On being Catholic and infertile

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I’m a practicing Roman Catholic. And so, when first faced with our infertility troubles, I made an effort to better understand the church’s stance. (I knew that the church does not approve of IVF, but why exactly? What about IUI? Hormone injections?) Fortunately, while exiting church one day, I spotted the above pamphlet for $0.50. I bought it, and here’s what I learned:

Catholic church-approved infertility treatments:

  • charting (also the only approved form of birth control; we Catholics call it Natural Family Planning or NFP)
  • ovulation test strips/monitors (POAS = not a sin)
  • most testing/evaluation procedures (see exception below)
  • drugs, hormones, suppositories (whether taken for the purpose of encouraging ovulation or supporting implantation or pregnancy)
  • corrective surgery

Unapproved infertility treatments:

  • Testing sperm obtained by masturbation (Yep, jerking off = still a no-no. As an intriguing side note, there are apparently Catholic church-approved ‘perforated condoms’ that can be used to collect semen samples during sex – the perforations are necessary to avoid violating church teaching about contraception. And, suddenly my mind jumps to a wildly inappropriate prank idea…Then, that thought is replaced by a mental image of showing up at Dr. Y’s office and handing him a dripping condom…)
  • IUI or any other form of artificial insemination
  • IVF (or ZIFT or GIFT…do people still do these?)

So, what are the underlying moral objections to these forms of treatment? What I learned in this little booklet didn’t come as much of a surprise. I’ll paraphrase:

  1. The purpose of sex is procreation, so any act that divorces the two is a sin.
  2. Life begins at conception, and any act that destroys life [even an embryo] is a sin.

Now I have to acknowledge that Catholic Church teaching is consistent. That first statement is the single reason why the church forbids masturbation, anal/oral/etc. sex, contraception, and gay sex – all of which represent sex without the possibility of procreation. Assisted reproductive technologies (including IUI, IVF, etc.) on the other hand represent procreation without sex.

It wasn’t hard for me to reject the first argument. In fact, I rejected that argument a long time ago. (Judging by the size of the average Catholic family these days, I think it’s safe to say most American and European Catholics reject that argument, whether consciously or not.) Specifically, I don’t believe that God would make gay people only to present them the unappealing choice between being celibate or a sinner. I also don’t believe that God would limit heterosexual couples to a contraceptive choice that forces one partner to choose between ignoring her hormonal urges each month or getting pregnant with her 12th child… (Incidentally, I was especially surprised a few years back to learn that my favorite Dominican priest, Fr. D. shares this concern!)

The second argument is more difficult for me, and I’ve managed to avoid it during the IUI process, but not if we move forward with IVF. This is the same argument for why the Catholic Church opposes abortion, an issue which I also struggle with – perhaps more so now that we are experiencing infertility. I’ll set aside abortion for now, but what do I think about the destruction of embryos as a result of IVF? If you had asked me a year ago, I would have given a totally lame answer:

“I think it’s great that many suffering from infertility will get to achieve their dream of pregnancy by IVF, but I wouldn’t go to those lengths.”

If pressed, I might have continued that it would seem like “such an extravagant use of resources just for the luxury of my own biological child.” That “there are so many unwanted children in need of homes,” and that “maybe it was God’s way of saying he had another plan for me.” Yup, I was one of those people. I can’t believe my good friend N. (who went through 3 or 4 fresh IVF cycles – I lost count – ultimately resulting in a gorgeous little boy) didn’t slap me across the face when I told her I’d never do IVF. I’ve since apologized for being such a hypocritical idiot!

So my feelings about IVF have changed. Did they change because now it’s me? Because now IVF is my best chance at a genetic child? Certainly that has something to do with it. But something else has changed too.

After a miscarriage at 9 weeks followed 10 months of infertility (not to mention another six failed pregnancies among close friends in that same time period), I just don’t think of embryos the same way. Before this whole experience, I think I easily could have viewed each sperm cell and each egg as a ‘potential baby’. Under the right conditions, they could fulfill their destiny and grow into a living breathing human being. [insert slight sarcasm here]

What is now apparent is that, even under the best conditions I can muster (cushy uterus, healthy & “relaxed” host, optimum timing, perfect super-sperm), I’ll be lucky to get one of my eggs to reach its so-called ‘potential’. And the best chance of doing so is through IVF.

