixing what is broken. The demand in our community for biologically related offspring has meant that fertility specialists have kept pushing…to provide an ever-widening range of options...our choices go way beyond simple remedial treatment.” In fact, if the healthcare startups have their way, IVF might be seen as the normal, responsible route for parents to have children to give them the best hand in the genetic lottery. The future envisioned by these companies lies eerily close to the conception of society depicted in the movie Gattaca, where a human's future is fated on whether their birth was “natural” or “screened”, or the hatcheries in Huxley’s Brave New World, where humans are screened and manufactured into predetermined social castes intended to facilitate social stability. 

Even though most Christians, and I hope most common-sense humans, will condemn the practice of grading embryos and freezing excess embryos, this is unlikely to slow the normalization of IVF as a method of conception. Many people will embrace IVF for the promise of remedying the grief of infertility. IVF demand has increased primarily to meet the demands of infertile women and couples for a child. Dr. Best notes, “the diagnosis...is so distressing for a couple that they may not stop to think about the treatment....they are prepared to go to extraordinary lengths to get the child they desire.” Indeed, the demand for IVF and the demand for the inputs into IVF – donor sperm, donor eggs, and surrogate wombs – all revolve around achieving the human desire for a child. The financial, emotional, and physical costs are seen as small burdens in light of this one good, which is often held as central to personal identity. In Christian circles, the association of fertility with blessing and infertility with barrenness further impresses on many the importance of children to personal fulfillment. (See, for example, Amy Laura Hall’s Conceiving Parenthood: American Protestantism and the Spirit of Reproduction.) It is common for couples, including evangelical Christian couples, to resort to IVF as a means to have children after an infertility diagnosis. 

At the same time, social pressure could quickly  normalize  these technologies, especially when couched in the language of being a good parent. While pastors might be counseling couples who have been diagnosed with infertility and are considering IVF today, or with couples who have already undergone an IVF cycle, now, in the future they might be faced with couples who seek the pastor’s advice regarding which of the ranked embryos a couple should implant. Indeed, if the premise of IVF is the promise of a healthy child, and IVF grading offers a better chance of choosing a healthy child, choosing between embryos will inevitably be a future concern. Such a choice, however, reveals the rotten fruit of the whole endeavor. If you have to choose between embryos to discard and ones to keep, you have already made a thousand bad choices to get you to that point. And if being in such a position to choose feels morally repugnant, then perhaps there was something morally repugnant about the actual act of creating humans in a lab. While I am by no means giving pastoral guidance on how to walk with a couple through infertility, these dystopian and looming technologies prompt the Church to consider their morality before leaving IVF to the conscience of the couple.

However, the majority of Protestant churches are unwilling to make this step, and exist in a state of basic uncertainty regarding IVF, treating the practice as a matter of Christian wisdom, provided that no embryos are intentionally destroyed in the process and the genetic material originates from the intended married couple. The Presbyterian Church in America (PCA) and Orthodox Presbyterian Church (OPC) have no stated position on the procedure. The Evangelical Presbyterian Church (EPC) does not have an independent paper on IVF, but in its position paper on abortion notes that couples should not “produc[e] more embryos by in vitro fertilization than would be implanted in utero,” which at best makes IVF a matter of Christian liberty. The Lutheran Church Missouri Synod (LCMS) adopts a similar position. In 1996 it claimed that when more embryos are created than can be implanted in, “the womb that God created to receive them, then the unique and sacred expression in the embryo of the one-flesh union of marriage is subject to distortion and diminution.” This judgment, like the EPC, expresses hesitancy with some of the unfortunate circumstances and the consequences of IVF, but again does not rule on if the act itself is permissible. (Emma Waters’s taxonomy of the various positions taken by Protestant denominations is helpful.)

