Despite growing up in the church, attending a Christian school, and spending a decent amount of my young adult life studying the Bible, I arrived at marriage with the general assumption that I would and could have babies.

Never mind the plight of Sarah, Rebekah, Rachel, Hannah, or Elizabeth, who endured years, if not decades, of grief in their barrenness. The concept of infertility was a vague idea in my mind. I knew it existed but I didn’t know anyone close to me who had suffered through its silent, isolating effects.

And then, I got pregnant — more quickly and easily than I could have predicted, even in my naivety. Ours was a story of fertility, it seemed. The first child conceived the first month we tried. The second while I was still breastfeeding the first. The third, laughably, right when we decided to “wait a few more months this time around.” Three precious babies in three and a half years. It wasn’t until two miscarriages before our fourth was born that I truly understood the sting of an empty womb.

However, while my husband and I were busy procreating, those around us were not. During our season of fruitfulness, my closest friends were struggling to conceive. One couple was pursuing some fertility options after years of trying for and praying for a child. Our other best friends suffered a miscarriage after months of trying. My childhood best friend went on medication to help her ovulate as the rest of her peers were popping out babies left and right.

I learned the art of the tentative birth announcement. I would gently tell these friends the news of my pregnancy, knowing the words would bring happiness mixed with pain. I would continue to mourn with them even as they rejoiced with me—the mark of a friendship built on Christ. My prayer journals during that season are filled with the names of every woman in my life who was struggling to conceive. I can look back now on a whole page of names and exalt God for his faithfulness; every single woman now has at least one child — whether biologically or through adoption.

Beyond my close friends, I began hearing stories of infertility everywhere. My friend’s sister. My grad school classmate. My husband’s cousin. I had never imagined a world where it was so hard to have a baby.

One night, we went over to our friends’ house for dinner, and the discussion turned toward reproductive medicine. This couple had suffered through a long period of infertility but had finally conceived with a bit of medical support. They had researched and prayed about their options in the vast world of fertility treatments and had landed at the conviction that IVF is unethical. It was the first time I had ever heard anyone talk about reasons that IVF could be immoral. I was just coming to terms with the reality that women don’t “just” get pregnant, and still trying to learn the difference between IUI and IVF. But this conversation was eye-opening to me. I had never considered the ethical implications of fertilizing eggs, often in great volume, and putting them in a freezer.

I am so thankful for that dinner conversation long ago because, without it, I would likely still be like many other Christians, with a completely unformed worldview regarding fertility and reproduction technology. Children are a blessing, but we need to ask some deep questions before we create them in a lab and stick them in a freezer for possible future use.

A few years later, I was in a Bible study with a woman I now consider a good friend. As we got to know each other, I learned that her toddler had been conceived through IVF and that she and her husband had two more embryos waiting for them. They had prayerfully created only three because they were committed to implanting each one. She planned to take a fun trip to Mexico with her husband, now that her daughter was done nursing, and start the process of implanting the next embryo after the vacation. God’s plan was a surprise natural pregnancy instead. She rejoiced over the arrival of this unexpected second child, canceled her Mexico trip, and took a deep breath for the road ahead. With two embryos still preserved, she embraced the prospect of having four children, when just a few years ago, she was desperate for one. However, at age 35, she knew she would likely be pregnant and nursing until age 40, but she was faithfully committed to the path she had chosen.

Up until this point, I had only heard bad IVF stories, either failed transfers after years of trying or the opposite problem... parents whose IVF was successful multiple times in a row but who now faced the nagging problem of lingering embryos on ice. My friend’s story was the first one I had heard that had beauty and logic in it. Three embryos, lots of prayer, an unwavering commitment to the children created, and a surprise fourth child because God loves to fill cups to overflowing.

It wasn’t until recently that I learned even more about the risks of IVF. Beyond the sobering reality that over 1 million babies live in freezers across the US, there is also the harsh truth of the ways IVF affects female bodies. Research shows that the hormones and medications used during IVF can cause cancer and other conditions such as stroke, torsioned ovaries, and ectopic pregnancies. These risks are present even during intrauterine insemination (IUI), which most Christians consider an ethical fertility treatment since an embryo is not created. This is where the man’s sperm is washed (to get rid of weak cells) and inserted into the woman’s uterus at the exact time of ovulation. However, the doctor typically has to regulate the woman’s ovulation with drugs to make this happen. I have several friends who were able to conceive through the IUI method, but when they considered doing it a second time for the chance of another child, they were all hesitant. At first, I didn’t understand their reluctance to repeat a treatment that had been successful for them. That was before I understood the stress their bodies had endured in the process. Ovarian stimulation is a risky business.

These are just the risks and moral questions we must consider within the context of a married man and woman who are pursuing fertility treatments. I don’t have time in this essay to discuss how IVF technology props up the entire industry of surrogacy and enables same-sex couples to create children for their desires, without any regard for the rights of the baby. I know one sad story of twins who were created in this context and one was abandoned by the same-sex couple when he was traumatically injured shortly after birth — the siblings forever separated. If you haven’t yet learned about the cruelty of the surrogacy industry, I urge you to listen to this episode on Big Fertility and this episode on IVF on Allie Stuckey’s podcast.

