>> So tonight I figured
we'd start at the beginning
with the beginning of life issues
that revolve around technologically
assisted procreation.
So what I wanna do, just to start with is
this is still front page news.
Now this was a Time Magazine
article or Newsweek piece
that was taken off a series of billboards
that were run in New
York City some time ago
by a group of obstetricians,
reproductive endocrinologists,
infertility specialists
who were becoming more
and more troubled by
the number of women who
were waiting very late in life,
into their late 30s and 40s to begin
trying to have a family
and expecting medicine
to produce miracles for them.
And the physicians
wanted to make some sort
of public statement to
say basically we are not
medical miracle workers.
And so they put out a series of billboards
that went on buses and park
benches and things like that.
And they were absolutely
castigated by the community
for how dare you tell
us about how we ought
to be living our lives?
And they said, actually,
to be honest we're doing
nothing of the sort, we're just,
this is just the facts.
Because the longer we wait, typically,
the more difficult it
becomes to conceive a child.
And sorta the big idea on this is that
you know, M.D. when it comes
to infertility specialist
does not stand for Master of Deity.
Although you'd never know that
by some infertility physicians.
But it is not, you know,
they are not medical miracle workers.
And once you start bumping
up against some limits,
the success rate for many
of these technologically
assisted reproductive methods
is actually somewhat low.
So In vitro fertilization
for example has roughly
a 25 to 30% success rate.
And that has held pretty steady
over the last 10 to 15 years.
So roughly one in three
to one in four couples
will come to an IVF clinic, drop
anywhere from 12 to $15,000
and walk away empty handed.
Now that's one of a number
of sort of little known facts
about the infertility industry
that we'll try and expose.
The immediate concern
for this is that we talk
about the moral issues involved.
Because my guess is in our churches,
my guess is that most
people in our churches
who undergo IVF and other
technologically assisted
programs have no idea
of the moral quagmire
that they've just stepped into.
Because generally what
couples at this phase of life,
what they care most about is
the success rate and the cost.
And I can't tell you how many couples
I've had call me to say
we've just went through IVF,
we're done having children,
and we have five embryos
left in storage, what do we do?
And I say I wish we would
have had this conversation
at the beginning and not the end,
when figuratively speaking
the horse is already
out of the barn.
So, I wanna, the goal for tonight
is to give you the tools to
have this moral discussion
with couples who are contemplating
going down this road.
And I would, it would be,
it would be a huge
achievement if at the end
of our time tonight,
you would feel confident
enough to see yourself
as a resource person
for your church or the
people that you have
in your particular sphere of
influence on this, all right?
Now, one resource that's
forthcoming on this
is a book that will be
released in February of 2011
called Outside the Womb,
subtitled Moral Guidance
on Assisted Reproduction,
published by Moody Press.
Dr. Joy Riley and I
have done this together
and it's an update of
a book that I published
about 15 years ago on these technologies.
But 15 years ago is a life time ago given
all the technological
changes that have occurred.
That will be out, I encourage
you to look for that
when it comes out, because
that's the kind of thing
that you can give to a friend
or give to an infertile
couple and they'll find it
a helpful resource.
All right?
Now,
let's, I'm gonna put you
guys on the hot seat here
for just a minute.
You are the pastor to family ministries
in your particular church, all right?
And you have sitting across the table
from you is a couple who have been married
for about six years, they've been trying
unsuccessfully for the last three years
to have a child.
They have just returned from visiting
the local infertility
clinic for a consultation.
And now they are coming
to you to help them sort
out everything that
they've just been told.
They have a mind numbing array
of options in front of them
that is more alphabet soup
than they know what to do with.
And so what they wanna know is which
of these technological options fits within
the parameters of scripture, okay?
Now, what would you tell them
about the options that
are available to them?
All right?
I'm gonna give you
about two, three minutes
with the person next to you.
And what kind of advice
would you give them?
All right? Go.
Let's see what, what advice would you have
for this couple?
You would have some advice for them.
[audience laughing]
Right?
