Frequently Asked Questions About Fertility Planning (by Steven Bozza, MA)
Can the contraceptive pill be taken for medical reasons?
Can the contraceptive pill be taken to regulate the fertility cycle?
What are the options available to the couple if one or both test positive for genetic illnesses?
Are fertility drugs acceptable if a couple cannot conceive?
What can a couple do if fertility drugs do not work?
If God is a God of life, how can in vitro Fertilization be wrong?
Are persons conceived by in vitro Fertilization less than human?
What if a couple is infertile due to natural causes, is their marriage still ok?
What if a couple is sterilized through vasectomy or tubal ligation, what are their options?
The priest that is marrying us said that with issues of contraception, we have to use our conscience. Is he wrong?
Q. Can the contraceptive pill be taken for medical reasons?
A. The Church, moreover, does allow the use of medical treatment necessary for curing diseases of the body although this treatment may thwart one’s ability to procreate. Such treatment is permissible even if the reduction of fertility is foreseen, as long as the infertility is not directly intended for any reason whatsoever. Humanae Vitae #15
Pope Paul VI uses the Principle of Double Effect to come to this conclusion. The definition of the Principle of Double Effect is: one act, which is good in itself, has two effects. One is the intended good effect and the second is the unintended yet foreseen evil effect. The good effect has to be proportionately greater than the evil effect. The good effect in this case is the healing of a disease. In doing so, the woman’s fertility is going to be compromised. All the parties involved know this from the outset.
- Use of the contraceptive pill may provide relief of symptoms, but the doctor may not have diagnosed the cause of the problem. With more information on the cause, a more specific drug or therapy may resolve the problem
- For instance, physicians often prescribe the pill for acne problems. Is there a better treatment which does not disrupt the fertility cycle and avoids the risks of the pill?
- It may be that the contraceptive pill is the appropriate therapy. However, it should only be used as the last resort.
- The contraceptive pill is also an abortifacient (click on http://ccli.org/nfp/contraception/pill.php to learn how the contraceptive pill works). Therefore, the couple still needs to assess where the woman is in her fertility cycle and time intercourse for the time of infertility so there is no chance that a child is conceived. Otherwise, there is still a chance that fertilization may occur, and using the pill may abort the child.
Q. Can the contraceptive pill be taken to regulate the fertility cycle?
A.Cycle irregularity can mean different things. Most of the time it is not caused by a serious illness, rather it is caused by some hormonal imbalance. In a time when managed care dominates the practice of medicine, physicians oftentimes are forced to be expedient at the expense of thoroughness. It is easier to prescribe the contraception pill rather than order tests to discover which hormones need to be adjusted.
In reality, the pill does not regulate a cycle. It causes a regular withdrawal bleeding without the ovulation. The root of the hormonal imbalance which caused the irregularity in the first place still exists and will return after the therapy is over.
Since the individual is solely responsible for his or her health care decisions, the woman should not just settle for the contraceptive pill without asking for other testing to diagnose the root cause of the irregularity and the appropriate medication or therapy to treat it. (Click on http://www.naprotechnology.com/ for more information.)
Q. What are the options available to the couple if one or both test positive for genetic illnesses?
A. If we look further to physical, economic, psychological, and social conditions, responsible parenthood is exercised by those who, guided by prudent consideration and generosity, elect to accept many children. Those are also to be considered responsible who, for serious reasons and with due respect for moral precepts, decide not to have another child for either a definite or indefinite amount of time. Humanae Vitae # 10
Genetic testing for congenital illness did not exist in 1968 when Pope Paul VI wrote this encyclical. However, the principles he stated above can be applied to answer this question.
A child has a right to the love, care and nurture from his or her parents. Therefore, in the name of justice for the child to be conceived, couples with a significant probability of having a child with serious disabilities have a duty to examine ahead of time whether they have the physical health and strength to care for a handicapped child. Do they have the economic means to do so? Are they mentally equipped to deal with the stress and other factors associated with raising a special needs child? If the answer is no to one or more of these questions, then they ought to avoid having a child at this time. This does not mean that later on these conditions will still exist. The couple remains open to life if they decide to revisit the issue down the road.
What are the moral precepts the Pontiff asks couples to respect? First, abortion, vasectomy, tubal ligation, and contraception still are morally wrong even in this situation. Second, the practice of Natural Family Planning is morally acceptable for however long it takes the couple to prepare themselves physically, mentally, and economically for the possibility of having a special needs child.
NFP is 99% method effective when used by a motivated and properly trained couple. The couple can add additional safeguards such as extending the abstinence period a day or two. Also, fertility monitors such as Clear Plan are very effective in predicting ovulation.
