A court decision in a wrongful-death case in Alabama last month drew a spotlight to in vitro fertilization, an increasingly popular method of conceiving babies for the infertile. In vitro — Latin for “in glass” — fertilization brings together a man’s sperm and a woman’s egg in a petri dish. After maturing through cell division, the fertilized egg can be implanted in a woman, beginning a pregnancy that may lead to the birth of a baby.

Why do people use it? And what does the Catholic Church say about it?

1. What Is an Embryo?

When a human male sperm penetrates a female egg, they unite in a single cell called a zygote, which contains all of the genetic information of a new organism (a word that means “living being”). That’s an embryo, a term biologists use to describe the stage of human development from fertilized egg to about the eighth week of pregnancy.

If formed through sexual intercourse, the embryo may attach to the lining of the uterus after about six days. If it doesn’t attach, the embryo will die, either before or after leaving the woman’s body during her next menstrual period. Scientists estimate that between 10% and 40% of embryos don’t attach to the wall of the uterus and that roughly 40% to 60% of embryos do not make it to birth.

2. What Is a Pre-Embryo?

Many supporters of in vitro fertilization say a fertilized egg in its early stages is not a human being and should not have the rights of a human being.

In 1979, the Ethics Advisory Board of a federal agency then known as the U.S. Department of Health, Education, and Welfare concluded that “the human embryo is entitled to profound respect; but this respect does not necessarily encompass the full legal and moral rights attributed to persons.”

In 1986, supporters of in vitro fertilization in the United States and in England independently began referring to a fertilized egg before implantation in the wall of a uterus as a “pre-embryo.”

The term is designed to differentiate the biological and moral status of this particular stage of development from that of an implanted embryo. One supporter of in vitro fertilization, Dr. Howard W. Jones Jr., in 1989 called a fertilized egg that isn’t implanted in the wall of a uterus “a special bit of humanity” that nevertheless “cannot have the moral equivalent of an adult” and therefore could rightly be subject to “use for experimental purposes when certain conditions are met … for an experiment that is carried out to enhance the human condition.”

Opponents of in vitro fertilization see no biological or moral distinction between a fertilized egg that hasn’t been implanted in the wall of a uterus and one that has, so they don’t use the term “pre-embryo.”

3. What Does the Catholic Church Say About Embryos?

The Catholic Church teaches that an embryo is a person with rights that must be respected.

“… [F]rom the moment the zygote has been formed,” says Donum Vitae (“The Gift of Life”) (I, 1), a 1987 document from the Vatican’s Congregation for the Doctrine of the Faith co-authored by the future Pope Benedict XVI, “the fruit of human generation … demands the unconditional respect that is morally due to the human being.”

It adds: “The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life.”

Destroying embryos, freezing embryos, and experimenting on embryos are all immoral because they violate the dignity and rights of the human person, the Church says.

Such practices should be illegal, the Church says. Since embryos are human beings, civil law “cannot tolerate — indeed, it must expressly forbid — that human beings, even at the embryonic stage, should be treated as objects of experimentation, be mutilated or destroyed with the excuse that they are superfluous or incapable of developing normally,” Donum Vitae says (III).

4. What Does the Catholic Church Say About In Vitro Fertilization?

The Catechism of the Catholic Church acknowledges that infertile couples “suffer greatly” and encourages fertility research, but condemns in vitro fertilization.

One of the Church’s major objections is that IVF separates conception from the marital act. Techniques used to conceive a baby outside the womb “dissociate the sexual act from the procreative act,” the Catechism states (2376), adding that “the act which brings the child into existence is no longer an act by which two persons give themselves to one another.”

A child has a right to be “the fruit of the specific act of the conjugal love of his parents,” the Vatican’s 1987 document Donum Vitae states (II, 8).

Another objection is that “spare” embryos are destroyed in the IVF process.

Specialists who practice in vitro fertilization often create more embryos than the prospective mother wants, because individual embryos may not be the desired sex or may have physical defects, and because of the high failure rate of growth, implantation and development.