>> Audience Member: To each his own.
>> Thank you Dr. Relativism.
[audience laughing]
>> Audience Member: Adoption.
>> Okay, seriously consider
adoption, would be,
would that be your,
do you think that should
be their first choice?
>> Audience Member: Well,
I guess it depends how,
how much finances contributes
to what they feel--
>> Okay, let's assume
just for this that money's
not an object.
>> Audience Member: I don't
know enough of the issues that,
>> Okay, fair enough, that's okay.
>> Audience Member: There's children
that need love and care.
>> That's exactly right, okay.
>> Yeah, something in this kind
of an issue with me too.
I don't know all the
options and everything,
but I would talk to them in
terms of what are the options
that the doctor or whatnot gave you,
look at if any of them do actually fit
into the biblical parameters.
>> That's what she's asking you for.
>> Oh okay.
>> So which ones do?
>> So yeah, yeah, okay, so
no, I would be basically
the same,
>> Adoption?
>> Yeah.
>> Okay.
>> So you would say don't,
no going down the
technological road at all.
>> As far as I know, yeah.
>> Okay, all right.
>> Audience Member: I'm fairly
ignorant to the infertility,
or to the in vitro, so I'm
not sure if I'm speaking
correctly on this, but I
think what has to be addressed
is they have been educated on what,
and I assume maybe they
would come with an education
from the doctor, but that
could be really skewed bias
I'm assuming too.
There's money involved there.
But they need to understand
what is being created here
through this process.
Is it one life?
Is it multiple lives?
Who's gonna be responsible
for the multiple lives,
if there are multiple lives?
>> All good questions
and I'm not sure there's,
I'm not sure there's a predictable answer
at the very beginning.
Now, they can tell you
what kind of a thing
they're creating, although that probably
will be somewhat skewed also.
But how many of them, a
lot of these technologies
is just impossible to say at the start.
That's what makes them so challenging.
Others?
>> Well, you could, I
mean obviously an adoption
is one option they have.
Another option is simply
to not have any kids.
>> Okay, remaining childless.
>> Remain childless, use
their resources, their time,
their energy investing in
other people, other parents
who are struggling.
And then if they decide to move forward,
>> That's better than your
to each his own earlier.
>> Yeah I know.
[audience laughing]
I'm learning already, see?
You're a great teacher.
>> You are a quick study my man.
>> And then if they were
to kind of move forward
with infertility services you
could suggest some principle
that they could kind of keep in mind.
So for example, you know
we know the scripture
teaches that the taking of innocent life
is never permissible, so you say look,
any procedure that you do
should exclude the opportunity,
the option of say sex selective
abortion or terminating it
if you have like four human
beings growing inside you,
because of some infertility services
>> Good.
>> Say oh well,
we're going to reduce
two or three of them.
>> Okay, all right.
>> You know that's not,
that's not possible.
So just give them some principles to,
>> Okay, broad general
principles or parameters
as opposed to specific counsel.
Okay, we'll at least do that.
I think we can be a little more specific.
I think there are some
technologies that are
out of bounds and some that
are clearly on the table.
As a result of those principles,
but it's a by and large, a good approach.
Yes.
>> And isn't one thought,
they've only been trying
for three years that,
I don't know, do people
always have children
every three years or, how
do they know that they're?
>> Okay, all right, how
do they know that they're
in it at the end of the
line trying naturally?
That's a good question.
Because usually if, if you
see an infertility clinic
before you've been trying for a year,
they'll probably tell
ya to come back later.
Okay?
Three years is starting to
get to be desperation time.
And so they could
continue to try naturally,
that is certainly an option.
They're starting to
think that maybe we need,
you know, this isn't working,
we need to do something else.
Okay?
But, granted three years is not forever,
but when you're trying to
have a baby every month,
three years, that's a long time.
And they've probably
had at least two years
of at least one day a month
when all hell breaks loose.
Right?
Emotionally for them.
All right, anything else?
Yes.
>> You talked about how
we would counsel them
to figure out what the root for their need
for infertility or to that route
and help them spiritually in that way.
