Q. I am in a moral predicament. I am Catholic and my husband is Orthodox. He is nearing 40 and I am nearing 35. We have been married for nearly four years. We have been told we have a 1% chance of natural conception given male infertility issues (low sperm motility). Both my husband and I have tried surgical methods and vitamins to enhance our fertility, but have seen little improvement. We have also tried the Creighton Model, but that primarily deals with female infertility, not male. The only medical solution available to us for conceiving our own child of which we are aware is in vitro fertilization (IVF) using a technique known as Intracytoplasmic Sperm Injection (ICSI, where a single sperm cell is injected into the cytoplasm of the egg (this overcomes the motility issue). The Orthodox Church does not teach against IVF and in fact encourages it in cases like ours, and very few Catholic priests ever state plainly the Catholic position. Because of my strong desire for parenthood, I have come to be open to IVF. If we choose it, we will use my eggs and my husband’s sperm, so no donors would be involved, and we would not do pre-genetic screening to “discard” any embryos. I admit I am not fully 100% OK with doing IVF and have consulted my priest friends who have stated they are not moral theologians and thus can’t advise further on the details of the Church’s teaching. Could you please offer some advice in the near future? I am currently scheduled to begin my first cycle of IVF June 5. I thus respectfully ask for a reply before that time if at all possible.

A. I want to begin by apologizing to you on behalf of the Catholic Church, and particularly on behalf of the priests, bishops, catechists and teachers that you’ve had in your life who have badly failed you. I am very sorry for this, truly, because it will doubtlessly make your reception of the truth of the Catholic teaching more difficult and doubtful. Please read my reply prayerfully.

Your beautifully worded dilemma comes down to a simple question: Is it ever morally legitimate to create new human life outside the context of marital intercourse? For if it is, then surely your situation — a devout, faithful, married Christian couple struggling with male infertility — would warrant a limited appeal to a technology like IVF.

But the answer to the question, according to the authoritative, repeated and unchangeable teaching of the Catholic Church, is No. I tell you this with my deepest compassion and sympathy. I am sorry, but there is no wiggle room whatsoever. And anyone who tells you otherwise, including any priest or bishop, may not understand this teaching but nonetheless, is misleading you and betraying the Catholic teaching.

Perhaps an explanation of that teaching might be of some assistance.

IVF is a relatively new technology and so it is only in the last half-century that the Catholic Church has had anything to say about it. One of the first and most authoritative — and still the clearest — teachings on assisted reproduction is in Donum Vitae, the 1987 Instruction of the Congregation for the Doctrine of the Faith (CDF) written by its then prefect, Cardinal Joseph Ratzinger at the request of St. John Paul II. [It is far more authoritative than anything published by the U.S. Conference of Catholic Bishops.]

In Part II, the document explains why procreation should always be a “fruit of marriage” (i.e., should only ever supervene upon an act of intercourse between married persons).

The text says human procreation “must be the fruit and the sign of the mutual self-giving of the spouses, of their love and of their fidelity.” It says that this follows from a truth taught by Pope Paul VI in Humanae Vitae, namely, that

[there is an] inseparable connection, established by God, which man on his own initiative may not break, between the unitive and procreative meanings of the marriage act, both of which are inherent to the marriage act (12).

The unitive meaning of the marriage act is that by which a man and woman joined together in matrimony become “one-flesh.” The text, of course, is referring to sexual intercourse. There is an “inseparable” connection, Humanae Vitae teaches, between the mutual self-giving of the spouses in sexual intercourse and the coming-to-be of new human life.

Since we know that the connection between intercourse and procreation is not inseparable physically (since we can easily break it, at least today), the inseparability referred to must be a moral quality. And in fact, this is precisely what the text implies when it teaches that “man on his own initiative may not break” the bond: may not, not cannot. That is, it is never morally legitimate intentionally to separate the coming-to-be of new human life from marital sexual intercourse.

Pope Pius XII taught this principle as far back as 1956, when addressing the just-burgeoning possibility of severing the link he proclaimed: “It is never permitted to separate these different aspects to such a degree as positively to exclude either the procreative intention or the conjugal relation” (see here for the Spanish text).

