Embryo Selection in the Context of In Vitro Fertilization

From the Catholic perspective, in vitro fertilization (IVF) is morally problematic because it artificially separates the procreative and unitive aspects of the conjugal act. Embryo selection (ES) in the context of IVF is an injustice against the resulting embryos because it treats them as commodities and works against their right to life by determining their implantation potential in light of their features. The Church opposes the eugenics mentality underlying ES. Meanwhile, the IVF industry increasingly uses artificial intelligence (AI) for ES. However, doing so could worsen the injustice by deepening the disrespect of human lives under the technocratic paradigm. As such, Catholic bioethicists are encouraged to advocate for the Church's teachings with renewed vigor. In this commentary, we will examine (1) ES in the context of IVF, (2) using AI for ES, (3) the moral implications of using AI for ES, and (4) points for further consideration. Summary: Using AI for Embryo selection in the context of IVF deepens the disrespect of human lives under the technocratic paradigm.

The Barren Bear Fruit: Good News for Sterile Couples

It is estimated that between 2.1 percent and 8.3 percent of Catholic couples remain biologically childless after exhausting all morally upright approaches for assisting reproduction. This represents a significant group within the Church earnestly seeking to live a fruitful married life in the absence of conceiving children. This essay seeks to provide a theologically and pastorally enriching exploration of marital fruitfulness for sterile Catholic couples in two ways: first, by demonstrating how the meanings of human fruitfulness and sterility have been definitively transformed by Christ and second, by exploring some of the ways sterile Christian marriages are abundantly fruitful. The insights of twentieth-century theologian, Hans Urs von Balthasar are drawn upon and shaped for this purpose. The essay concludes by highlighting ways that sterile Christian couples can be supported to come to a better understanding of the abundant fruitfulness of their marriage.

Fertility Technology Research and the Use of Human Beings as Property

In January 2020, an article in the Journal of Human Reproduction exploring whether human embryos could be obtained via uterine lavage and to compare their quality to embryos created via in vitro fertilization. Any embryo that was not removed via lavage was either prevented from implanting by giving the women injections of gonadotropin releasing hormone antagonists or aborted with either methotrexate or uterine curettage. This research was done using women in Mexico, who were paid the equivalent of over two months' wages and who signed away their rights to their embryos, including agreeing to have an abortion if implantation did occur. Not only is this another instance of human beings being treated as property but is against the dignity of these women by turning them into, as one ethicist says, "human petri dishes."

SUMMARY

Researchers continue to use people as objects to obtain their goals. In this case, it was poor women in Mexico and their embryos. The Editors of Journal of Human Reproduction enabled this by publishing the report.

Does Periodic Continence Harm Spousal Love?: Pope John Paul II's Response to the Pastoral Difficulties of Living Out Humanae Vitae

The main reason for the widespread dissent from Humanae vitae is not primarily academic. Rather, dissent arises first on a practical level by couples themselves on account of the difficulty they experience in living out the teaching. More specifically, couples often feel that there is a "contradiction" between the responsible regulation of birth and the unity of their love. This essay addresses this pastoral objection head on through a candid appreciation of the "difficulties" couples experience and through demonstrating Pope John Paul II's idea of cultivating a "conjugal spirituality," which moves couples interiorly from merely following rules to fostering reverence both for one's spouse and for God.

SUMMARY

This article provides a pastoral response to the difficulties of living out the teaching of Humanae vitae, by explaining the teaching of Humanae vitae through the lens of Pope John Paul II's Theology of the Body. Specifically, I explain John Paul II's exhortation to couples to develop a "conjugal spirituality" through the virtues, so that they will grow in reverence for their spouse and for God.

Systematic Review of Ovarian Activity and Potential for Embryo Formation and Loss during the Use of Hormonal Contraception

The purpose of this review was to determine whether there is evidence that ovulation can occur in women using hormonal contraceptives and whether these drugs might inhibit implantation. We performed a systematic review of the published English-language literature from 1990 to the present which included studies on the hormonal milieu following egg release in women using any hormonal contraceptive method. High circulating estrogens and progestins in the follicular phase appear to induce dysfunctional ovulation, where follicular rupture occurs but is followed by low or absent corpus luteum production of progesterone. Hoogland scoring of ovulatory activity may inadvertently obscure the reality of ovum release by limiting the term "ovulation" to those instances where follicular rupture is followed by production of a threshold level of luteal progesterone, sufficient to sustain fertilization, implantation, and the end point of a positive β-human chorionic gonadotropin. However, follicular ruptures and egg release with subsequent low progesterone output have been documented in women using hormonal contraception. In the absence of specific ovulation and fertilization markers, follicular rupture should be considered the best marker for egg release and potential fertilization. Women using hormonal contraceptives may produce more eggs than previously described by established criteria; moreover, suboptimal luteal progesterone production may be more likely than previously acknowledged, which may contribute to embryo loss. This information should be included in informed consent for women who are considering the use of hormonal contraception.

Summary

For this study, the authors looked at English-language research articles that focused on how hormonal birth control, such as the birth control pill, may affect very early human embryos. The authors found that abnormal ovulation, or release of an egg followed by abnormal hormone levels, may often occur in women using hormonal birth control. This may increase the number of very early human embryos who are lost before a pregnancy test becomes positive. For women who are thinking about using hormonal birth control, this is important information to consider.

Bioethical and Moral Perspectives in Human Reproductive Medicine

A reductive reading of Humanae vitae seeks to limit its appeal to a ban on contraception. In truth, however, it offers a vision of human sexuality and conjugal love with broad and enduring relevance. In setting forth the intrinsic complementarity and irreducibility of the unitive and procreative dimensions of the conjugal act, Paul VI has given us a hermeneutical key for assessing many contemporary ethical dilemmas in human reproductive medicine. From this perspective, this article seeks to apply the logic of Humanae vitae to several real-life scenarios confronted by medical practitioners, educators, and ethicists working in the field of fertility and reproductive health. These include a consideration of the ethics of prescribing hormonal contraceptives, the possibilities of investigating male infertility, issues of cooperation in counseling and assisting conception in same-sex relationships, the ethics pertaining to assisted reproductive technology (ART), the contested case of prenatal adoption, and the application of double-effect reasoning.

Summary

On the occasion of the fiftieth anniversary of the promulgation of Pope Paul VI's encyclical Humanae vitae, this article seeks to defend its enduring relevance to modern-day society, through application of its reasoning to contemporary dilemmas in reproductive medicine. It considers real cases of the ethics of prescribing hormonal contraceptives, of investigating male infertility, of cooperating in counseling and assisting conception in same-sex relationships, of ART, of prenatal adoption, and the application of double-effect reasoning.