>> Okay, so what's sort of
driving this in the first place.
>> Mm hmm.
>> Okay, I think they
might say something like
it's our God given
procreative constitution
that's driving this.
With a bit of exasperation at God
for why this is taking so long.
I mean that's sort of the norm.
All right, now there may
be other things driving
that, and it'd be very good
pastorally to get at that
if you can, right?
Yes?
>> You might be able
to figure out what's
causing the infertility
and administer drugs.
>> Mm hmm, okay, yeah, now that's,
I would say that's first.
I mean their physician probably
told them that first thing
anyway, so what they'll
try to do is to figure out
if there's any specific medical reason.
And that will dictate
which options are more
on the table than others.
About a third of all cases
of infertility though is,
what, for lack of a better term,
what we call mystery infertility.
Where there's no specific
medical indication
for why they can't get pregnant.
But certainly having the plumbing checked
initially is clear first step.
Now what about, what would you say or ask
or encourage this couple for
spiritually and emotionally?
What kind of things would
you want to ask them
or say to them to minister
to them spiritually?
>> Audience Member: Do
they have a support group?
>> Do they have a support group?
Probably not because
what you'll probably find
is that most of their friends
that are their similar age
are multiplying like
rabbits at the moment.
And so they, you know,
chances are they've,
you know, they've stopped
going to baby showers,
and they've probably stopped
being invited to baby showers.
I'm pretty sure they don't go to church
on Mother's Day or Father's Day.
And it's probably the case that you know,
Thanksgiving and Christmas
can't get over fast enough.
Okay so they, that's a good question.
Hard to say.
But maybe one of the things
you do as their friend
is to put them in touch
with couples who are
on the other side of this or other couples
who are in the middle of this themselves.
Good question though.
Yes.
>> Audience Member: I know
this is kind of obvious,
but just prayer for
guidance, God can lead them
in what direction, and what
he has planned for them.
>> Except they probably
don't want guidance,
they want conception.
>> Audience Member: Well, but guidance
for whatever their plan
or God's plan is gonna be for them
on how they would handle that,
for accepting whether it's
adoption or being childless.
>> Okay very good.
It's prayer for the ability to accept
whatever God has for them.
Which may or may not be a child.
Right? Now we'll come back to this.
We gotta be really careful with that.
>> Audience Member:
Another thing spiritually,
there's an assumption out there
that because they're not conceiving,
or getting something that they desire,
>> Excellent, excellent, very good point.
That, you know, what, you
know, what's wrong with me?
You know?
What have I done to
deserve, now we, that's,
I mean theologically that's perverted
to think of God as a
punitive God like that.
But you'd be surprised how
frequently that emotion is felt.
That I must have done
something to merit this.
Or demerit this.
Maybe a better way to go
about this would be to say,
what are some things that
you would not say to them?
Or at least, at least if
you said this to them,
you oughta duck.
[audience laughing]
>> Audience Member: Is
there sin in your life?
>> Is there sin in your life?
That, I suspect, you better, you might
take a step back from
them after you say that.
Now, certainly theologically,
infertility is a result
of the general entrance of
sin into the world, right?
It was not, infertility was not the way
God originally intended it to be.
I take it infertility is a malfunction
of somebody's reproductive
system analogous
to heart disease being a
malfunction of the cardiac system.
Or other types of malfunctions.
Caused by the general entrance of sin.
Now it may be, there may
be cases where that's true.
For example we know medically
that one of the side effects
of virtually every sexually
transmitted disease for women
is an increase in the
incidence of infertility.
Either through scarring of the uterus
or blockage of the fallopian tubes.
Now, that's not true for men,
which is one of the
great gender inequities.
The other one is that
men can sire children
into their 70s.
And I don't know why it's like that,
but that is one of the
gender inequities of life.
But I'd be really
careful how you say that.
As though repenting will
bring you fertility.
Which, last time I checked,
that's not necessarily true.
Okay, but good, I would
definitely stay away from that.
