It is nearly impossible for those with children to comprehend the depth of the suffering of those who would love to have their own kids but cannot because of infertility.
The Catholic View of Infertility Treatments
The Bible mentions a number of women who were unable to conceive and were thus considered “barren” by their kinfolk. Their anguish is plainly evident—not because of the opinions of others, but because of their natural yearning for a child. Elkanah asks his wife, “Hannah, why do you weep, and why do you refuse to eat? Why do you grieve? Am I not more to you than ten sons?” (1 Samuel 1:8). Of course, there are other examples, including Abraham’s wife Sarah, and Elizabeth, who conceived St. John the Baptist in her old age. The pain does not only fall upon the wife; a husband and wife who cannot conceive often fundamentally see themselves as incomplete in what the Church describes as their “reciprocal self-giving.”1
Donum Vitae clearly acknowledges the suffering experienced by an infertile couple: “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” [¶8].
Those who suffer from infertility may naturally seek out a technological solution. But, as we have seen, the most common assisted reproductive procedures, including in-vitro fertilization, not only constitute offenses against the unity of husband and wife, they commodify human life. They are extremely expensive, have high failure rates, and tend to result in higher rates of birth defects, and women often suffer severe side effects from hyperovulation treatments. Infertile Catholic couples should instead look into the rapidly‑growing field of alternative procedures that can actually restore fertility in most cases.
According to the executive director of Resolve, the national infertility counseling organization, various micro‑surgery techniques can restore fertility to about 70% of infertile women of reproductive age.2 Dr. Joseph Ballina, Director of the Laser Research Institute of New Orleans, has reported an 80% success rate in repairing blocked or cut Fallopian tubes. After surgery, 80% of these women later become pregnant.3
The repair of damaged Fallopian tubes is an example of using medicine to repair an injury or pathological condition, after which natural conception and pregnancy can take place. By contrast, IVF and certain other assisted reproductive procedures replace natural intercourse.
The Catholic Church has consistently encouraged the scientific community in its research directed towards resolving persistent infertility problems in a manner that respects the dignity of the person and the laws of God. In 2004, Pope St. John Paul II said:
I would like to encourage scientific research that seeks a natural way to overcome the infertility of the spouses, and likewise to urge all specialists to perfect those procedures that can serve this end. I hope that the scientific community—I appeal particularly to those scientists who are believers—may advance reassuringly on the road to true prevention and authentic treatment.4
Here the Holy Father was merely reiterating earlier teachings from the Congregation for the Doctrine of the Faith in its Instruction Donum Vitae:
Many researchers are engaged in the fight against sterility. While fully safeguarding the dignity of human procreation, some have achieved results which previously seemed unattainable. Scientists therefore are to be encouraged to continue their research with the aim of preventing the causes of sterility and of being able to remedy them so that sterile couples will be able to procreate in full respect for their own personal dignity and that of the child to born.5
The Catholic teaching on infertility treatments provides specific guidelines for evaluating the morality of various assisted reproductive technologies. To briefly summarize, acceptable methods assist the marital act instead of replacing it, and they always preserve the sacred union between husband and wife. Furthermore, discarding human life (such as the “spare” embryos often involved in IVF) is prohibited.
Some Licit Assisted Reproductive Technologies
Dignitas Personae summarizes in general the Church’s attitude towards a scientific or technical solution for infertility:
Certainly, techniques aimed at removing obstacles to natural fertilization, as for example, hormonal treatments for infertility, surgery for endometriosis, unblocking of fallopian tubes or their surgical repair, are licit. All these techniques may be considered authentic treatments because, once the problem causing the infertility has been resolved, the married couple is able to engage in conjugal acts resulting in procreation, without the physician’s action directly interfering in that act itself. None of these treatments replaces the conjugal act, which alone is worthy of truly responsible procreation [¶13].
Gamete Intra‑Fallopian Transfer (GIFT)
Standard IVF procedures mix human sperm and eggs in a glass dish, and the embryo(s) are then implanted into the uterus. By contrast, a GIFT procedure fertilizes a woman’s egg inside her body.
Doctors incise the Fallopian tube at a point past any blockage and, using a laparoscope, remove the woman’s ripe egg from the follicle and place it and the man’s sperm inside the tube (the sperm was previously collected by a method such as use of a perforated condom, thus not violating the sanctity of the marriage act). If fertilization occurs, the pregnancy will proceed in the usual way―the embryo will travel down the tube and implant in the uterus.
GIFT currently comprises only about 1% of all assisted reproductive procedures in the United States.6
Until this time, the Catholic Church and most Bible‑believing Protestant churches have not voiced objections to GIFT, because it does not involve sins such as masturbation to obtain the sperm, or the discarding of “excess” embryos. GIFT meets all of the five criteria of licit assisted reproductive procedures specified in Donum Vitae. As long as GIFT does not involve masturbation or gametes from persons other than the husband or wife, Catholics, after rightly forming their consciences, may choose either to use it or reject it.7
However, some research has shown that GIFT has a somewhat higher miscarriage rate compared to normal conception, and for this reason some orthodox theologians oppose it.8 Additionally, it is not yet clear whether or not this procedure is assisting the marital act or replacing it.9
GIFT has a 20 – 30% success rate, comparable to IVF, and a single GIFT procedure costs about the same as one IVF cycle―$7,000 to $10,000.
