Reproductive Health — with Dr. Dan Wickert
The topic of conceiving and bearing children can often feel difficult to discuss - but it doesn't have to be. What does scripture say about our desire to build families?
This week Janet and Jocelyn welcome Dr. Dan Wickert, an OB-GYN and chairman of the hospital board for the Western region of the Sisters of St. Francis. He shares insights on our desire to have children, and how to approach medical challenges to conception through the lens of God's word.
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Episode Transcript
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How IVF Can Be Morally Right - Wayne Grudem
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Transcript:
Jocelyn: I don't just need to feel better. I need the truth. And ultimately that will make me better.
Janet: I just want to make it as totally simple as possible for ladies to see that the Bible is really applicable to their everyday life.
Jocelyn: When they understand theology, the application flows out of it quickly with joy.
Janet: It is a journey, but even the journey itself is joyful when I'm doing it, holding the hand of my savior and trusting him all along the way. This is the joyful journey podcast, a podcast to inspire and equip women to passionately pursue beautiful biblical truth on their journey as women of God. When you choose truth, you're choosing joy.
Janet: Okay, welcome back. This is Janet once again with my trusty co-host, Jocelyn.
Jocelyn: Hey there, friends.
Janet: And a good friend of ours, Dr. Dan Wickert. You may remember he and Jocelyn did an episode earlier on postpartum that was incredibly helpful and we've asked Dr. Wickert to come back and share on a topic that, again, Jocelyn was pretty excited, so we had to do it.
Jocelyn: So it's really my daughter who is excited about this. She went to the Purdue Bible Fellowship education night that they had. This year they're doing topical information on a bunch of different issues that the leadership believed would be helpful for college students to know. And my daughter called me that night. She was like, Dr. Wickert spoke on reproductive health and it was so amazing.
Janet: So live up to that, Dr. Wickert.
Jocelyn: And so she told me to that, she told me all about it and it was like, basic physiological anatomy information, but it really made a huge impact because. It was spoken to the guys and girls together. Hey, here's information about the female anatomy that you need to know. Here's information about how anatomy works. What is conception? What is IVF? What is abortion? What is miscarriage? And it was just really you would think they would have learned that in health class, but it was very elementary and introductory, but also from a fundamentally biblical point of view. And so we need, and especially as I heard about this, we were leading into the election cycle and all anyone was talking about was how one of the parties was just espousing that they were standing for reproductive health and making sure that women's rights were heard. And I thought you know who cares about women's rights? The Lord Jesus Christ, who created women and said that we were pretty good the way we are and that functioning within His design will make us the happiest. And so I believed that it was really going to be helpful for our listeners to hear basic truth from a physician who is also a God-follower dedicated to the Lord Jesus Christ in his words. So Dan, help us understand this topic.
Dan: As we think about this and talk about this, initially it was like, could you talk about in vitro fertilization as one of the main components that we need to talk about or think about? I did this to and with the Purdue Bible Fellowship, the college class. It was fascinating to watch as I walked through this session with them for a good hour, 70-80 minutes. Even, it was fun to watch the guys .
Jocelyn: I bet.
Dan: Because the guys are like, their eyes just got bigger and bigger.
Jocelyn: We didn't know that.
Dan: Wow, we didn't know what, that. And what I did first with them was, and this is fascinating to think about, when I was younger, we used to do Bible drills. We'd pull out your Bible and look for a verse. So I said, okay, everybody get your cell phones out. They all have phones, right? I said, turn them over. Turn them over. Okay, turn them over. All right. Now, turn it over. I want you to look up, what does the Bible say about in vitro fertilization? And tell me how many hits there are. Tell me how many websites there are. And ready, set, go, turn it over. Got on Google and how many, what does the Bible say about in vitro fertilization? There's thousands. Thousands of hits, thousands of websites, thousands of references to where you can go for. So there are people who are talking about this and giving their opinion and I think we need to communicate. Listen, this is a very personal, very emotional, and for some very passionate. The words we use are incredibly important. We should be incredibly sensitive, caring, and compassionate as we think about this. The element comes into this element of infertility, And unfortunately, when we talk about this subject, as many other subjects, we, to some degree, we want a simple answer. Is in vitro fertilization biblical? Yes or no?
Jocelyn: Check, yes or no?
Janet: Yes.
Dan: And check the box, please. And this, you can't do that. There's not a simple yes or no answer to this question. Is in vitro fertilization biblical, ethical, moral, or not? And we all want that simple, straightforward answer, but it's much more nuanced, much more complicated. And even in the Christian community, there are different opinions on this. So for me, can IVF be moral and biblical? Yes. Can IVF be not moral and biblical? Yes. So it really requires us to think about this critically. I don't mean to be criticizing, but to critically think about the subject and to understand there is some basic physiology that once we understand this then we can get to a better understanding of what are some of the possibilities that could be good and some of the possibilities that could be bad. The other challenge we face is that there are Christian couples, who struggle with infertility, who are going to see an infertility specialist or their primary care doctor, their OBGYN, or the specialist, and are being presented with these options. So I really encourage us to think about this subject because you said I don't, it doesn't impact me. It doesn't. But there are couples that it does impact and without this knowledge, they may be asked to make decisions and then later on go, ooh, I didn't know that or didn't think about that or, oh, now I'm in a position in which I don't like where I'm at now, but it's because of all the decisions I made beforehand and didn't think about or know about. And there's always an appropriate amount of tension when we address this subject. I'm going to try to paint a little bit of a 30, 000 foot view. I'm going to try to stay out of the weeds mainly, mostly, there'll be some details we'll get into, but I want to provide some basic understanding, some basic suggestions, some basic potential guidelines. And I think my goal, my prayer is to be, is to educate and communicate and to discuss, not to convince people, here's what you should think or believe, but to say, think through this carefully and make some decisions and decide this. I think it would be great if churches had more of a do you talk about with your young couples class about these kinds of issues? Because there's going to be people who are going to walk through this and be challenged by this.