What else? Somebody else.
Yes.
>> Audience Member: I think
even the first thing you say,
you're saying being
adoption can sometimes be,
>> Absolutely right.
>> Just harsh 'cause--
>> Absolutely right.
>> They're already feeling
like there's something wrong
if they're pursuing this kind of avenue,
it's their child,
>> Okay.
That's a really good observation
because to use that as
the default position
feels like admitting defeat.
And that there's a huge
value in quote having
a child of my own.
Which I don't think is
all necessarily a bad
or narcissistic thing.
I think again that's part of
our procreative constitution
that's a part of how God made us.
But going immediately
to adoption is almost,
the couple hears that as saying
well, you might as well
throw up the white flag.
And give up.
Although at the end of the day,
that might be the best advice they'll get.
Okay what else?
Yeah.
>> Audience Member: Maybe
they're not meant to have kids.
>> Oh no, that's a dagger to the heart.
Have you considered that
God might not want you
to have children?
No, I never once thought about that.
Of course I've thought about that.
Generally what I've found that that means
to the couple who says it is thank God
that it is you and not me
that's suffering from this.
It's often, it's often a
way of just being callous
to what people are feeling.
Now, that, you might be right about that.
It may be that God doesn't
intend for them to have children.
That may be true.
But generally we, I
would never suggest that
unless I've had lots of
time just hanging with them,
and praying and weeping with them.
And they almost have
to give you permission
to say those kinds of things.
Good point.
What else, anything else?
That you shouldn't say?
>> I wasn't gonna say this
'cause it's not so theologically
sound, but we wrestled
with infertility for
about four years ourselves
and a lot of times people come up
to say to us, they say,
hey look, just relax.
>> Just relax.
>> That's all it takes, you
know, you're just trying
too hard, just relax and it'll come.
It's like yeah, but like
you said, when that time
of the month comes and
it's like, okay, game on.
It's like you can't relax
because it's the very thing
that you're stressed out about, you know?
But it practically wasn't good advice.
>> No, that's terrible advice.
And that's the callous thing too.
I mean that's just a
platitude that somebody's
throwing out there.
In fact, what, really, what
a lot of infertile couples
will tell you is that after a while
sex just isn't any fun.
'Cause it's all about conceiving a child.
I mean they'll talk about how the husband
will get a call at work saying,
the window's open here, get home now.
And it's about as unromantic
as you can find it.
Sometimes they'll ask couples,
well, when's the last time
you took a romantic vacation?
Or I've actually heard some people ask,
how much time do you spend in the hot tub?
>> Audience Member: Yeah,
or change your underwear.
>> Or change your underwear, yeah.
Like this is any of
anybody else's business.
But somehow, infertility
gives people a reason
to think they can ask those kinds
of silly personal questions.
Here's the general
guideline, be really careful
about saying or asking anything
that will minimize the pain
that these couples feel.
Because the pain of
infertility is off the charts.
I'll give you an example.
My wife and I wrestled
with infertility for
about three and a half years.
And we had, she had a medical problem
that wasn't specifically female related,
but it was really, it was
totally affecting her fertility.
We got that fixed through
pretty simple medication
and her, it was a neurological thing,
and her neurologist predicted
that days of infertility
were about to be over.
As it turned out, he was right.
And we entered what I call the ranks
of the frighteningly
fertile at that point.
And we had, I mean we had three boys
and without any problem after that.
But I asked my wife about,
this was about I don't know,
a year or two ago, which
experience was worse.
In 2006 she had breast
cancer, double mastectomy,
full rounds of chemotherapy
where she lost her hair,
reconstruction, basically
last all her female parts.
I remember I sat, I sat
next to her on the edge
of the bathtub as she was
pulling clumps of her hair out.
And I asked her, what was worse,
breast cancer or infertility?
And guess what she said.
Without any hesitation,
it was infertility.
In fact she said by far,
that was more painful.
Part of the reason was
that infertility affected
not only her dream of having a child,
but it also affected her gender identity.
