Introduction
Marriage is a sacred institution between a male and a female, ordained and blessed by God. Etsiakoh views marriage as a bond between the couples and the families involved, with the blessing of children serving as its seal. However, infertility has emerged as a matter of serious concern, increasingly cited as one of the major factors contributing to divorce. The causes of infertility may be either psychological or medical in nature. Beyond infertility, certain cardiac conditions place the lives of pregnant women at significant risk, while others choose, for personal reasons, not to carry a pregnancy naturally.
The frustration and stigmatization experienced by couples who are unable to bear children have made in vitro fertilization (IVF) an aspect of assisted reproductive technology (ART) the only viable option for many, despite the considerable costs and health implications involved. This article seeks to examine IVF and surrogate motherhood from a Christian perspective. To achieve a comprehensive examination, the following sub-topics will be critically explored:
- Explanation of Key Terms
- The Surrogate Industry
- IVF: Processes, Challenges, and History
- Christian Response
- Conclusion
Explanation of Key Terms
Surrogacy / Surrogate: The term “surrogacy” refers to a substitute arrangement; in this context, it denotes a person who carries a pregnancy on behalf of another woman.
Surrogate Motherhood: This refers to the arrangement in which a surrogate acts in the capacity of a mother. The legal implications vary depending on the type of surrogacy and the laws of the country in which it takes place. In traditional surrogacy, motherhood is attributed directly to the surrogate. In gestational surrogacy, the legal framework differs; in the United States, for example, both the egg donor and the carrier may be legally associated with the child’s motherhood.
The Commissioned Family: The family or couple who are in need of a child through surrogacy arrangements.
Assisted Reproductive Technology (ART): A broad term referring to all technologies in which gametes are manipulated outside the human body.
In-Vitro Fertilization (IVF): An aspect of ART in which fertilization occurs outside the uterus, in a laboratory incubator. The process involves ovarian stimulation, follicular aspiration, sperm preparation, oocyte insemination, embryo culture, and embryo transfer.
The Surrogate Industry
According to Scott Rae, the term “surrogacy industry” encompasses all arrangements associated with surrogate motherhood and the IVF process. These arrangements are classified across three dimensions: typological, commercial, and level-based.
Types of Surrogacy
Traditional surrogacy is the arrangement in which the surrogate is also the egg donor, making her both the genetic and biological mother of the child. In most cases, the sperm is artificially inseminated into the surrogate. A biblical parallel may be observed in the account of Sarah, who gave her maidservant Hagar to Abraham with the understanding that any child born would belong to Sarah. This practice, though ancient, has historically been associated with legal disputes, and the United States has since prohibited it.
Gestational surrogacy involves a separate donor and carrier. In this arrangement, a third party provides the eggs, and the process typically involves IVF. The carrier has no genetic link to the child. Some jurisdictions have ruled that the carrier is the biological mother, while the egg recipient is the genetic mother. Custody of the child is generally awarded to the commissioned wife.
Commercial and Altruistic Dimensions
The commercial dimension of surrogacy involves financial compensation to both the surrogate and the donor (unless the commissioned wife serves as the donor herself). The cost is substantial in the United States; expenses range from $20,000 to $50,000, while in India, the total cost, including antenatal care and related expenses, is approximately $6,000. Surrogacy agencies typically manage these arrangements, and the identities of commissioned families are usually kept confidential.
Altruistic surrogacy, by contrast, is regarded as a charitable act. A family friend, relative, or church member may voluntarily carry a pregnancy for a couple in need, with only antenatal costs covered. No financial compensation is involved beyond necessary medical expenses.
Levels of Surrogacy
Partial surrogacy involves the insemination of the surrogate with either the commissioned father’s sperm or that of a donor. In this case, the surrogate remains the biological and genetic mother of the child.
Full surrogacy involves IVF, in which eggs and sperm are fertilized externally. Various combinations are possible: the eggs and sperm may belong entirely to the commissioned couple; the commissioned husband may donate sperm while eggs are sourced from a donor; or, in some cases, both eggs and sperm may come from external donors. This form is commonly used when the commissioned mother faces a life-threatening medical condition or uterine damage.
IVF: Processes, Challenges, and History
In vitro fertilization is the most complex yet most successful treatment for infertility within the ART spectrum. Originally developed in the late 1970s to treat women with blocked or damaged fallopian tubes, IVF has since expanded to include women of advanced age (typically above 50 years), those with uterine complications, and those who choose not to carry a pregnancy themselves, including same-sex couples.
The first child born through IVF arrived in 1978. Today, the practice is widespread, with over 3.78 million babies born through IVF annually. The United States and India record the highest numbers of IVF births globally. Within Africa, countries such as Nigeria, Ghana, and South Africa are among the nations where IVF is gaining increasing recognition.
The IVF Process
- The patient is treated with injectable fertility medications to stimulate the release of multiple eggs at the time of ovulation.
- Prior to ovulation, the eggs are retrieved transvaginally under ultrasound guidance while the patient is under sedation.
- The retrieved eggs are fertilized in a laboratory setting.