- Testing positive for a genetic defect does not guarantee having a child with the defect. There is a very good chance that the couple’s children will be healthy.
- Although the practice of NFP instills self mastery and selflessness in the couple, there still lies the danger that the couple can fall into a contraceptive mentality.
Q. Are fertility drugs acceptable if a couple cannot conceive?
A. God created man in his own image and likeness: “male and female he created them” (Gn.1:27), entrusting to them the task of “having dominion over the earth”(Gn.1:28). Basic scientific research and applied research constitute a significant expression of this dominion of man over creation. Donum Vitae Intro. #2
The ability to develop drugs to overcome deficiencies of our bodies and find ways of curing illness and disease is part of our call to refine and perfect creation.
- As in all medications, fertility drugs may have adverse side effects. It is easy to overlook these side effects for the sake of having a child.
- Multiple births are common with fertility drugs. If ovulation produces too many eggs as a result of fertility drugs, aspirating some of these unfertilized eggs from the woman before intercourse is morally acceptable.
Q. What can a couple do if fertility drugs do not work?
A. Human freedom is far reaching. You are free to eat from any of the trees of the garden. But it is not without limits except from the Tree of the Knowledge of Good and Evil. From that tree you shall not eat; the moment you eat from it you are surely doomed to die. Gen 2:16-17. The consequences of going beyond the parameters set by God is stark – death and destruction. This sets up the whole objective moral order.
In regard to human reproduction, marriage and conjugal love are by their nature ordained toward the begetting and educating of children. Children are really the supreme gift of marriage and contribute very substantially to the welfare of their parents. Gaudium et Spes #50. Thus, the freedom to find ways to overcome infertility must be rooted in marriage and have as its source the language of love, the marital act. Any act or procedure outside marriage and the marital act will lead to the degrading of human dignity and loss of respect for human life.
The procedures which are always morally wrong are:
- in vitro Fertilization, (IVF)
- Intra Cytoplasmic Sperm Injection (ICSI)
- Donor Sperm and Donor Eggs
- Surrogate Motherhood
(click on http://www.usccb.org/prolife/issues/nfp/treatment.htm,
and http://www.catholicinfertility.org/guidelines.html for more information)
Q. If God is a God of life, how can in vitro fertilization be wrong?
A. In vitro fertilization is wrong for many reasons. As was stated above, ways to overcome infertility must be rooted in marriage and have as its source the language of love, the marital act. Any act or procedure outside marriage and the marital act will lead to the degrading of human dignity and loss of respect for human life.
For the majority of cases, IVF is procured by married couples who cannot conceive a child. However, it is also procured by single women who want a child yet do not wish to be married. It is also procured by homosexual couples who wish to have a child together. In every case, IVF happens outside the marital act. It replaces the intimacy of marital union with an impersonal clinical procedure.
Before the procedure takes place, a woman is hyperstimulated and as many as 30 eggs are retrieved and placed in the petri dish along with the sperm with the hope that some will unite. Since IVF has a 25% success rate, most often conceptions will not take place.
However, five or six embryos may develop in a particular procedure. A physician may only implant three, which is also risky for the embryos. The left over embryos are frozen for later implantations, experimentations or are destroyed.
There is a form of IVF called Intracytoplasmic Sperm Injection (ICSI) which is often used. ICSI is a procedure in which a single sperm is injected with a fine needle into a single egg. It has a 30% success rate.ICSI is immoral for all the reasons IVF is. It is also immoral because it tampers with the natural selection process, in which the strongest and most genetically fit sperm penetrates the egg for fertilization.
According to CVS Caremark – Motorola, “It has … been reported that ICSI babies have a four-fold increased risk of sex chromosome-linked genetic abnormalities that can result in various clinical syndromes… [T]here appears to be an increased risk of birth defects among babies conceived through ICSI. A study of 5,138 Australian children showed that babies conceived through ICSI or IVF had twice as high of a risk of having a major birth defect as compared to babies that were conceived naturally.”
To explain this phenomenon, the normal ejaculate contains an average of 200-500 million sperm. Only one of them succeeds in fertilization. One of the functions of the cervical mucus is to weed out defective sperm. Those that make it to the egg must be chemically able to penetrate the shell of the egg with speed. This is natural selection, the process that insures the survival of the fittest.
During the ICSI process, the physician chooses a sperm which appears to be healthy. Since in nature, this sperm has a very slim chance to fertilize an egg on its own, genetic defects are more likely to appear in children conceived by ICSI and/or their descendants than those conceived naturally, thus, in effect, eroding the human gene pool.
