Human Conception, embryological development, and childbirth are a triad of medical concern. Following fertilization of the mature female ovum, successful fetal growth and safe delivery of the infant are a major responsibility of the medical profession. The spectacular advances made in maternal welfare and infant safety have been reflected in the decline of maternal morbidity and the reduction of neonatal deaths. Continued care and caution during the prenatal and the lying in periods will no doubt improve the already excellent status of obstetrical care.
Intimately associated with the successful development and culmination of pregnancy is the problem of sterility. The obstetrician assuming care of the growing embryo must also be interested and sympathetic to the infertile organism. Until recent years, those couples unfortunate enough to be positively sterile were faced with the alternatives of a continued childless state or of obtaining children by adoption. Because popular belief regarded the wife as being the cause of the childless marriage, comparatively little progress was made in finding a physiological solution to the problem of infertility.
However, various studies have shown that of the 10% to 15% of barren marriages, 30% to 50% are due to the husband’s inability to produce living sperm. The purpose of this discussion is to present the salient features relative to physiological assistance in this latter group.
Although sporadic efforts had been made in the past to artificially induce pregnancy in women married to infertile men, it was not until after World War II that the practice became generally accepted and commonly used. By prescribing the method one becomes involved in medico-legal, psychological, moral, and spiritual complications. Therefore, to obtain a sage and scriptural interpretation of the implications of such procedure I shall offer a detailed analysis of the problem.
Those marriages in which the husband ]las been proved incapable of impregnating ]lis wife will continue barren unless the wife’s fertility can be exploited. This potential fertilization may be accomplished by exposing her mature ova to a pool of viable spermatozoa. Artificial insemination refers to the introduction of semen, the male ejaculate, into the female genital tract without direct contact with the donor.
Indications and Conditions
Although three indications for the use of heterologous or donor’s semen are ordinarily given, I find only one to be worthy of legitimate discussion. That is the case in which the husband’s semen is found to be completely devoid of living sperm or harbors only grossly defective sperm. The other two indications involve the likelihood of inheriting disease or the possibility of erythroblastosis foetalis, a fatal blood disease, in the infant due to the Rh negative factor in the wife’s blood. To advocate artificial insemination for such conditions would lead directly to indiscriminate use of the method for eugenic breeding purposes.
Before resorting to artificial insemination the following conditions must be met:
1. A complete absence of healthy, living spermatozoa in the husband’s semen.
2. The female genital tract and reproductive organs must be normal.
3. Husband and wife must be in good health and both must be psychologically stable and mature.
4. Donor must have the same general racial, physical, and temperamental characteristics, have the comparative intellectual equivalent, and be of the same religious background as the sterile husband.
5. Donor must be free of inheritable diseases, such as epilepsy, diabetes, hemophilia, or venereal disease.
6. Donor and recipient must never know each other.
Little space need be reserved for the technical aspects of the procedure. The physician alone is aware of the donor’s identity and it is his responsibility that the recipient or her husband never know the source of her pregnancy. The donor also must be completely ignorant of the disposition of his semen.
The recipient is inseminated on several selected days of her theoretical fertile period. The ejaculate is microscopically examined for potency and then carefully inserted into the vagina, or may even be injected into the cervical canal. Pregnancy may not occur with the first attempt. since even the union of a fertile husband and wife will not necessarily produce impregnation at each exposure. Therefore it is important to repeat the process as often as is practicable during the receptive period. The procedure should not be considered a failure unless it has been adequately tried for at least several years. The husband’s semen may be pooled with that of the donor, and thus the unknown factor of final fertilization will never be positively known.
Legal forms granting permission for this procedure must be signed by both parties, and the donor must also waive all claims to any potential progeny he may procreate in this manner.
Benefits to be Gained
Couples who obtain children by artificial insemination need never expose the origin of the pregnancy. Therefore the husband’s sterility is concealed. Husband and wife experience the pregnancy, labor, delivery, and parenthood together, thereby allowing all the natural factors of childbirth to influence their relationship to each other and to the child.
Adopting a baby is becoming increasingly more difficult because the demand is so much greater than the normal supply. Many childless couples will never enjoy the pleasures, privileges, and responsibilities of parenthood because of this shortage. By taking advantage of the large potential of wives who are capable of becoming pregnant, it would allow a proportionately greater number of couples in which the wife is infertile to find children for their desires.
Babies born of artificial impregnation, to parents who have made every attempt in the past for normal pregnancy or adoption, are “wanted” babies. Usually those couples who request artificial insemination give a history of many years of hope and desperate longing for children. Only after all the ordinary measures of fulfilling such desire have been exhausted do they resort to this method.
Because of their mutually intense yearning, these parents develop a high degree of love and sense of responsibility toward their children.
Since parents of such children are ignorant of the real father’s identity, there is the possibility of involuntary incest taking place later, when half-brothers and sisters, unaware of their common parentage, marry each other. This is definitely within the realm of probability when a donor’s semen is successfully used in more than one case. Restrictions as to area of use would be a means to prevent such possibility.
The psychological impact of his sterility may affect an occasional husband. Trauma to the male ego has been cited as a real threat to the couple’s future happiness. However, statistics hardly bear out such theory. In one series of 3,000 cases, not a single divorce resulted as a direct aftermath to artificially induced conception. The possibility of a fixation in the wife’s mind toward the unknown father of her baby is also a nebulous quantity. Actually, she depends on her husband’s love and support and help all during pregnancy. The secret experience they share seems to intensify the bonds of devotion and affection which have carried them through their years of infertility.
From a medico-legal standpoint there are certain associated difficulties. However, problems of legitimacy and inheritance laws become real only when there is exposure of the fact that the husband is not the father. Such admission might be made if the relationship between husband and wife is altered.