The “spare” embryos are either frozen for future use or destroyed, which makes human beings who make these decisions “the giver of life and death by decree” and sets up a “dynamic of violence and domination,” according to the Vatican’s 1987 document Donum Vitae (II).

Creating embryos only to destroy them, the document says, reflects a “cold logic” stemming from “the abortion mentality” that “leads, whether one wants it or not, to man’s domination over the life and death of his fellow human beings and can lead to a system of radical eugenics.”

5. How Common Is In Vitro Fertilization?

About one in six people experience infertility, according to the World Health Organization.

In 2021, 2.3% of all babies born in the United States were conceived through “assisted reproductive technology” (which includes in vitro fertilization and less common fertility measures), according to the U.S. Centers for Disease Control and Prevention. That year the country had 501 fertility clinics, of which 453 clinics reported 246,087 assisted reproductive technology procedures, resulting in 97,128 live births, according to the CDC.

Users include infertile heterosexual couples, single women and same-sex couples.

One financial analysis estimated the value of the in vitro fertilization market in 2022 at $23 billion and predicted it’s likely to grow to $39 billion by 2032.

6. Why Are Some Embryos Frozen?

The first live birth of a baby initially frozen as an embryo occurred in the Netherlands in December 1983.

Fertility clinics freeze embryos in order to stop chemical reactions in the cells of the embryos, massively slowing down the aging process. Embryos are stored in liquid nitrogen, with a temperature of -320 degrees Fahrenheit, which, according to the Texas Fertility Center, “halts all metabolism of the embryo, allowing embryos to be safely stored for an indefinite period of time.”

Over time, the “freeze-all” embryos strategy has become common, because the “quality of frozen embryos” meets or even exceeds “fresh embryos,” and freezing them allows doctors to time implanting an embryo in a woman’s uterus during the most favorable conditions, according to a 2022 study in the medical journal Translational Pediatrics.

Freezing embryos also allows time to test them for genetic disorders, which increases the chance such embryos will not be implanted in a woman’s womb.

In addition, fertility clinics often create more embryos than the prospective parents want in case an implantation fails and the embryo dies in the uterus. Fertility clinics may implant two or three embryos at a time and hold back others in case a woman wants an additional implantation. Some surplus embryos are discarded.

It’s not clear how long a frozen embryo can survive. But a baby was born in Tennessee in November 2017, 25 years after being frozen as an embryo in 1992.

7. Why Are Some Embryos Discarded?

In vitro fertilization specialists engage in a “winnowing process” to try to maximize the chances of the birth of a healthy baby that the prospective parents want.

A YouTube video produced by an in vitro fertilization practice, Illume Fertility, describes a hypothetical scenario in which 12 mature eggs retrieved from a woman’s body become 10 fertilized eggs that yield three to five embryos capable of being implanted in a woman’s uterus. Genetic testing of those may yield only two “that are genetically or chromosomally normal,” according to the narrator, and therefore likely to be implanted.

“This would actually be a good outcome,” the narrator, nurse practitioner Monica Moore, says in the video.

Embryos that are genetically abnormal may be discarded. Most in vitro fertilization clinics in the United States offer sex selection, according to a 2018 study in the Journal of Assisted Reproduction and Genetics, meaning prospective parents can discard embryos that are not the desired sex.

Though exact numbers are hard to come by, some observers estimate that more embryos are destroyed in in vitro fertilization in the United States each year than by abortion.

8. Can You Adopt an Embryo?

Two evangelical Christian organizations offer prospective parents with fertility problems the ability to “adopt” an embryo frozen after in vitro fertilization.

Nightlight Christian Adoptions began its embryo adoption program, called Snowflakes, in 1997. It matches couples willing to donate their frozen embryos to couples seeking a baby. The National Embryo Donation Center in Tennessee acquires donated embryos and implants them in women seeking to give birth.

Both organizations serve only intended parents who are Christian married couples. Both organizations charge fees for their services.

Legally, adopting an embryo is not akin to adopting a child. It’s a contractual transaction between the owner of the embryo and the couple who want to acquire the embryo.

Only a small percentage of embryo transfers in the United States come from donated embryos — about 1.5% in 2019, according to a 2022 study published by the American Journal of Obstetrics and Gynecology.

