by Ryan Simón
THIS PAST WINTER, my girlfriend Kim and I attempted having a child through IVF (in vitro fertilization), which involves surgically extracting eggs from the ovaries via needle suction and mixing them with sperm in some sort of lab dish to create embryos. Once inseminated, only a few eggs successfully develop into embryos. Of those embryos few mature into sizable enough cell counts to qualify as viable embryos for impregnation. And of those viable embryos few pass the preimplantation genetic screening (PGS) for chromosomal abnormalities that may either cause miscarriage or birth defects. Prior to PGS, we had one beautifully symmetrical, mature embryo. Our doctor texted us a photo of the embryo, a little circle of cells that we jokingly, lovingly, naively named “Henry.” Against my better judgment I fell in love with the photo, all the while imagining myself as a father to what would become either Henry or Henrietta — didn’t matter, really — and how my girlfriend and I would give Henry/Henrietta the love and support and guidance that our absent fathers never gave us. I loved those cells because they carried pieces of Kim and I, comprising a 50:50 blueprint of our combined genetic makeup — uniting my DNA with that of the person I love — and so when the PGS results came back with a detected abnormality, a missing arm on the X chromosome, and our embryo was discarded, I could only feel a paralyzing sense of loss and betrayal and sadness.
We deluded ourselves into imagining our embryo promised anything more than a “clump of cells,” the in-fashion phrase used to deny an embryo’s life-potential. Philosophically, Kim and I fell in love with the embryo’s potentiality, with its potential to grow into our child, despite its actuality as just a clump of cells. With this distinction between potentiality and actuality in mind, the phrase, however hostile and sardonic and ungrateful, is accurate: the embryo actually is just a clump of cells. If you’ve yet to see what an embryo actually looks like, bear witness to ours:
As we enter this brave new world of lab-cultured human embryos, how we clarify our attitude towards IVF will inevitably alter our perspective on abortion. I crudely declare my stance on abortion as being “politically pro-choice, ethically pro-life,” and yet, since undergoing IVF, I find this semantic framework of “life” vs. “choice” inappropriate, somewhat creepy, and all-around arrogant. We’ve yet to reach a consensus on what constitutes life, let alone when life starts, so what does it mean to be pro-life? More importantly, who in this debate is genuinely anti-life? It seems that by limiting the abortion debate to pro-life vs. pro-choice we’ve implicitly defined “choice” as an adversary to “life” — i.e., choice is death. This is both false and disingenuous as, from my perspective, I see pro-choicers as being predominantly concerned with women’s quality of life — with quality attained not necessarily (or, at least, not intentionally) at the expense of the quantity of lives. For many women, the choice to have an abortion isn’t merely a choice between having a child or not having a child but rather when to have a child: e.g., “I am not yet ready,” with the operative word here being “yet.” Even so, for many, choosing to abort a pregnancy is an incredibly difficult decision, as the intent to have a child later does not guarantee a later child. Pregnancy is a window of opportunity that varies in size (the easability of getting pregnant) and duration (the age range most conducive to pregnancy) from couple to couple. With the allegorical baby-toting stork in sight, abortion artificially shuts the window to prevent the stork from entering the allegorical house of parenthood — i.e., before child-birth. IVF, which attempts to artificially keep the window open longer, may theoretically lessen the difficulty in choosing abortion — e.g., such as for the professional woman who wishes to stall parenthood to focus on her career. In this sense, IVF, as a pro-birth measure, complements abortion, an anti-birth measure, from a pro-choice perspective. The two together potentially grant humankind greater control — or choice — over when and how pregnancy does or doesn’t occur.
But, of course, the current financial cost of IVF drastically outweighs that of abortion. An abortion is generally affordable. Few can comfortably afford an IVF cycle. As of now, IVF is an upper-class privilege, and with Kim and I falling substantially below the upper-class tier, our IVF cycle has roughly placed us $20k in debt with no recourse in terms of monetary discount or additional IVF trials. And the financial impact compounded by the emotional distress, as detailed above, is solely felt on the consumer end of the procedure. Successful or not, the clinic profits either way, unabated by any substantial commitment to consumer protection, morally neutered by emotionally detached graphs and statistics. Had we achieved success, no doubt my outlook on IVF would be much more positive — in other words, our personal debt would have been worth the child. But given the enormous financial cost of IVF compared to its unreliable success rates (even the most fertile age falls below a 50% average success rate), the procedure in its current state seems somewhat exploitative. It’s my suspicion that, without some sort of money-back guarantee, IVF clinics do not provide a net increase in quality of life overall; and I say this with gratitude towards IVF’s miraculous pro-birth tech. On the flipside, the legality of IVF morally conflicts with the predominant anti-abortion claim that life begins with conception.