Two conclusions follow: 1) Sexual intercourse may never rightly be chosen while simultaneously choosing to exclude the possibility of procreation (i.e., contraceptive sex); and 2) procreation may never rightly be chosen outside the context of martial intercourse.

Donum Vitae concludes saying that “fertilization” is only ever legitimately pursued “when it is the result of a ‘conjugal act which is per se suitable for the generation of children to which marriage is ordered by its nature and by which the spouses become one flesh’” (italics in original; internal quote from Canon Law, 1061).

This teaching has been repeated multiple times over the last 30 years. For example, the Catechism of the Catholic Church teaches:

Techniques involving only the married couple (homologous artificial insemination and fertilization [including IVF]) … remain morally unacceptable. They dissociate the sexual act from the procreative act (2377).

Other important texts include the 2008 Congregation for the Doctrine of Faith’s document Dignitas Personae (16-17; 17 addresses ICSI); the 2009 USCCB text “Life Giving Love in an Age of Technology” (pp. 6-10). Indeed, all the doctrinal documents on assisted reproduction on the USCCB website are unambiguous in their affirmation of this teaching.

This teaching may feel legalistic, as if Church authorities arbitrarily have chosen to draw this “inseparable” line and then have imposed it upon the Church, imposed it upon those of us whose concerns and needs are far removed from theirs.

Where, you might ask, does the absoluteness of this link between the marital act and procreation arise from? Under extreme circumstances such as ours, why can’t an exception be made? After all, we have no intention of accepting the many evil actions that the wider IVF community engages in: creating multiple embryos, destroying some, freezing others, “selectively reducing” multifetus pregnancies, etc.

I agree that choosing IVF while excluding every intention to kill, experiment upon or freeze, or tolerate the killing, experimenting upon or freezing of, the embryonic children you create, while positively intending to receive lovingly those who survive, to nurture them healthfully and raise them in the faith, is far better than the majority of our contemporaries who choose IVF.

But it is still wrong, and seriously so. Why?

Because children not only have a right to be raised lovingly by a father and mother, they have a right, the Church teaches, to be brought into the world through a mother and father’s act of love. The embryos you are considering bringing into existence are human persons. There is nothing more awesome, more valuable, more worthy of respect in the entire created universe — not even angels — than human persons. As such, they have a grave natural right to be brought into the world in a way that fully befits their personal dignity, in a way expressive of committed human love; and we have a grave responsibility to respect that right.

There is only one human act that adequately expresses this love: marital intercourse. When embryonic children supervene upon an act of self-giving love, they are literally begotten in and by love.

IVF children, on the other hand, even one’s belonging to good people like you, are not begotten in love, they are made. They are the products of a laboratory procedure, where constituent elements are mixed together under the wary eye of a technician at a controlled temperature, inserted into warming trays, and observed under a microscope till ripe for implantation. These children come into existence not by an act of love, but by a technique in a laboratory. In this way they are treated as products. The fact that their parents intend to raise them lovingly in the faith does not and cannot erase the fact that from their first vulnerable moments of existence, they are treated as subhuman; sinned against; harmed. What then should you do? Well, the first thing any of us must do when considering available options is exclude morally wrongful alternatives. So you should cancel your June 5 appointment. This will be difficult. But it is the right thing to do. Then you discern how to proceed. Have you considered intrauterine/fallopian insemination (IUI)? Here, a couple performs marital intercourse; sperm are collected from the woman’s vagina (not through the use of a perforated condom); the sperm is washed and relocated within her fallopian tubes or uterus. The egg may also be removed and relocated. Some theologians believe this constitutes a replacement of the marital act, but I do not agree. It seems to me a morally licit way to assist the completion of the marital act. The Church has not taught specifically on the morality of IUI.

If in the end you find no morally licit way to conceive your own children, then, like all serious unavoidable sufferings that people face, you should do your best to accept your infertility as a cross that Jesus, at least for the time being, is asking you to bear. But you mustn’t try an end-run around the cross. It will end badly for you and those you love.

I would be happy to speak with you further about this.