- The fertilized eggs (embryos) are allowed to develop in the laboratory for three to five days.
- One or two embryos are transferred into the uterus of the patient or surrogate via a small catheter. Remaining embryos may be cryopreserved for future use.
Challenges
Despite its success rates, IVF presents significant medical and psychological risks. These include uterine rupture, gestational diabetes, psychological trauma, and various other complications that render the process both physically demanding and emotionally stressful for all parties involved.
Christian Response to IVF and Surrogate Motherhood
Morality is often described as dynamic, varying across cultures and contexts. However, the Divine Command approach maintains that morality remains absolute; ethical issues must therefore be evaluated in alignment with divine principles as revealed in Scripture. This response to IVF and surrogate motherhood adopts a deontological ethical framework, consistent with Christian and Pentecostal ethics, which upholds moral principles over consequentialist intention.
The Problem of Exploitation
The surrogacy industry has created conditions that are highly susceptible to exploitation of surrogates, donors, and commissioned couples alike. Countries such as India and the United States have become prominent examples of this. Commercial surrogacy has given rise to numerous agencies that operate as intermediaries, often charging exorbitant fees when they perceive the desperation of couples seeking children. In parts of India and Africa, vulnerable young women are frequently exploited by such agents, receiving little compensation for significant physical and emotional sacrifice. Christianity firmly opposes exploitation. Second Peter 2:3 warns that those who exploit others out of greed will face destruction and divine judgment.
The Question of Bonding
Christianity places significant emphasis on the sanctity of procreation and familial bonds. The nine months of pregnancy are understood to establish a profound emotional, spiritual, and physical bond between mother and child. When sperm, eggs, or a womb is effectively “rented,” this foundational bond is inevitably compromised. Research has indicated that child-rearing difficulties are more frequently encountered in such circumstances, and children born through IVF may face challenges rooted in the absence of this early bonding experience. Christians are called to train their children with intentionality and love — a task that requires a strong relational foundation from the outset.
The Call to Faith
Redford and Onyina affirm that faith is stronger than misfortune and suffering. Scott challenges Christians to address the issue of infertility within the framework of their faith. Etsiakoh similarly asserts that the Bible adequately addresses infertility and that Christians facing this challenge should encourage themselves in God, trusting in His capacity to heal every infirmity and resolve every situation of childlessness. Lee and Redford both affirm that healing and miracles have been defining features of Pentecostalism. Tansi holds that infertility is a condition that can be addressed through prayer. Scott Rae further argues that supporting surrogacy arrangements that facilitate exploitation is morally indefensible and that dependence on faith for healing and miracles is the more appropriate Christian response.
The Issue of Homosexuality
Evangelical Christians strongly oppose IVF on the grounds that it is commercially driven and, more critically, that it effectively endorses homosexuality. One of the primary social deterrents to same-sex relationships has historically been the inability to bear children biologically. However, IVF now makes it possible for lesbian and gay couples to have children, thereby removing this barrier. The Bible unequivocally condemns homosexuality, and the destruction of Sodom and Gomorrah stands as a solemn scriptural warning. Any practice that enables or endorses homosexuality is, in the Christian framework, contrary to divine principle and must not be encouraged within the Christian community.
The Case for Compassionate Practice
Nevertheless, some Christians draw on the promise of Exodus 23:25–26 that God’s blessing prevents barrenness and miscarriage to argue that the ability to bear and carry children is itself a blessing meant to be shared with others. From the Christian virtues of love, empathy, generosity, and compassion, some Christian women have established agencies that use IVF practices as a ministry of care for those longing for children. Jesus’ own encounter with barrenness in Mark 11:12–25 and the broader scriptural acknowledgment of the pain of childlessness have led some Christians to regard involvement in reproductive assistance as a genuine form of ministry.
Authors’ Position
While the work of the Holy Spirit is fully capable of bringing about healing, many Christians simultaneously seek medical treatment and rightly so. The argument that IVF inherently endorses homosexuality must be examined carefully: same-sex practices existed long before IVF was introduced, and the technology itself is not the cause of homosexuality. Furthermore, beyond one’s service in the house of God, one’s professional vocation is also a divine calling, a means of serving others. Therefore, just as seeking medical treatment or adopting children is not regarded as contrary to Christian faith, IVF in the form of altruistic or partial surrogacy, particularly where the commissioned couple provides both sperm and eggs, is not inherently incompatible with Christian principles.
Conclusion
The foregoing discussion demonstrates that IVF and surrogate motherhood attract diverse and complex opinions when evaluated through an ethical lens. It must be acknowledged that those directly affected by infertility experience its weight in ways that those on the outside cannot fully appreciate. While Christianity is fundamentally deontological in its ethical orientation, it is also, in certain cases, ontological, as illustrated by Jesus, who healed on the Sabbath. A situation in which a couple donates their own sperm and eggs within the context of altruistic surrogacy does not, in the view of the authors, compromise the Christian faith. The ontological dimension of Christian ethics, as it relates to IVF, deserves greater reflection from Christian leaders, particularly given that the IVF process is, in many respects, not fundamentally different from blood transfusion or organ transplantation.
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