So how can I view the demise of 3- or 5-day-old embryos (assuming I’m lucky enough to get any) as ‘destroying a life’, when they almost certainly would never have existed without IVF, and when we are actively doing everything in our power to help them develop into a baby?

Frankly, I can’t (or won’t) see IVF that way. At least not now. And as a Roman Catholic, I’m okay with that!

Postscript: To those who would call me a ‘Cafeteria Catholic’

I know you’re out there; people who will accuse me of being a ‘Cafeteria Catholic’ or ‘CINO’ (Catholic-In-Name-Only), or what have you. Aside from trotting out my Catholic credentials (baptized, confirmed, and married in the church; attend mass weekly and on all holy days of obligation – including while traveling; fast and abstain during lent; confirmation sponsor to my sister; selected by the priest to serve on my church’s Pastoral Council; etc.), and getting angry (man that term irritates me!), I like to point out two observations:

  1. Everyone I’ve ever heard accuse someone of being a ‘Cafeteria Catholic’ is, by their own definition, a Cafeteria Catholic. It’s hard not to be. The Catholic Church – more than any other church – has an official opinion on just about everything. To not be a Cafeteria Catholic, someone would first have to take the time to learn everything that the Catholic Church teaches, and then take on the Herculean task of adhering to that teaching. Actually, to spot the hypocrisy involved in this accusation, you typically don’t even have to work that hard. Pick an issue outside of Catholic moral teaching (better yet, just pick something outside of the small subtopic of sexual morality) and ask the accuser how they live that teaching in their own life. Almost invariably, users of the term Cafeteria Catholic totally ignore some or all tenets of Catholic teaching on social justice, stewardship of the environment, capital punishment, just war, and so on. (For some reason, these folks seem to be obsessed with sex. Maybe they are angry that they’re not having enough …and are envious of everyone that is.)
  2. The use of the term ‘Cafeteria Catholic’ betrays an utter misunderstanding of where Church teaching comes from. Catholic Church teaching is not static. In fact, one of the things about it that so many fundamentalist Christians find objectionable is that we don’t believe the bible to be the final and supreme word of God. Instead, we believe that God continues to speak through an ever-growing Church tradition. New issues (moral and otherwise) arise, and the Church responds, typically by enlisting a panel of experts and church leaders, who engage in extensive discussions, and prayer, and ultimately arrive at some kind of consensus that is adopted as the official Church teaching. Thoughtful and prayerful consideration of issues is part of the process. Consistent with that tradition, priests are NOT mindless drones that regurgitate official Church teaching. The majority are highly educated critical thinkers, taught to ask challenging questions and grow in their faith through independent thought and prayer. Why should laypeople behave any differently?

If I disagree with American policy (or even a small subset of American policy), am I a ‘Cafeteria American’? Can I be a ‘Cafeteria Chemist’? The Catholic Church is losing enough believers as it is. Do we really want to be in the business of telling people they don’t belong?

I don’t mean to imply that the Church is ‘wrong’ about infertility treatment, and that my beliefs are ‘right’. I fully recognize that my knowledge and experience is inherently limited, that God’s plan is beyond my comprehension in this life. But I also feel confident that I am thoughtfully and prayerfully considering the consequences of my infertility treatment, and as of today, I am comfortable proceeding with IVF if this IUI cycle fails…

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Looking good!

So today I had a blood estradiol (E2) test, and ultrasound to see how I’m responding to the Menopur, and all looks good. 🙂

The annoying part is that they only do the estradiol test at the hospital lab across town, and only from 7-7:30 am. So I had to wake up at 5:30 this morning to get ready and drive east to the hospital, and then drive back west in rush-hour traffic to teach my 8:30 class. Fortunately, the infertility clinic is on this side of town, so making it to my 10:30 ultrasound appointment was no problem.

Anyway, the result is that I have two decent-sized follicles, and one smaller one. This is good news, since our target is 2-3 follicles for IUI. Based on the size of the follicles and on my estradiol (281 pg/mL), the nurse practitioner recommended upping my dose of Menopur from 300 IU to 375 IU per injection, and repeating the blood draw (5:30 am wakeup – Boo!) and ultrasound on Friday. Depending on those results, we may do the insemination as early as Saturday!