In fact, the logic of these institutional positions tracks with Wayne Grudem’s prescriptions in a piece published by The Gospel Coalition. His reasoning is representative of the typical Protestant approach. He first concludes from several biblical passages that, “it is right to consider infertility as something that, in general, we should seek to overcome with the confidence that God is pleased with such efforts.” Next, he also reasons from the Bible that modern medicine is good and part of fulfilling the commission to “subdue” the earth (Gen. 1:28). Therefore, medicine employed to overcome infertility can be morally good. At the same time, he concludes from Scripture (Ps. 51:5;39:13, Ex. 21:22–2) that the unborn child is a human person from conception, and from the broad injunctions of Scripture against adultery (Ex. 20:14; Lev. 20:10; Deut. 5:18; Matt. 15:19) that children should only be conceived and born within the context of a marriage. Since IVF is a medical process that can overcome infertility, it can be good if it does not violate those principles. Grudem’s reasoning and position represents the majority of the Protestant literature on IVF. In his book Bioethics and the Christian Life, David VanDrunen takes a similar position, “Christians may only consider pursuing IVF procedures for which they are committed to nurturing every one of their created embryos through the entire course of a pregnancy.” VanDrunen even allows more children to be made than can be implanted in a single cycle, as long as those children are frozen and given a chance to be implanted later on. 

These positions arise from the basic logic of a moral framework that derives moral knowledge  solely from explicit prescriptions in Scripture.  The commands of Scripture function as explicit laws binding on Christians as the source for larger ethical principles. Where Scripture does not explicitly address an ethical question, the problem is relegated to the realm of “conscience,” and relevant explicit prescriptions touching related matters are utilized as guardrails. This is the type of logic that allows for freedom of conscience in the realm of contraception as long as the contraception is not abortifacient, and that the married couple will be generally open to children at some point in the marriage. Similarly, IVF can be a matter of conscience so long as it is undertaken within marriage and without the unnecessary destruction of human life. 

Even recent critics against IVF reason within the same meta-ethical framework and derive certain moral conclusions from explicit commands of Scripture and reasonable inference. Andrew Walker and Matthew Lee Anderson critique Grudem’s prescription by asserting that, “Scripture is unambiguous about the inextricable normative union of procreation and sex.” On its surface, this is true. Scripture places the capacity for children as an essential part of marriage and the marital act’s unique ability to bear children, which is why evangelicals oppose gay marriage and fornication. Both gay marriage and fornication, in different ways, sever sex from procreation. IVF is an instance of severing procreation from sex, so it would follow against the vision intended in Scriptural commands on sexuality. However, even given this principle, its application to every sexual and procreative act is not evident from the Scriptures.

Aside from this argument, Walker and Anderson give other concerns with IVF including the fact that IVF involves multiple parties in conception, that IVF doesn’t solve the medical problems preventing infertility, and that IVF orders our imaginations to view humans as objects for our desires. These concerns are all valid, but at best these concerns make IVF morally suspect. The framework of arguing for or against a moral position based on the authority of Scripture alone for certainty easily devolves into a face off between Scriptural texts subject to interpretation with regard to both meaning and application. 

This moral epistemology is anemic and an instance of solo or nuda Scriptura instead of sola Scriptura. Yet Scripture itself says that while it is our highest authority in judging moral acts, it is not the only way we can come to know the goodness and badness of human acts. Paul says that there are gentiles “who do not have the law, (but) by nature do what the law requires” (Rom 2:14). There is a kind of natural law we experience through the stirrings of conscience. It is limited in what it can do and we can, of course, sear our consciences. But those limitations are not equivalent to it being altogether powerless or non-existent.