The Moral Enigma
With the foregoing as an introduction to the real problem, we hope to view the moral and spiritual implications of such procedure from a truly objective stand point. I am as yet in no position to make a positive statement regarding the moral issues involved. It is for this reason that the subject has been presented. For pastors, lawyers, doctors, marriage counselors, and social service workers, a realistic approach to the spiritual interpretation is necessary. All those who have been, or will be, confronted in an advisory capacity should clearly comprehend all the ramifications of the problem.
The two major questions to be answered are:
1. Is artificial insemination actually technical adultery?
2. Is successful artificial impregnation essentially the bio-genesis of a new life by interference with the natural laws of God?
Webster defines adultery as: “Voluntary sexual intercourse by a married man with another than his wife, or by a married woman with another than her husband.”
The new Funk and Wagnalls Dictionary refers to adultery as: “The sexual intercourse of two persons, either of whom is married to a third person; unchastity; unfaithfulness.”
It is apparent that the essential meaning of the term adultery is the voluntary submission of the reproductive organs and powers to the service and (or) enjoyment of a person other than the legitimate husband or wife. The connotation is that such submission is desired and granted for purposes of satisfying sexual appetites rather than for procreation.
It has been held by some courts that adultery can be considered only if there has been actual invasion of the reproductive tract. Anything short of coitus, regardless of how obscene, immoral or indecent such behavior may be, does not constitute adultery.
Rape is defined as the illicit carnal knowledge of a woman without her consent. Although there is penetration of the genital tract, this is considered by law on a level different from that of adultery. Actually, the only distinction is that of consent.
Recent court decisions in the U.S. have held that children born in wedlock, although not conceived by rape or sexual intercourse, are illegitimate—the offspring of an adulterous act. Our laws were written before the possibility of artificial insemination was considered. Therefore, since the child is conceived in a woman whose husband is not the father, and since this conception is not the result of rape, the only conclusion remaining is that it is technically an adulterous pregnancy and an illegitimate birth.
Regardless of how one may react to the principle underlying the proposition of artificial insemination, it cannot conceivably be classed as adultery according to the definition stated. When husband and wife voluntarily submit to the procedure, none of the conditions peculiar to adultery are present. On the contrary. instead of gratifying carnal lusts and surrendering the reproductive organs for the pleasure of another, only the noble passion of begetting progeny is the moving force.
Scripture seems to offer even more positive refutation to the stigma of possible adultery. Jesus, quoted by Matthew in 5:27–28, says: “Ye have heard that it was said by them of old time, Thou shalt not commit adultery. But I say unto you, that whosoever looketh on a women to lust after her hath committed adultery with her already in his heart.”
Jesus certainly does not confine his interpretation of the seventh commandment to the mere physical act of cohabitation. Rather, we may conclude that if copulation occurs it is an incidental act in a sequence of illegitimate events. According to the words of Jesus the essence of the offense of adultery is in the moral relationship, not the physical.
In artificial insemination there is no physical contact between donor and recipient. Since they are unknown to each other there can naturally be no immoral transfer of thought or illicit desire. Whatever our concept of the procedure may be, it should be obvious that present terminology does not define or confine it. It can hardly be considered an adulterous act by human standards and less positively by Scriptural edict.
Contrary to God’s Law?
Personally, I have my greatest difficulty with this final thought—the induction of a new life. A physician is dedicated to prolongation and protection of human life in every contact he may have with it. He is morally and legally bound to uphold life instead of destroying it. Real as the indications for euthanasia may seem, he must not consciously yield to its humane temptation. It is wrong to destroy life by abortion when no real medical indication exists. But are the criteria which govern the physician’s attitude toward existing life the same as those inherent in generating life?
Criticism leveled at proponents of artificial insemination charge that it is wrong to initiate a life artificially. The sacredness of life and of the marital relationship is such that human tampering with natural conditions is sacrilegious.
Genesis 30 graphically describes how Jacob and Rachel reacted to this problem, which disturbed their relationship. Rachel was desperate because of her infertility and she said to her husband, “Give me children, or else I die.” The account continues, “And Jacob’s anger was kindled against Rachel and he said, Am I in God’s stead, who hath withheld from thee the fruit of the womb?” So Rachel offered her maid Bilhah to her husband so that he might have direct physical relationship with her and she might bear children in Rachel’s stead. “And Bilhah conceived and bare Jacob a son. And Rachel said, God hath judged me and hath also heard my voice, and hath given Me a son; therefore called she his name Dan.”
Abraham and Sarah also despaired in their aging years, insomuch that he succumbed to his wife’s pleading. He took the maid she offered and copulated with her so that she conceived. Although Jacob’s submission to Rachel’s desires was apparently blessed by God, Abraham’s was not. This was probably not because of the method he used, but because he thought God’s arm was shortened and that be should himself institute the means of carrying out divine promise.
The case of Rachel is certainly worthy of our careful attention. To overcome her sterility she resorted to a stratagem whereby the sterility might be circumvented, namely, having her husband take another woman in her place. The question in my mind concerns the comparison of methods. Our modern component is in the same position as the biblical example. Is interference with the natural course of marital infertility, by artificial impregnation, in a different category from offering a maid as receptacle of the pregnancy?
The principle of artificial insemination seems hardly to be on a lower moral plane than the substitution of one womb for another.
The introduction of extraneous material into the living organism to prolong life or to improve it is not considered objectionable. To inject living blood from one being into another is to thwart the natural course of life and death. Instead of dying from hemorrhage, the person lives because other blood is substituted. Is there then something immoral about introducing an extraneous substance into the mortal organism to initiate life?
It is hoped that this analysis and question may stimulate sound research and wise counseling. We who are confronted by the actual problem must be decisively led in our interpretation.