Catholic ethicists are divided over whether such “adoptions” of embryos are moral, as the Register reported in 2023. Some say it’s an act of charity that can save a life and therefore may be morally licit. Others say in vitro fertilization is so immoral Catholics (and others) should have nothing to do with it.

The Vatican has not made a final pronouncement on such embryo “adoptions,” but has taken a dim view of all the possible options after an embryo is frozen: destruction, experimentation, implantation and suspended animation. A 2008 document from the Vatican’s Congregation for the Doctrine of the Faith called Dignitatis Personae (“The Dignity of the Person”) described the existence of frozen embryos as “a situation of injustice which in fact cannot be resolved” (19, italics in original).

9. Where Did In Vitro Fertilization Come From?

In 1878, Austrian embryologist Leopold Schenk (1840-1902) fertilized eggs of female rabbits and guinea pigs outside of their bodies by adding male sperm.

In 1934 a biologist at Harvard named Gregory Pincus (1903-1967) took eggs out of a female rabbit, mixed them with sperm from a male rabbit, and transplanted the mixture back into the mother, resulting in the birth of offspring. Pincus predicted that some day the same process could be done with human beings. Negative publicity, including from The New York Times, helped get Pincus fired from Harvard, according to Jonathan Eig’s 2014 book The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution.

In 1944, after six years of trying, gynecologist and fertility expert John Rock (1890-1984) (a Catholic father of five) and his lab technician at the Free Hospital for Women in Brookline, Massachusetts, Miriam Menkin (1901-1992), fertilized human female eggs with human male sperm in a dish: the first human in vitro fertilization. Menkin retrieved the eggs and leftover sperm from the ovaries of women who had just had surgery at the hospital, according to Margaret Marsh and Wanda Ronner’s 2019 book The Pursuit of Parenthood: Reproductive Technology from Test-Tube Babies to Uterus Transplants.

In 1961, an Italian physician, Daniele Petrucci (1921-1973), created an embryo through in vitro fertilization and kept the embryo alive for more than a month, before destroying the embryo.

In 1978, Louise Brown, called the first “test-tube baby,” was born in Manchester, England. (The term was later changed to “in vitro fertilization” because fertilization of the egg takes place in a glass petri dish, not in a test tube.)

10. What Does the Law Say About In Vitro Fertilization?

The U.S. federal government does not currently regulate in vitro fertilization. States do.

In vitro fertilization is legal in all 50 states. Only Louisiana has a state law prohibiting destruction of embryos; a 1986 statute there prohibits destroying a viable fertilized egg, which it defines as “a juridical person.”

Fifteen states require health insurance plans to cover in vitro fertilization, according to

Resolve: The National Fertility Association, which supports in vitro fertilization and tracks laws concerning it.

11. What Happened in Alabama Last Month?

In December 2020, a patient at the Mobile Infirmary Medical Center wandered into a fertility clinic at the hospital and removed several frozen embryos from what the clinic calls a “cryogenic nursery.” The deep-freeze temperatures freeze-burned the hand of the patient, who dropped the embryos on the floor, which destroyed them.

Three couples who are parents of five destroyed embryos sued the hospital and the fertility clinic. One of the lawsuits claimed that negligence by the hospital and fertility clinic led to the wrongful death of a person. All three couples sought damages for mental anguish and emotional distress. The hospital and clinic countered that the frozen embryos do not qualify legally as either a “person” or a “child.”

But on Feb. 16, the Alabama Supreme Court said they do.

The court cited the current Alabama Constitution, which voters adopted in November 2022, which includes a section stating, “This state acknowledges, declares, and affirms the sanctity of unborn LIFE and the rights of unborn children, including the right to LIFE” (capital letters in the original).

By an 8-1 majority, the court found that state law does not contain “an unwritten exception to that rule for extrauterine children — that is, unborn children who are located outside of a biological uterus at the time they are killed.”

The court said the wrongful-death case can go forward. That led major fertility clinics in the state to pause in vitro fertilization treatments, out of concerns about their liability.