From the essential constitution of humanity as rational animals, we can discern what is inherently good for it: sustenance, family life, political community, and, ultimately, communion with God. Corrupt actions such as murder and stealing violate God’s law, and God’s judgment on such actions is manifested in the deterioration of human life. The universality of this order is expressed in the widespread agreement across civilizations on prohibitions against acts like theft, murder, and disrespecting parents. C. S. Lewis captures this universal moral order by referring to it as the "Tao," signifying the timeless and universal applicability of these laws to all humans by virtue of their creation. According to Lewis, Natural Law implies that certain moral attitudes are not merely emotional states or reflections of societal conventions, but rather expressions of conformity to God’s goodness and inherent order. “Those who know the Tao can hold that to call children delightful or old men venerable is not simply to record a psychological fact about our own parental or filial emotions at the moment, but to recognize a quality which demands a certain response from us whether we make it or not.” Though the natural moral law is not like a law of physics which determines objects to one path or another, human action, it still reflects and reinforced an order of the proper function of human life, irrespective of human desires. In fact, deviations of human desires from this order reflect a corrupt or fallen human intellect and will, which rebels against the moral order, and its result is its own destruction. 

The abandonment of natural law, by which I simply mean “reflection on the order and end of human life as a source of moral reasoning,” reveals the nominalism latent in Christian social thought. Nominalism is a term that is thrown around a lot in theological conversations, almost as much of gnostic, but by nominalism I simply mean words disconnected from reality. When moral vocabulary is nominalist, the goodness and badness of moral acts are disconnected from reality and are grounded in the command of the lawgiver. In evangelical settings, moral nominalism concerns itself with what, if anything, Scripture says on a topic, without reference to the actual reality of the moral act.

The need for a biblical case for or against IVF already is tinged with nominalism, because it at least implies the need to have moral commands be grounded somewhere in Scripture instead of reflecting on whether an act itself is intrinsically good or bad as defined by how it accords or does not with human nature. Natural law is our participation in God’s design for us and the  actual fulfillment of His goodness in us. Creation, as an order instituted by God, mirrors God's goodness, enabling humans to discern and participate in this order, thereby achieving the fulfillment God intended for them. Consequently, natural law not only affirms an order imposed by God but also God’s governance of the world, guiding it toward its ultimate end. 

As Oliver O’Donovan notes, God does not create the world with multiples of unspecified energies, but orders it toward himself, “The wholeness of the universe depends on its being a created universe, and thereafter on its being reconciled, brought back into the order of its creation.” Scripture proclaims the fulfillment of this creation order in Christ. Christian ethics can look both backward to the origin of the created order and forward to its ultimate end. The issue with Protestant ethics isn’t therefore just nuda Scriptura but severing Scripture from reality itself by abandoning the need to reflect on the very creation Scripture confirms and fulfills.

By calling for engagement to natural law, I am not calling for another sourcebook of propositions akin to Scripture’s place in nominalist ethics. Rather, by embracing natural law, I am urging Protestants to engage with the reality of creation and its order to gain understanding and clarity about moral positions ultimately grounded in how God intended us to be. Reflection on natural law connects the precepts of Scripture back to reality. Intrinsically bad acts actually corrupt our nature, moving us further from God, and they can have lingering consequences. Moreover, Scripture may not always explicitly address every moral act, but this does not render such acts morally neutral. Instead, its goodness or badness can be determined by analyzing the act itself, and how it relates to our created end. The Spirit authorized work of moral reflection not only enables us to judge whether an act is good or bad, but also comes to understand the formal reason why, leading us to a greater understanding of the order God created. Even in the absence of explicit Scriptural warrant, we can have certainty and clarity regarding a moral act based upon our certainty of the principles of creation and analysis of the act itself.  

In fact, the work of receiving, reflecting, and judging on the actual reality of our acts is our participation in-between creation and restoration. Turning back to IVF, Christian ethics must ask whether it is an opportunity for human resistance to God or or an opportunity for moral agents to reflect and anticipate the restoration of all things in Christ. From the start we can observe that the current conclusions among Protestants about the personhood of the embryo at fertilization and connection of bearing children in marriage already disqualify surrogacy and the discarding or destroying of embryos. As a corollary, selecting embryos based on genetic markers, which necessitates discarding others, amounts to destroying human lives solely for the desire to have a seemingly “perfect” child.  