Just last month, IVF became the most popular topic in the news when the Alabama Supreme Court made a ruling that unborn children who are located outside of a biological uterus count as persons. The ruling determined that if someone kills one of these extrauterine children (IVF embryos) they may be liable for the wrongful death of a minor, an act that already protects unborn children in the womb in the State of Alabama.

Here is a summary of why this issue made its way to the Alabama Supreme Court. Three different couples were storing their embryos in the “cryogenic nursery” (freezer) of the Center for Reproductive Medicine, which sits inside a larger Alabama hospital. In December 2020, a patient from the hospital allegedly wandered into the freezer and lifted a container holding the embryos. The subzero temperatures burnt the hand of the patient, causing him to drop the embryos on the floor, killing them. The parents (plaintiffs) sued the fertility clinic for the wrongful death of these minors, stating that the clinic had an obligation to secure the nursery at all times. The ruling declared that the embryos were persons (not property), so the original lawsuits could move forward under an 1872 law allowing parents to claim civil damages for the deaths of their children. No one was charged with anything. The ruling did not restrict IVF in any way.

The Right and the Left are incensed about this ruling because it may affect IVF access and policy in the future. Democrats say this is a hypocritical move from Republicans. Isn’t IVF just another means to be pro-life? Ultimately, they are concerned that this ruling could prevent same-sex couples from creating children. The Right is horrified that this mode of conception could be regulated in the future when so many hopeful married couples have used IVF in the past with great success.

In the short term, this ruling doesn't really "do" anything other than allow a lawsuit to proceed. But both sides know that this is a moment of reckoning. It calls into question the morality of creating a plethora of embryos and leaving them in a freezer forever. Currently, it’s common practice in the US to retrieve as many eggs as possible and create upwards of ten embryos at a time. Then the embryos can be implanted, saved, donated, or discarded. Unwanted or “abnormal” embryos are often destroyed. Other embryos face abandonment when their parents stop paying the storage fees for their “superfluous” children. The ruling begs the question we should have asked a long time ago — should destroying or abandoning embryos be a legal offense?

Some Alabama fertility clinics paused IVF treatments for a few weeks after the ruling, claiming to be fearful of liability. My haunch is that pausing treatments was mainly for media attention. It reminded me of the weeks after the Dobbs decision in the summer of 2022 when the media came up with all these “what if scenarios” (usually regarding ectopic pregnancy or miscarriage) to make the Dobbs ruling seem dangerous. In response, the Alabama Legislature pushed through a short-term bill that extends criminal and civil immunity to IVF clinics. Sadly, this subverts the justice that the parents in the original lawsuit are seeking for their deceased children.

When conservative rulings are handed down from the courts, people tend to react to what the ruling doesn’t say rather than what it does say. Just as Dobbs didn’t outlaw abortion (it just handed abortion legislation back to the state level), this ruling affirms that a couple could sue for wrongful death if their embryo is intentionally or negligently harmed, just as a couple could for a newborn in a hospital setting.

Conservatives have no reason to think this is a bad thing. The angry Christians who are rushing to decry this ruling since they have conceived through IVF are not thinking clearly. They appreciate IVF technology because it gave them a child. This is where empathy comes in handy. Gaze upon your child who was conceived via IVF and imagine for a moment that his or her little body, as an embryo, had gone crashing to the floor in an unsecured freezer. He or she would not be here today. The parents who sued the clinic lost a combined five children. I don’t know the parents’ desires, but these were likely children they hoped to hold someday. These children will never know the safety of their mother’s womb or emerge into the world with tiny toes and chubby cheeks. They will never taste their first birthday cake, toddle across the lawn, or hold the chalkboard sign on their first day of kindergarten. Five precious lives were lost. Anyone who has experienced the daunting process of egg retrieval or prayed their way through implantation or experienced the joy of watching their IVF baby grow up should not denounce a ruling that seeks to protect children just as yours once was — fixed in a freezer while waiting for a womb.

Christians, if we are truly pro-life, then we should be grateful for the Alabama ruling. We should be thankful for a reason to pause and consider the ethics of in vitro fertilization. We should be eager to analyze the risks and benefits of creating children in a laboratory.

If you study IVF around the globe, you will find that other countries regulate IVF more strictly than the US does. Israel restricts the age of women pursuing IVF. Germany, Italy, and Austria do not allow egg donation. Most European countries and some Asian nations do not allow surrogacy. Some of these countries limit how many embryos can be created. Genetic testing of embryos is not allowed in Denmark, France, or Spain. In the UK, Ecuador, and Sweden, no more than two embryos can be implanted at a time. The US is unique in its unfettered access to IVF at any time, in any volume, for any person.

In most cases, I am against increasing government oversight, but I support rules to protect the tiniest humans among us from death and exploitation. Laws should exist to protect life. I am thankful Alabama was willing to lead the way in affirming the personhood of these vulnerable children. They may be invisible to the human eye, but they are knit together and known by God.

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