The Facts Behind Assisted Reproductive Technology
An infertile couple is often tempted to consider assisted reproductive technology (ART) as a means to bear a child. Not surprising considering all of the publicity the procedure receives since the birth of the first “test tube baby” in 1978. Today, the delivery of ART conceived babies to high profile celebrities makes headlines.
You, or someone you know, may be considering an ART route to address an infertility problem. The following information is provided so that you can act from a position of knowledge. Before reading this, please read Barren – A Look at Infertility. When properly grounded you can then review these facts and make an informed decision regarding the course of action that pleases God.
Infertility: Approximately 1 in 8 couples experience infertility, 1/3 of which is attributed to the female partner, 1/3 to the male partner and 1/3 a combination of problems with both.
ART: Approximately 85-90 percent of infertility cases are treated with drug therapy or surgical procedures. Fewer than 10% need assisted reproductive technologies (ART) like in-vitro fertilization (IVF). In 2003 there were 437 ART clinics in the United States.
Advertising ART on the Internet: The majority of fertility clinic websites do not adhere to their own association’s advertising guidelines raising the concern that “vulnerable patients may be misled by information that does not give the whole picture – in some cases the FTC has audited and penalized fertility practices for misrepresenting the success rates of their in vitro fertilization services.” (quote from: Ascribe Higher Education News Service, January 18, 2007)
Source of Eggs: Almost three-fourths (74 percent) used freshly fertilized embryos from the patient’s eggs; 14 percent used thawed embryos from the patient’s eggs; 8 percent used freshly fertilized embryos from donor eggs; and 4 percent used thawed embryos from donor eggs. Over 11 percent (11.6 percent) of all cycles involved implanting embryos created using a donor’s egg (rather than using the eggs of the patient carrying the pregnancy).
Number of Embryo Transfers: This statistic shows the circumstance in which the patient’s own eggs are extracted for an ART procedure that involves fertilizing them in a laboratory and then implanting the embryos in her fallopian tubes or uterus. These figures do not include frozen embryos. The following represents what percentage of cycles implanted the stated number of embryos:
- 1 embryo: 7.5 percent
- 2 embryos: 36.2 percent
- 3 embryos: 32.7 percent
- 4 embryos: 15.6 percent
- 5 embryos: 5.1 percent
- 6 embryos: 1.9 percent
- 7 or more embryos: 0.9 percent
Success: In 2003, 122,872 cycles were reported (ART attempts); 29.1 percent (35,785) of them resulted in a live birth. Approximately 35 percent of the live births resulted in multiple births (twins, triplets, etc.). A total of 48,756 babies were born through ART in 2003.
All Births: Approximately 1 percent of U.S. infants born in 2003 were conceived through ART. Those infants accounted for 18 percent of multiple births nationwide.
Birthweight: The percentage of ART infants who experienced low birthweight ranged from 9 percent among singletons to 94 percent among triplets or higher order multiples. The percentage of ART infants born preterm ranged from 15 percent among single births (called “singletons”) to 97 percent among triplets or higher order multiples.
Repeats: In 2003, 56.5 percent of ART cycles were performed on women for the first time. While 20.4 percent had one previous ART attempt another 11.2 percent had two previous ART attempts, 5.6 percent had three previous ART attempts, and 6.4 percent had four or more previous ART attempts.
Age: Percentage of attempts resulting in a live birth for women undergoing their first ART attempt:
- Less than 35: 38.3 percent
- 35-37: 31.2 percent
- 38-40: 20.4 percent
- 41-42: 9.5 percent
- Older than 42: 4.1 percent
Types of ART: There are four primary type of ART. Following is a description of each type and in what percentage of cycles was that type used:
- IVF, with ICSI (55.6 percent of all ART cycles) – In vitro fertilization (IVF) is a technique that involves fertilizing an egg with sperm in a laboratory dish and placing the fertilized egg into the uterus. When combined with ICSI (Intracytoplasmic Sperm Injection) the IVF procedure is enhanced by capturing a single sperm and injecting it into an egg for fertilization. (33.4 percent of attempts of this type of ART resulted in a live birth).