And we were caught almost
completely off guard
by how deep and how prolonged
the pain of that was.
We quit going to church,
Mother's Day and Father's Day
were by far the two
worst days of the year.
I finally got my church on those two days
to acknowledge infertility,
which was huge.
And we acknowledged it by saying,
these holidays are not,
we're not going to presume
that these are celebrations for everybody,
for a variety of reasons.
You may have been abused by your mother.
Your mother may have just recently died.
You may want to be a mother
and biology hasn't coop,
and we went through the
whole litany of things.
And I think short of losing a child,
either after birth or a miscarriage,
infertility is about as
deep as the pain gets.
And I'm sure that I said
some of those dumb things
to other infertile couples
without realizing it.
And it's not that you're,
it's not that this couple's friends
are callous or insensitive intentionally.
I think they realize that
they just don't have a sense
of how painful that is.
So, sorta spiritually
speaking, be really careful
that you don't do anything or say things
that will magnify the pain that they feel.
There's a lot to be said
for being with them,
praying for them, asking how can we,
how can we be of help?
Just being with them.
That's it, without, sort
of take the approach
of Job's friends, you know,
before they started to speak.
[audience laughing]
Just being with them, okay.
So if you've been down that road yourself,
or know someone who's been down that road,
I suspect you're a
little bit more in touch
with how painful that is.
Questions about that before we move along?
Okay.
All right, let's think a little bit
about what the options
are that are available
to this couple today.
All right, now there are,
I'll try to give you the
latest sort of price figures
on these too, it's been a
while since I've masqueraded
as an infertility patient to
try to get an accurate read
of what the prices are.
And we'll talk about the
ethics of that masquerade
some other time.
[audience laughing]
We won't deal with that now, okay?
First, and generally
what's attempted first,
and we're gonna assume here
that there's no clear medical indication
for why they can't conceive.
First is what's called
intra uterine insemination
and we used to call this
artificial insemination,
that's really not the term
we use for it anymore.
Artificial insemination is
generally the term we use
when this is done with animals.
But not with people.
So intra uterine insemination generally
is done with the husband's sperm, okay,
though it can also be
done with donor sperm,
either anonymous or named, okay.
See in some parts of the world now,
they are requiring that
sperm donors be identified
so the child can track them if they want.
Which understandably has
produced a plummeting decline
in the availability of sperm donors.
Frequently what accompanies this
are the high powered
multiple ovulation drugs
that go with in vitro fertilization.
Now, sometimes it's
because it's the process
is just cheaper.
Sometimes it's just medically
indicated that way as well.
But what will happen
is the woman will have
the high potency fertility drugs
that enable her to release
multiple eggs per cycle,
you know, five, eight, 10,
12, 15 or so eggs per cycle
and, but the eggs won't be harvested.
Sometimes in order to save money,
at that point they'll just do
the artificial insemination.
And so they'll bypass harvesting the eggs
and fertilizing them in
a lab and re-implanting,
all that expense.
But if you do the math on this,
you have multiple eggs
and a couple million sperm
all together with no control at all
over how many pregnancies result.
Most of the time, this was not the case
with Octomom,
Octomom actually had IVF done
in a really irresponsible way.
But most of the time when
you have major multiples,
you know, four and above, of children,
this is the way it's done.
I know, we'll talk
about the ethics of that
in a little bit.
You can also inter uterine insemination
can be done with donor sperm.
What's analogous to that is egg donation
which is quite a bit
pricier than sperm donation
because there's
substantially more involved
in the process of procuring
eggs than there is
involved in procuring sperm.
Okay, if you are on a
college campus regularly,
I would encourage you to
look in the campus newspaper.
You won't find these
ads in the Chimes here.
But you will find them
in virtually every other
college newspaper, are
ads soliciting egg donors
and to a lesser degree, surrogates.
Because college age women
are at the prime age
to donate their eggs and it's not uncommon
for women to donate the
harvest of their eggs
in order to pay a year's
worth of tuition for college.
And there's, there's a
lot more risk to this
than meets the eye.