The Republican-dominated state Legislature quickly put together and passed a bill that seeks to prevent future lawsuits or criminal prosecution for “the damage to or death of an embryo … when providing or receiving goods or services related to in vitro fertilization.” Gov. Kay Ivey, a Republican, signed the bill into law on March 6.

12. What Is Congress Doing About In Vitro Fertilization?

A bill currently before the U.S. Senate proposes a nationwide right to discard embryos and would allow health insurance companies to cover in vitro fertilization if they wish. The sponsor is U.S. Sen. Tammy Duckworth, D-Ill., who has two children through in vitro fertilization. Duckworth, who filed the bill Jan. 18, sought unanimous consent for it after the Alabama Supreme Court issued its ruling in mid-February; the bill has avoided the usual process of review by at least one legislative committee. But a Republican, U.S. Sen. Cindy Hyde-Smith of Mississippi, has blocked the bill, which means it is unlikely to pass quickly. The bill is currently before the U.S. Senate’s Committee on Health, Education, Labor, and Pensions, which, as of mid-March 2024, has not scheduled a hearing on it.

On Feb. 28, the U.S. Conference of Catholic Bishops sent U.S. senators a letter opposing Duckworth’s in vitro fertilization bill, calling it “neither pro-life nor pro-child.”

The bishops said they “grieve with many couples bearing this cross” of infertility.

“The solution, however, can never be a medical process that involves the creation of countless preborn children and results in most of them being frozen or discarded and destroyed,” states the letter, signed by Bishop Robert Barron of the Diocese of Winona-Rochester, Minnesota; Bishop Kevin Rhoades of the Diocese of Fort Wayne-South Bend, Indiana; Bishop Michael Burbridge of the Diocese of Arlington, Virginia; and Archbishop Borys Gudziak, who leads the Ukrainian Catholic Archeparchy of Philadelphia.

The bishops raised alarm about a provision in Duckworth’s bill that would exempt it from the federal Religious Freedom Restoration Act of 1993, which the bishops say might force “faith-based non-profit charities, schools, and church organizations” to pay for in vitro fertilization procedures “that violate their beliefs” in their health insurance plans or else “exit the field.”

13. What Do Americans Think of In Vitro Fertilization?

A CBS News poll released in early March 2024 found that 865 of Americans think in vitro fertilization should be legal.

An Axios poll released Feb. 28 found that only about 31% said frozen embryos should be considered as people and those who destroy them held legally responsible, while 66% oppose those positions. About 35% said they know someone who has used in vitro fertilization.

The presumptive presidential nominees of the two major political parties — President Joe Biden and former president Donald Trump — last month released statements saying they support in vitro fertilization.

14. Can a Baby Born of In Vitro Fertilization Be Baptized in the Catholic Church?

The Catholic Church’s Code of Canon Law of 1983 provides only two conditions for baptizing an infant (868):

A. At least one parent (“or the person who legitimately takes their place”) consents.

B. There is “a founded hope that the infant will be brought up in the Catholic religion.”

Canon law makes no distinction for baptism between babies conceived normally and babies conceived through in vitro fertilization. So, yes, babies born of in vitro fertilization can be baptized in the Catholic Church.

15. What Fertility Treatments Get the Catholic Church’s Blessing?

Fertility drugs that stimulate the production of eggs in a woman’s body and surgery that overcomes blockages in the male or female reproductive system are among fertility measures the Catholic Church deems morally licit, according to an article by National Catholic Bioethics Center founder John Haas posted on the U.S. Conference of Catholic Bishops’ website.

The Vatican’s 2008 document Dignitatis Personae gives a moral green light specifically to “hormonal treatments for infertility, surgery for endometriosis, unblocking of fallopian tubes or their surgical repair” (13).

The National Center for Women’s Health at the St. Paul VI Institute in Omaha, Nebraska, offers reproductive treatments “consistent with Catholic moral principles,” according to the institute’s website. A Catholic infertility ministry called Springs in the Desert offers guidance from a Catholic perspective. The National Catholic Bioethics Center offers personal consultations on the ethics of in vitro fertilization.