Low Tube Ovum Transfer (LTOT)
Low tube ovum transfer (LTOT), acceptable to the Catholic Church and many other faiths, relocates the woman’s egg past the damaged portion of her Fallopian tube so that in vivo (in the body) fertilization takes place after normal intercourse.10 Another procedure acceptable to almost all faiths is sperm intra‑fallopian transfer (SIFT).11
There are many other assisted reproductive procedures that are basically variations and enhancements of AI, IVF and ovum and embryo transfer, some of which are licit and some of which are not. Those in doubt should consult with a Catholic theologian with experience in such matters.12
Dr. Thomas Hilgers, director of the Pope Paul VI Institute for the Study of Human Reproduction in Omaha, Nebraska, has developed a method for dealing with the problems of repetitive miscarriage and infertility, based upon more than thirty years of observations of both normal and abnormal fertility cycles. NaProTECHNOLOGY (Natural Procreative Technology) uses fertility care, not fertility control, with both medical and surgical techniques employed to heal the body.
In general, the couple uses the Creighton Model of natural family planning to monitor hormonal events during the menstrual cycle. This gives the physician the information needed to cooperate with the woman’s reproductive system to attempt to solve infertility problems. Dr. Hilgers and his fellow physicians have developed advanced surgical techniques to include diagnostic laparoscopy and the removal of endometriosis with a view towards preventing subsequent adhesions.
But If All Attempts Fail…
If a couple suffering from infertility has explored every licit avenue and still cannot conceive, they can find substantial comfort in the teachings of the Church. They will have the satisfaction of knowing that they have tried everything they could within God’s will.
Pope St. John Paul said:
Even when procreation is not possible, conjugal life does not for this reason lose its value. Physical sterility in fact can be for spouses the occasion for other important services to the life of the human person, for example, adoption, various forms of educational work, and assistance to other families and to poor or handicapped children.
The plight of the couple may cetainly greatly ameliorate the intense and similar suffering of children who do not themselves have parents. Dignitatis Personae tells us, “In order to come to the aid of the many infertile couples who want to have children, adoption should be encouraged, promoted and facilitated by appropriate legislation so that the many children who lack parents may receive a home that will contribute to their human development” [¶13].
 Congregation for the Doctrine of the Faith. Donum Vitae (“Instruction on Respect for Human Life in Its Origin and the Dignity of Procreation: Replies to Certain Questions of the Day”), February 22, 1987, II,A,1.
 Claudia Wallis. “The New Origins of Life.” Time Magazine, September 10, 1984, page 40.
 “In Vitro Lab Approved.” National Right to Life News, January 1980, page 23.
 Address of Pope St. John Paul II to the members of the Pontifical Academy of Life, February 21, 2004.
 Congregation for the Doctrine of the Faith. Donum Vitae (“Instruction on Respect for Human Life in Its Origin and the Dignity of Procreation: Replies to Certain Questions of the Day”), February 22, 1987, Section 8.
 American Society of Reproductive Medicine (ASRM). “Assisted Reproductive Technology: A Guide for Patients” (2015). Downloaded from the ASRM website on January 7, 2016.
 July 31, 1996 letter from Father Germain Kopaczynski, OFMConv., Director of Education, the National Catholic Bioethics Center.
 Several discussions with Adolfo Castañeda of Vida Humana Internacional.
 The debate over GIFT has been going on for more than twenty years and has not yet been definitively settled. See John M. Haas, Ph.D., S.T.L. “Begotten Not Made: A Catholic View of Reproductive Technology.” National Catholic Bioethics Center, 1998, and Rev. Benedict M. Guevin, O.S.B. “Reproductive Technologies in Light of Dignitas Personae.” The National Catholic Bioethics Quarterly, Spring 2010 (Volume 10, Issue 1), pages 51 to 59.
 David Q. Liptak. “Catholic Hospital Begins ‘In Vivo‘ Ovum Transfers.” The Catholic Standard and Times, September 22, 1983, page 14. Also David Q. Liptak. “New “Infertility Bypass (LTOT)” Assessed.” Catholic Transcript, January 6, 1984.
 Orville N. Griese. “Promising Approaches to Human Infertility.” International Review of Natural Family Planning, fall 1986, pages 243 to 255. SIFT involves collection of sperm after the husband uses a perforated condom during normal intercourse. The surgeon makes a small incision in the wife’s abdomen and locates the Fallopian tubes with a tiny camera, then uses a syringe to deposit the sperm there.
 These procedures include Fallopian tube sperm perfusion (FSP), intrauterine insemination (IUI), pronuclear stage tubal transfer (PROST), sub‑zonal insemination (SUZI), transvaginal intratubal embryo transfer (TIET), transvaginal‑transmyometrial embryo transfer (TTET), transvaginal tubal embryo stage transfer (TV‑TEST), tubal embryo stage transfer (TEST), tubo‑ovarian transplantation (TOT), vaginal intratubal insemination (VITI), zona pellucida drilling and cutting and zygote intra‑fallopian transfer (ZIFT).