>> Audience Member: To the college girl?
>> To the donor, yeah.
And I encourage ya, there's a book,
I forget who the author
is, but it's entitled
Confessions of a Serial Egg Donor.
And the medical risks involved in that.
The other, we're gonna
show this here on campus
probably later on in October,
it's a new film that's just
been produced called eggs,
E-G-G-S, Eggsploitation, which is
about the egg donor industry.
All right, you can probably
get a word on that,
it's called thecbc.org.
It's the Center for Bioethics in Culture
up in the Bay Area.
Okay.
Stop, if there are questions
on any of these, say so.
IVF.
It used to be that
there was a whole family
of technologies that resembled IVF,
but those really aren't
done very often anymore.
The vast majority of infertility
procedures in this family
are technically IVF.
Gift was one that used
to be done quite a lot.
But it's just not done very often anymore.
IVF is the main thing, where
the eggs are harvested,
fertilization takes
place in the Petri dish,
and then they will
implant usually anywhere
from two to six embryos
depending on the woman's age.
It's on a graded scale.
The older the woman is, the
more embryos they implant.
So, those are the general guidelines.
Octomom had six embryos
implanted and two of them split.
Which then became identical twins,
which is how she got eight total.
And I would suggest that
Octomom was carrying a litter
of children and she's a good argument
for why God did not intend
women to carry litters.
Then there are a variety
of surrogacy arrangements
although there's really
only a couple of these
that are predominant today.
Genetic surrogacy, or what's
called traditional surrogacy
is actually not done very much today.
And part of the reason
for that is that the law
in most states gives
genetic surrogates maternal
rights to her child.
You may be familiar with the Baby M case
from the 1980s where the couple who hired
the surrogate who carried
Baby M ended up pursuing her
half way across the country.
Baby M's mother really, was her mother,
asked that she could
keep the baby for a week
before turning over custody
to the couple who hired her.
Why they allowed her to do
that, I've never figured out.
But she fled the state.
She fled New Jersey and
ended up in Florida.
And the Florida state police
literally broke the door down
of her place where she
was staying in Florida
and grabbed the baby out of her arms,
to take the baby back to
the couple who hired her.
And the New Jersey Supreme
Court said there is something
desperately wrong with this picture.
When, for one, you force a
woman to give up her child,
because she signed a contract to do that.
The court essentially
said that contract is akin
to you and I going out
and signing a contract
that we're gonna have a dual with pistols
at 50 paces, if I back out of that,
you can't sue me for breach of contract.
The court would say that's inherently,
intrinsically invalid contract.
Which is what they said about
these surrogacy contracts.
So the law has kind of done a number
on genetic surrogacy.
Most surrogacies today are what are
called gestational surrogacies,
where the surrogate
does pregnancy and childbirth,
but has no genetic
contribution to the child.
In fact, cases that would
be much more easily handled
medically by a genetic surrogate,
instead what they're advised
to do is get an egg donor
and a gestational surrogate.
I was in a couple in
my church a while back,
where she's in her late 40s and they,
it would be, and she's done
kinda having a child
genetically related to herself.
It would have been way
simpler and way less expensive
for them simply to have
a genetic surrogate
where her husband would
inseminate artificially
a surrogate, but the legal
risk that the surrogate
would keep her child, because
she's rightly the mother
of that child, was too much.
And so they encouraged, they
ended up probably paying
an additional, my guess
is probably an additional
10 to $15,000 to have an egg donor
with a gestational surrogate,
which is about 15 to 20
grand, plus the broker
which is another 20 grand.
Plus all the medical
expenses which is not covered
by their insurance, that's
probably another 10 grand.
So they're probably, I
don't know if they're
gonna go ahead and do this,
but they're probably in it
for about $60,000 to do that.
You understand why they would do that,
legally it's just much
safer under the law,
because under the law,
gestational surrogates
have zero rights to the
child that they are carrying.
Yes.
>> Audience Member: As
a rule is it generally
the, that the surrogate mother
is artificially inseminated?