- IVF, without ICSI (43.8% of all ART cycles) – 31.9 percent of attempts of this type of ART resulted in a live birth.
- ZIFT (0.4 percent of all ART cycles) – Zygote intrafallopian tube transfer (ZIFT) is a form of in vitro fertilization in which the eggs are fertilized in a laboratory dish and then placed in the woman’s fallopian tube. (25.9 percent of attempts of this type of ART resulted in a live birth).
- GIFT (0.1 percent of all ART cycles) – Gamete Intra-Fallopian Transfer (GIFT) is a procedure in which the eggs are mixed with sperm, and the mixture is then injected into the Fallopian tube. It is suitable for women who have at least one healthy Fallopian tube. The aim of GIFT is to allow fertilization to occur in the right place and implantation at the right time. (20.8 percent of attempts of this type of ART resulted in a live birth).
Frozen Embryos: Just under one in five (17.8 percent) of ART cycles involved attempted transplantation of frozen embryos. Using frozen embryos results in an 8-20 percent reduction in the possibility of a live birth over using a fresh embryo.
Problems: The reason for the discontinuation of ART in 82.9 percent of cases, was because of a complete lack or an inadequate production of eggs.
Sources for Information:
- U.S. Center for Disease Control, 2002 Assisted Reproductive Technology Surveillance; United States, 2003; CDC
- The American Society for Reproductive Medicine (www.asrm.org)
- Ascribe Higher Education News Service, January 18, 2007
- High rates of embryo wastage with use of assisted reproductive technology: a look at the trends between 1995 and 2001 in the United States, Fertility and Sterility, Vol. 84, Issue 2, August 2005, Pages 325-330
- How Many Frozen Human Embryos Are Available for Research?, Rand “Law and Health Research Brief” [RB-9038 (2003)]
Number Crunching and Interpretation: Scripture teaches us that life exists already at conception (Psalm 51:5). Biologically speaking, once fertilization takes place and cell division commences, life grows and changes location. Allowed to continue on its “natural path” a woman’ egg fertilized matures into the child we cuddle and hold at birth.
ART, in general, is a well-intentioned effort to resolve an emotionally-difficult reality of infertility. The greatest cause of concern is the callous and cavalier attitude about life in the embryonic stage. Consider these startling facts:
Of the 122,872 cycles of ART performed in 2003, a minimum of 348,465 embryos were created. The statistics show that there were 48,756 live births resulting from 29.1 percent of the “successes” reported from ART. That means approximately 300,000 lives in the embryonic stage were lost in the effort. In other words, for every one child born, about six had to die to make it possible.
None of this diminishes the value of those who live, but the process denigrates the ones who died and ignores the Creator’s prohibition to kill.
There is, in all of these numbers, a suggested alternative for Christians respectful of life. The GIFT procedure takes the egg and sperm, mixes them together, and inserts them prior to fertilization into the fallopian tube where, by God’s providence, fertilization may take place. While the success rate seems to be low (20.8 percent of attempts) the difference is that a failure may likely be that fertilization did not take place, and therefore life was not lost. In the other procedures (IVF and ZIFT) a failure always means a lost life in the embryonic stage.
There have also been recent reports that implanting one embryo in IVF increases the probability of success. The rate of improvement is about 6 percent, but the number of lost lives still is phenomenally high.
Included in ART is the practice of freezing embryos. Since 1970 it is estimated that about 400,000 frozen embryos are in storage in the United States. While most of these were frozen with the expectation of being used in later attempts of IVF or ZIFT, the reality is that an increasing number are in limbo, with no plans for implantation.
While an IVF and ZIFT procedure is risky for life in the embryonic stage, childless Christian couples may wish to “rescue” these unborn and unwanted children. While statistically the odds for a successful implantation procedure for these children are low, the slim chance is better than no chance at all.
Some organizations exist to connect childless couples with a couple wishing to donate excess embryos. Pursuing these avenues is walking the delicate balance between rescuing lives that might otherwise be lost and encouraging a procedure (IVF) that original placed the lives in peril. A couple will need to investigate this option with great care to assure that nothing compromises the witness to the life that exists, the God who is Author of life, and the error in placing such lives in peril.