Furthermore, that the practice of freezing embryos is abhorrent is a conclusion from these two prior principles. Freezing embryos denies the embryo's inherent right to grow and develop, a right proper to every human as God intended. One who freezes embryos essentially suspends human lives that are owed, at the very least, the right to continue living and developing naturally. In this state, the frozen human is imprisoned without cause, treated unjustly, and reduced to an instrument for fulfilling another's desires. Moreover, the Apostle Paul commands Christians to “bring [children] up in the discipline and instruction of the Lord” (Eph 6:4). Raising children inherently involves caring for their physical needs and guiding their development, a responsibility that freezing embryos directly opposes. Such an act is disobedient to this command, which is intended to reflect parental duties towards children in light of the Gospel's power to restore human fellowship. The very existence of a frozen embryo implies that its being is contingent upon serving the interests of someone else—namely, the desire of parents for children on their own timeline. Therefore, freezing embryos does not “redeem” creation but rather halts its progress. Indeed, perhaps the most compelling rebuke against freezing embryos is that it denies another human being the opportunity to hear the Gospel and respond in obedience and freedom to the restoration of all things in Christ.

But perhaps IVF was done by an infertile Christian couple that only wants to harvest and have 1-2 embryos in a cycle, and intend to implant those embryos regardless of the results of genetic screening. The health outcomes of IVF's current state are relevant. Studies tracking children conceived through IVF note higher rates of developmental disability, notably caused by low birth weights. These low birth weights are primarily caused by twinning, which is heightened in IVF, and premature delivery. As noted by Janice Raymond in her book Women as Wombs, the medical problems also extend to higher rates of  spina bifida (five times the expected rate), and a heart defect called transposition of the great vessels (6.7 times the expected rate). Part of this is caused by the fact that the eggs harvested in IVF may not be the same quality of eggs that mature in ovulation, and the sperm utilized in IVF may not be the same sperm that reaches the egg in natural production, which is usually higher in quality. Even in cases of single implantation, there is a risk to the embryo in the handling and exposure of egg and sperm and cascading effects of the hormonal treatments in the first part of the cycle. The irremovable possibility that IVF could be the cause of a damaged human, is enough to conclude against the practice itself.  The act itself would violate the first principle of medical ethics: “do no harm.” Medical procedures that involve the mother and child, such as intrauterine blood transfusions, carry a risk of danger to the child but also a chance of great benefit. In contrast, in  IVF, Paul Ramsey observes, “the mother seeks a benefit; this benefit can be delivered only at some risk of grave injury to the future possible child.” This benefit comes at the risk of doing harm to the child. The only way such an act could be considered moral is if, in Paul Ramsey’s words, “to believe couples have such an absolute right to have children” irrespective of the induced risk to the child itself. 

It is not “healing” or redemptive to enable women to have children by any means necessary, means which can bring additional harm upon a person not yet conceived. IVF is wrong because it is human experimentation with the irremovable possibility of harm. The logic of optimizing gamete quality and genetic screening is in response to minimizing this possibility and perhaps, quixotically, engineering the best embryos. Their logic is akin to the pagan practice of leaving newborns in the wilderness to see if the child is fit enough to be reared and useful to society, a crude form of human experimentation. Even when the child did not die, the practice is still intrinsically disordered. Likewise, even if there are not measurable adverse physical outcomes in a particular child, the practice is intrinsically wrong. In fact, even when there are no biological complications in IVF, there may be psychological ones: a person conceived through IVF must live with the fact that he was conceived through medical technique, leading to potential psychological harm expressed in greater tendencies for anxiety, depression, and emotional disturbances.

The experience of psychological distress leads us to consider IVF irrespective of its adverse physical risks. That is, is IVF intrinsically wrong even if no embryos were destroyed and there was no possible physical harm to the embryo? Answering this question helps us discern the formal reason why IVF is bad by bracketing out intentions and resultant consequences. To answer this question, consider that psychological harm detected in children of IVF stems partially from the fact they were exceptions to the normal answer to the question, “where do babies come from?” 