Or is it ever really like,
>> You mean the historic way?
>> Yeah.
>> Generally not.
Every once in a while you
hear these goofy stories
where that--
>> But that's technically,
you do artificial.
>> Yes.
Yeah, in reality for
gestational surrogates
what other technology's required
for a gestational surrogate?
I'm sorry?
IVF, yeah.
Because egg's gotta come from somewhere,
sperm's gotta come from somewhere.
And they conceive in the lab
and you just implant embryos
in the surrogate.
Now most, I mean the vast
majority of surrogacy arrangements
are done for cash.
The number of people who
do this out of the goodness
of their heart for a family member
or a close friend is minuscule.
Most people do this because
they need the money.
And today, interestingly,
we are actually outsourcing
surrogacy to the developing world.
In fact there are a
handful of places in India
that have become centers
of what is becoming
known as reproductive tourism.
Where you go and you hire
a surrogate in India,
for about 2500 to $3000
which for those women
is probably a year's pay.
And it actually, it probably
doesn't really matter
if they are in tip top physical health,
as long as they are able to carry a child.
So we'll talk a little
bit more about that.
But that's, increasingly
we are outsourcing this
to other parts of the
world where it's cheaper.
>> Audience Member: So if you're getting,
this child is essentially, when
you're talking about makeup
or your, 50% of the
couple instead of a 100%
>> Right.
>> Audience Member: So
where is that natural drive?
Like what would be the
reason that a couple
would wanna do that?
>> Why would a couple wanna
do an egg or sperm donor?
>> Yeah.
>> It's a good question.
The reason is because
for most of these couples
half a genetic connection
is better than none at all.
>> Audience Member: Do you know if
that becomes an issue in--
>> It can.
It can become an issue because there are,
let's just say, it's
probably more so for men.
Men do not like to have
what I call procreative
pinch hitters for them.
I say, we'll talk about
their case in more detail
in a little bit, but
I sat across the table
some time ago with a
couple for whom adoption
was off the table, they
said that up front.
And he'd had the mumps when he was a kid
and wasn't producing any sperm
and she was beating on him unmercifully
to have a sperm donor.
And it was real obvious that
he didn't wanna go there.
And I suspect what happened,
I mean I wanted to, I
really wanted to smack her,
because when they started
telling their story,
she put it that, we can't get pregnant,
how'd she put?
We can't get pregnant and it's his fault.
>> Audience Member: Wow.
>> And you think ow.
So I mean we sort of,
you know, do not pass go,
head straight for marriage counseling.
But I suspect that what
happened is that she coerced
him into getting a sperm donor.
And either he's a lot bigger
man than I think he is,
or he's gonna have sort
of a smoldering resentment
that's gonna be hard to deal with.
That's not an unusual thing.
Yeah.
>> Audience Member: Also
to piggyback on that,
the egg donor too, [words
obscured by scratching near mic]
aren't as good and that's
where that 25 to 30% likeliness
comes in and if they
chose to do an egg donor
from a 20 year old.
>> Their chances go up dramatically.
>> Audience Member: A lot.
And a lot of doctors will guarantee it.
>> That's right, in fact,
some of these clinics
do IVF with a money back guarantee.
>> Audience Member: If they do that.
>> Right.
But you gotta follow all their rules.
Which takes all the control of it
out of the couple's hands.
I had a Talbot couple a while back that
they went to a new fertility
clinic in Minnesota
and they were promised three rounds of IVF
from start to finish for 25 grand.
And if they didn't have
a live birth at the end
of those three rounds they
got all their money back.
But if they conceived after the first try,
all the extra money went to the clinic.
So it was a calculated risk.
But they lost the ability
to say sort of what happens
to their embryos in the process.
That is a high price to pay in my view.
Yes.
>> Audience Member: Why would the clinic,
why would they want the
eggs, or the embryos
after that for?
I think I'm missing something.
>> Well, that's a good question.
With IVF a big part of the
expense is the hormones
to enable multiple ovulation, okay.
