In modern-day society, the problem of human infertility is remarkably complex. The current advancements in the medical industry present a broad spectrum of methods that help couples fight infertility. However, the fact that these medical interventions into the process of human natural selection and reproduction are considered legal does not mean that they can be perceived as moral (Cioffi, 2007). From an ethical point of view, the in vitro fertilization (IVF) industry has a destructive influence on embryonic human life. In Catholic teaching, having a child is considered ethical only within the context of a valid marriage. For this reason, the novel human procreation practices pose critical bioethical concerns, regardless of the medical and social benefits.
Description and Bioethical Analysis of Procreation Practices
Pre-implantation Genetic Diagnosis (PGD) is the type of prenatal testing aligned with the methods of artificial fertilization. It is the genetic diagnosis designed for the embryos formed in vitro that is required before embryos are transferred into a woman’s womb. The main goal of PGD is to ensure that only intact embryos or those of the desired sex and specific qualities are being transferred. Surrogacy is a crucial practice in fertility treatment, in which a woman gives birth to a child for an infertile couple that is unable to produce children naturally. In traditional surrogacy, a surrogate mother gets artificially inseminated with the father’s sperm, while in gestational surrogacy, the “in vitro fertilization” (IVF) technique is applied. IVF implies that eggs are gathered from the mother and are fertilized with the father’s sperm, and the embryo is placed into the uterus of a gestational surrogate (Congregation for the Doctrine of the Faith, 2008). From the ethical perspective and under religious considerations, such a decision should be faithful to Catholic moral principles and the individual’s intentions and values.
Another practice implies IVF embryo transfer, or “snowflake babies.” Some oocytes are transferred into the mother’s body and fertilized within artificial procreation, while others are frozen for future fertilization (Congregation for the Doctrine of the Faith, 2008). The concept of snowflake children refers to the adoption of frozen embryos left over from IVF. Artificial insemination is the process of artificially delivering semen to the female genital tract. This raises ethical questions about medical genetic selection. In other words, it is questioned whether artificial selection among human beings can ever be acceptable (Congregation for the Doctrine of the Faith, 2008). All these forms of infertility treatment are not ethically acceptable and are considered illicit since such practices lead to issues of a medical, psychological, and legal nature.
Natural Family Planning
Natural family planning (NFP), or fertility awareness, is a less unethical method of contraception when a woman takes full control of her menstrual cycle to determine when she can get pregnant. Through the ethical lens, this method is frequently compared to the traditional medical approaches to contraception, including birth control methods. However, NFP and contraception are the methods pursuing different attitudes towards humans, their sexuality, and moral dignity.
Bioethical Evaluation of NFP
NFP is a morally good technique based on an individual’s affirmation of love. It requires the couples to choose self-control and the virtue of chastity through periodic continence. The contraception method, in contrast, advocates against natural conception and does not require any self-control from the partners. Fertility awareness is built upon Christian anthropology and the integralist view of human sexuality (Cioffi, 2007). The contraception method, on the other hand, follows dualistic anthropology and separatist concept of sexuality. NFP method is approved by the Catholic Church for gestational achievements and postponing pregnancy. NFP is healthier than traditional methods of contraception because it does not imply any medical intervention in the human body, including unwanted side effects of contraception.
The primary ovulation symptoms include basal body temperature (BBT), cervix activity, and cervical mucus. The secondary ovulation symptoms encompass mittelschmerz, spotting, swollen vagina/vulva, increased libido, breast tenderness, general bloating, and ferning. These are the crucial factors that couples consider during the NFP method (Unseld, Rötzer, Weigl, Masel, and Manhart, 2017). The primary ovulation symptoms are fundamental to females’ fertility chart. A woman’s basal body temperature can lower and be followed by a rapid increase, approximately about 0.4 to 1.0 degrees, after ovulation. Additionally, the cervix can become higher, softer, and more open during ovulation. The female body produces more estrogen, increasing cervical mucus, and easing conception.
The secondary symptoms are more conditional, meaning that not every woman experiences them. Spotting (light vaginal bleeding) and mittelschmerz (pain in the lower abdomen) occur only among the minority of females. Before ovulation, a woman’s estrogen and luteinizing hormone levels increase, causing water retention and swelling, which leads to bloating. Some females also experience tender breasts or sore nipples due to the rush of hormones. One of the unique signs of ovulation is a change in libido, namely increased sex drive due to the rise of estrogen levels. Swollen vaginal or vulva occurs right before ovulation on the side from which a woman ovulates. The final possible symptom involves ferning: the cervical mucus produces fern-like patterns because of the crystallization of sodium chloride on mucus fibers.
Protocols and Methods
Some of the protocols and methods that are available today include the Creighton model (NaPro Technology), Couple to Couple (CCL), symptom-thermal method (STM), Billings method, and Family of the Americas (based on Billings). The Creighton Model (CrM) is an NFP method based, which refers to observations of the woman’s cervical fluid or mucus. CCL approach advocates for the symptom-thermal method of fertility awareness, promoting continuous breastfeeding. The STM method for natural family planning raises knowledge about the primary and secondary signs of fertility analyzed above (Unseld et al., 2017). The Billings method in the fertility awareness approach implies that women use their cervical mucus to determine their fertility level during the menstrual cycle (Unseld et al., 2017). Family of the Americas (FAF) practice in NFP entails the simple recognition of natural attributes of a woman’s fertility, which lasts a few days during menstruation. FAF significantly contributed to making it easier to educate and chart the system of the ovulation method and became a universally used method.
Conclusion: ERD Summary
United States Conference of Catholic Bishops (USCCB) presents the ethical and religious directives for Catholic health care services. They define the professional-patient relationship and issues in care for the beginning of life. By advocating for the ethical standards based on Christian doctrine about human dignity, USCCB (2018) emphasizes moral concerns facing Catholic health care. Based on the topic of this essay, it is crucial to consider the following directives. Church empowers abiding care for the sanctity of human life from its beginning to the marriage, including the marriage act that conveys human life. The Church’s protection of life covers the unborn and the concern for women and their children during and after pregnancy. The fertilizing and procreative significance of sexual intercourse cannot be separated.
Procreation naturally fits into the marriage act, so artificial human procreation methods, including external sperm donors, are strictly prohibited. The Catholic Church does not support heterologous fertilization, gestational surrogacy, homologous fertilization, IVF, contraceptive practices, and direct sterilization. However, Catholic health care services provide PGD and genetic counseling to enhance preventive care and responsible parenthood. Therefore, religious beliefs and ethical imperatives cultivated by them are essential in developing and considering the infertility practices in the modern health care system.
Cioffi, A. (2007). The Church and assisted procreation: Cautions for the “infertile” couple. Ethics & Medics, 32(10).
Congregation for the Doctrine of the Faith (2008). Instruction dignitas personae on certain bioethical questions. Pauline Books & Media.
United States Conference of Catholic Bishops (2018). Ethical and religious directives for Catholic health care services (6th ed.). USCCB.
Unseld, M., Rötzer, E., Weigl, R., Masel, E. K., & Manhart, M. D. (2017). Use of Natural Family Planning (NFP) and its effect on couple relationships and sexual satisfaction: A multi-country survey of NFP users from US and Europe. Frontiers in Public Health, 5.