In creation, God orders reproduction with sex, and both are ordered in the institution of marriage. As the Catholic Bishops' Joint Committee on Bioethical Issues response to the Warnock Commission on Human Fertilization notes, in normal procreation, “the child will be a gift embodying the parents' acts of personal ... involvement with each other. Procreation will thus have been an extension of the parents' whole common life.” In normal procreation, the child is begotten as an equal kind to the couple, the incarnate expression of the couple’s life and love. In IVF,  the child, however, is conceived through medical technique and takes “the same status as other objects of acquisition. The technical skills and decisions of the child's makers will have produced, they hope, a good product, a desirable acquisition.” Therefore, the child from IVF’s existence begins not as a gift or a natural overflow of love, but through a mechanical process of “making.” It is this underlying act of “making” that the child may sense, the perceived incongruity of this act with their status as a human being, equal to others, which can contribute to an existential dilemma and subsequent psychological distress. This psychological damage reveals God's intended positive vision for maintaining the unity of procreation and sex and confirms that deviations from this unity harm the child. This truth can be simply stated: every child deserves to be brought into the world as the expression of the loving relationship of their parents. 

In contrast, IVF makes a child a product made to fulfill the desire of his biological parents, and the result of medical technique. Though the child has an existence of his own as a person, he is conceived as a product of medical technique and financial compensation. Instead of arising from God’s mysterious providence, his beginnings were subject to manipulations, from the choosing of his precursors to the time and manner of implantation. The distinction between “begotten” and “made” corresponds to a real distinction between the origins between the child and his parents and the resulting relationship that forms due to that action. The act of “making” a child through overseeing and engineering fertilization in a lab forms a relation of ownership and domination between the parents and the embryos. This is the formal reason why IVF is bad, it is at the root for all other explanations of why it is wrong. The embryo is the property of his biological parents, an extension of their labor. The couple owns the embryos and can decide what to do with them. Property is not treated equally as persons, it is subservient to the interests of persons. The first moments of the embryo’s existence is one of being owned and dominated, an assembled organism. The manner of conception does not heal or restore creations but is an attempt to overcome its limitations, and in so doing violates the dignity of its product, a child who ought to be begotten, not made.

IVF, or more generally, the process of making children rather than begetting than, does not express God’s renewal and transformation of creation, but works to undermine it. By treating infertility as a medical problem to overcome, it instrumentalizes children, treating them as goods to which adults are entitled. The desire for children is good, but IVF as a means of having them  is intrinsically disordered. Engineering a child to medical techniques places them as property, not persons with inestimable worth by virtue of being in relationship to God.

I am not saying that Christians who have children by IVF, and who love and care for their children, are treating them like property. The means of conception does not take away from the dignity and worth of the person. Yet, confronting the actual reality of making people for our own desires, no matter how benevolent, compels Christians to deny IVF as a viable means of procreation. Indeed, Christians must become a refuge for children born through IVF, witnessing and affirming their inherent love and dignity. Likewise, we must be a refuge for parents who conceived children through IVF, who in all likelihood were offered choices they shouldn’t have been offered by medical providers eager to profit off infertility or motivated by a sincere, though morally uninformed, desire to aid infertile couples 

In fact, IVF must actually be opposed as an assault on the imago dei  and a corruption of creation as serious as abortion or slavery. Those who promote embryo grading and optimization are tantamount to anti-Christs, those who oppose the works of God by denying those “less than” life (John 9:3). Pastors and churches who remain unable to offer guidance and moral clarity on this issue, fail in their responsibility to lead the flock into maturity in Christ. The nominalism of Christian social teaching, coupled with the autonomous ethics of the west, has sent the church into a whirlwind in matters of anthropology. Guiding our congregations and renewing our anthropology begins with a confrontation of the reality of personhood at the beginning of life and the goods the embryo is owed, including the manner of his conception. And in the confrontation, Protestant social teaching must make this stand: God’s creation, order, and governance tell us that humans should be begotten not made. We will not fabricate man.