Plus it's also, it's also really tough
on the woman's body too.
You don't, that's not something
you wanna do every month.
And so, let's say that
you go through all of that
and don't get pregnant the first time,
it's a lot easier and a lot less expensive
to thaw out embryos
that you have in storage
as opposed to starting all over again.
It's primarily financial, but not totally.
'Cause there is concern
about the well being
of the woman too.
Yes.
>> Audience Member: Can
you just clarify between
[speaking faintly] IVF,
you said before that,
>> They are the same thing.
>> Okay.
So in both of those scenarios
there's multiple eggs
being released so,
>> Yes, that's correct.
Now, sometimes, sometimes you'll do,
sometimes you'll do this
without the fertility drugs.
So if there's no real medical
indication for the woman,
then they won't take the risk.
And increasingly, physicians won't do this
with the IVF drugs unless
the couple agrees in advance
to selectively reduce
the number of pregnancies
to a safe level.
All right, other questions on that?
Okay.
Okay, here, seems to me,
here are the main issues
that we wanna address.
This is where we'll go with
the rest of our time tonight.
First is, basically the question,
should we, should this couple
use any technological assistance?
That is
should the couple get on
the technological train
in the first place?
All right, sometimes
the way this is phrased
is should we interfere
in a natural process.
Now the answer to that
I think is pretty easy
because as it's stated like that,
'cause we interfere in all
kinds of natural processes
without a problem attached to it.
I mean we have, we replace
heart valves with pigs'
heart valves and pace
makers, you know dialysis
is interfering in a natural process.
I mean we do all kinds of things
that interfere in natural processes.
So, basically what we're asking here
is should we employ
any technological means
to assist us in having a child.
And if you are a
consistent Roman Catholic,
basically your answer to that question
is no, we should not.
Now couple caveats to that,
but basically no.
And if the answer to this is no,
then we sort of close in prayer
and go home, really soon.
But if the answer to that is yes,
that it's okay to hop on
the technological train,
then, the question becomes, at what point
do we have to get off the train?
And for a lot of people,
where they get off,
is when it involves some sort
of third party contributor, a donor,
or a surrogate.
Okay?
All right.
Now this turns out theologically
to be a very complicated question.
All right, and we'll look at that after
we take a break here in just a minute.
Now,
assuming here that the
answer to this is yes,
and then depending on how we answer this,
then with IVF, whether
it's with a donor or not,
we have really big issues to deal with
with IVF, and that is what to do,
That's probably not quite the right way
to put the question.
The best way to put it was how to avoid
having left over embryos
if that's possible.
And then second, what to do
with them if they are left over.
Last count, there are
in the United States,
there are roughly 400,000
embryos in storage
in infertility clinics.
400,000 as we would say, children on ice.
Now one that's, this is really complicated
to get our arms around.
This one is not as difficult.
Because this, having to
do selective reduction
on the number of pregnancies,
the need to have to do that
can always be avoided, right?
Now, whether it will be
is another matter, okay?
All right, then the issues that have to do
with surrogacy are a little bit different
because a surrogate is sort
of a different kind of donor
than a sperm or an egg donor.
And so really the
questions about surrogacy
revolve around who's the mother here?
Because in a genetic surrogacy,
that's not hard to answer.
The surrogate's the mother.
But if the gestational surrogate
doesn't contribute the egg
but she gives birth to the child,
we split motherhood traditionally in two.
And which one of those takes priority?
Or how to deal with a
stalemate if you agree
that that's a stalemate, is
really challenging to do.
My own view of this is that,
I'm not totally convinced that the law
handled this correctly.
I think this is one of those areas
where a good argument can
be made for the surrogate
being the mother, but
an equally good argument
can be made for the woman
who contributes the egg
being the mother.
So we'll come to that too
before the night's over.
All right, so that's
where we're gonna head
for the rest of the night, all right?
Guys game for that?
Lemme suggest, probably
a good place to take
about a 10 minute break.
When we come back, buckle up,
it may get a little bumpy.
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