Q. Are persons conceived by in vitro Fertilization less than fully human persons?
A. The issues of when human life begins and In vitro fertilization are deeply intertwined.
“From the time that the ovum is fertilized, a life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with his own growth."
Regardless of the circumstances surrounding the conception, God is always faithful to all human life. A child conceived using in vitro fertilization is still a child of God.
1. Declaration on Procured Abortion, Congregation for the Doctrine of the Faith (1974), paragraph 12.
Q. What if a couple is infertile due to natural causes, is their marriage still ok?
A. Infertility does not disqualify engaged couples from marrying in the Church nor does it invalidate an already existing marriage.
On the part of the spouses, the desire for a child is natural: it expresses the vocation to fatherhood and motherhood inscribed in conjugal love. This desire can be even stronger if the couple is affected by sterility which appears incurable. Nevertheless, marriage does not confer upon the spouses the right to have a child, but only the right to perform those natural acts which are per se ordered to procreation. Donum Vitae, II,B,8.
Q. What if a couple is sterilized through vasectomy or tubal ligation, what are their options?
A.Certainly we do not wish to ignore the serious difficulties that Christian spouses might encounter, since for them, as for everyone, “the gate is narrow, and the way is difficult that leads to life” (Mt.7: 14). Nevertheless their way will be illuminated by the hope of this life, just as by the clearest light, as long as they strive courageously “to live wisely and justly and piously in the world,” (Tit. 2: 12) knowing that “the form of the world passes away.” (1 Cor. 7: 31). Therefore, let spouses willingly take up the labors that have been assigned to them, strengthened both by faith and by hope, which “do not disappoint because the charity of God is poured into our hearts through the Holy Spirit who is given to us.”(Rom.5: 5) Let them constantly pray for divine assistance. And let them especially drink of grace and charity from the eternal font of the Eucharist. If, however, they are hampered by their sins, let them not lose heart, but let them humbly and constantly flee to the mercy of God, which the sacrament of penance abundantly provides. It is by this way of life that spouses will be able to advance toward perfection in their married life. Humanae Vitae #25
Pope Paul VI is clearly stating that couples who have been sterilized through vasectomy or tubal ligation always have the forgiveness and mercy of God waiting for them. All they need to do is to sincerely ask for it.
According to Humanae Vitae, the teaching authority of the Church has frequently declared that perpetual direct sterilization of the man or woman is always to be excluded as a licit means of regulating births. Do couples then have a responsibility to reverse the sterilization? At first glance, the answer to this question is yes. Not only for spiritual and moral reasons, but also for health reasons, sterilizations should be reversed (click on http://ccli.org/nfp/contraception/vasectomy.php for explanation of health risks from vasectomies, and http://ccli.org/nfp/contraception/tubal.php for tubal ligations).
However, do the parties involved have the financial means to do so? Are they in good enough health over all to undergo the reversal? Are there competent physicians in their area who can reverse the sterilizations? If the answer to any of these questions is no, then a couple is not obligated to have the reversal done.
Q. The priest that is marrying us said that with issues of contraception, we have to use our conscience. Is he wrong?
A.Technically he is correct. Deep within his conscience, man discovers a law which he has not laid upon himself but which he must obey. Its voice, ever calling him to love and to do what is good and to avoid evil, sounds in his heart at the right moment, do this shun that. For man has in his heart a law written by God; to obey it is the very dignity of man; according to it he will be judged. Gaudium et Spes #16
However, left out of this statement is the issue of forming our consciences. Just as the person is obliged to obey his or her conscience, he or she is obliged to form it.
Conscience must be informed and moral judgment enlightened. A well-formed conscience is upright and truthful. It formulates its judgments according to reason, in conformity with the true good willed by the wisdom of the Creator. The education of conscience is indispensable for human beings who are subjected to negative influences and tempted by sin to prefer their own judgment and to reject authoritative teachings. Catechism of the Catholic Church #1783
It formulates its judgments according to reason. This means that one way to form our conscience is to gather information either by research, study, experience, or talking to people.
It formulates its judgments…in conformity with the true good willed by the wisdom of the Creator, The Church is the articulator of the wisdom of God. The Church has no other light than Christ’s; according to a favorite image of the Church Fathers, the Church is like the moon, all its light reflected from the sun. Catechism of the Catholic Church #748. Thus, another indispensible way to form our conscience is to know what the Church says about moral issues.
Steven Bozza, MA is the Director of the Office of Family Life/Respect Life for the Diocese of Camden, email@example.com, 856-583-6116, Fax: 856-964-3401