The pro-lifer’s tolerance for IVF contradicts the pro-lifer’s intolerance for abortion. The belief that life begins at conception — at the point of insemination of the egg — crudely declares all embryos as alive. By this logic, the dismissal of all lab-cultured embryos is tantamount to mass genocide, despite the pro-life (or, more accurately, pro-birth) intent underlying IVF. My guess is that pro-lifers tolerate IVF’s dismissal of chromosomally aberrant embryos because of the procedure’s pro-birth intent. I don’t accept this. If abortion amounts to genocide from a pro-life perspective, then a consistent pro-lifer would also view IVF as genocide, albeit a well-intended genocide. Rather it’s not the nature of the embryo but of the embryo’s container that determines the criminality of the embryo’s dismissal. Embryos contained in a lab dish are okay to discard. But an embryo contained by woman? This is the deciding factor here for abortion bans: the woman’s body. And so it’d be more honest for pro-life pundits and politicians to admit that anti-abortion laws — that don’t also criminalize IVF — are primarily concerned with governing the woman’s body and only secondarily interested in the embryo’s moral relevance.
I’m optimistic that researchers will continue to improve and refine IVF procedures towards an increased average success rate. However, this scenario then brings to light another serious, incredibly uncomfortable debate on the question of what constitutes life, one that I believe is far more complicated than the “Should abortion be legal?” question. An embryo with a missing arm on the X chromosome risks miscarriage or, if carried to term, a condition called Turner syndrome. Another well-known condition associated with chromosomal abnormality: Down syndrome, which also qualifies an embryo for dismissal during the IVF genetic screening process. Famed atheist Richard Dawkins notoriously tweeted in 2014 that it’d be “immoral” to knowingly bring a Down syndrome child into the world:
@InYourFaceNYer Abort it and try again. It would be immoral to bring it into the world if you have the choice.
— Richard Dawkins (@RichardDawkins) August 20, 2014
Dawkins apologized after receiving backlash from parents of Down children, but with the caveat that: “If your morality is based, as mine is, on a desire to increase the sum of happiness and reduce suffering, the decision to deliberately give birth to a Down’s baby, when you have the choice to abort it early in the pregnancy, might actually be immoral from the point of view of the child’s own welfare.” And, yet, a 2011 study entitled “Self-perceptions from People with Down Syndrome” found that from a sample of 284 people with Down syndrome nearly:
- 99% indicated they were happy with their lives
- 97% liked who they are
- 96% liked how they look
- 99% expressed love for their families
- 86% felt they could make friends easily
People with Down syndrome seem to overwhelmingly live happy and fulfilling lives. So, what then are the social and human consequences of removing Down syndrome from our collective gene pool, whether by abortion or IVF genetic screening? We might enjoy a larger percentage of quote-unquote “healthy” humans who may better contribute towards the quote-unquote “social good,” but seeking this sort of genetic purity comes at the cost of removing arguably the happiest people in the world. And don’t be so naive as to think that control over pregnancy, whether on the abortion or IVF end, has nothing to do with genetic purity — especially given the socioeconomic implications of IVF’s cost vs. the cost of abortion.
We need to revise the abortion question to seriously consider how both pro-birth and pro-abortion procedures participate in socioeconomic and eugenic manipulation.
With that, I ask you, whether you’re pro-life or pro-choice, “Is a Down syndrome person alive?” And before you answer that, I suggest you first ask yourself: “Would I knowingly bring a Down syndrome fetus to term?”
Before answering the abortion question, we need to first answer questions such as these. What’s the difference between pro-birth IVF’s and anti-birth abortion’s dismissal of unfavorable embryos? Is there a difference? What are the large-scale consequences of selecting which embryos get to live and which do not? Who do we trust to make these decisions?
From there we might better identify who genuinely holds the moral high ground in this debate.