Janet: And those who aren't walking through it are around people who are.
Jocelyn: Yeah.
Janet: And some of us may be sharing our opinions, but we've not thought it through biblically here.
Jocelyn: Exactly. Yeah, totally.
Dan: And maybe those opinions came from who knows where.
Jocelyn: Someplace not biblical, possibly.
Dan: Correct. And again, you're right. This really did create some tension in the election cycle that we just went through. In vitro was discussed about, are we going to keep it? We're not going to keep it. We're going to have insurance pay for it, not pay for it. All those kinds of things. So it was really an interesting topic that came up during this election cycle. What I want to start out with is discuss some normal and abnormal physiology related to conception and pregnancy. Now you're like, oh, I've lost everybody already.
Jocelyn: Stay with us.
Dan: Stay with us. I want to discuss what normal physiology is and understand there's a wide range of normal, but I'm going to start with for a female, a normal menstrual cycle and some definitions for understanding. So the first day of a woman's menstrual cycle is the first day of that next cycle. That's called day one. In the ideal, and again, there's variation on this, it can be shorter and longer, but in the ideal 28 day cycle, from the start of the period to the start of the next period, now that's 28 days, day 14 is when typically ovulation occurs. Now again, we're talking typically, so it could, somewhere around day 14. How long can the egg be fertilized? Is it able to be fertilized for 24, 48, 72, three weeks? How long? And the answer is it really is only able to be fertilized for about 24 hours.
Jocelyn: That's amazing.
Janet: Wow.
Jocelyn: It's amazing that we are even populated on this earth.
Dan: And how long can sperm live inside of a female reproductive tract and be able to fertilize an egg? And the answer is probably somewhere in the 48 to 72 hour range. So day 14, when ovulation occurs, conception should occur within the first 24 hours. And then it typically takes about another six days for that new conception, new pregnancy, new human to move down the fallopian tube into the uterus and implant in the uterus. So implantation, when it actually, implants in the uterus occurs probably about, in the ideal, about day 21. Now again, if you say, no, it should be day 23, I'm okay with that, there's variation. We're just talking ideal as we think through this. And understanding this component then helps me as we walk through in vitro fertilization. Again, fertilization or conception occurs in the fallopian tube, implantation about day 21. An interesting sideline, just so we think about this and talk about this, what's the frequency of miscarriage in women who recognize and know that they're pregnant? And the answer is it's about one in six or about 15%.
Jocelyn: Okay.
Dan: Now, if you add in those individuals who, because when does pregnancy occur? When does conception occur? Day 14, day 15, day 16. Could people miscarry before they even knew they were pregnant?
Jocelyn: Totally.
Dan: Because they wouldn't have missed it. Wouldn't know, right? And the answer is if you add that, of people who miscarry, adding in the people who know and the people who don't know, that rate may be as high as 40 to 50%.
Jocelyn: My goodness.
Janet: Wow.
Jocelyn: That's amazing. That's amazing. Wow. Half of pregnancies.
Dan: Who would think about that, right? And so it's just one of those things you say why is that? The most frequent cause is a genetic abnormality, but there are other many other potential causes. And I would just say,, I think realistically it's the curse of sin that affects all of us.
Jocelyn: Yeah.
Dan: So next I want to talk about what are some of the definitions? Like, when we talk about in vitro fertilization, it's because people are challenged or unable to achieve pregnancy. How do we in medicine define that? We typically define the definition of infertility as one year of unprotected intercourse and not achieving pregnancy. And the frequency that's quoted 15 percent or 1 in 6. So think about this. If you're have a young married class or young married group in your church and there's 20, 30, 40 couples in your, in that class, one in six are, at least statistically, the numbers would say one in six are struggling with this concept of infertility. And they recommend a start evaluation of causes and treatments, if you've been, if it's been a year for those under 35 and for those over 35 at six months because.
Jocelyn: You have less time.
Dan: You have less time and the numbers are not in your favor as much as they are when you're less than 35. So the causes and broad strokes, but not a hundred percent conclusive are giving you this thing about why, what prevents people from getting pregnant? Three big ones would be there's a male factor. And we have to remember the guys would always go, oh, it could never be the guy. And the answer is, yes, it can be the guy. There's a 50 percent chance that it is you. So there can be male factor problems. There can be abnormalities in female ovulation. So associated with that, when you ovulate. When or if and when that occurs and how well that occurs. And there also may be structural abnormalities or anatomical abnormalities of the uterus and fallopian tubes that may be the broad brushstrokes of what prevents individuals from being able to conceive. So if we now talk about and think about that little description of physiology and understanding that. What about in vitro fertilization? When in the world did that start? And what's the numbers from that? The first reported pregnancies were reported back in 1976 and 1978. And since then, there's an estimated 8 million pregnancies that are achieved, have been achieved worldwide through in vitro fertilization.
Jocelyn: That's unreal.
Janet: That's a lot.
Dan: So just numbers that you would never think about. And by the way this element of infertility, I just, let me make one more point. We always think when can infertility occur? What do you mean by that? It can occur in a couple. It could occur that they, the couple, would never be able to achieve. They've never had a pregnancy. But it can occur at any point in a woman's reproductive career.
Janet: Even after she's had a baby.
Dan: She's had a baby and now never gets pregnant again.
Janet: Yeah.
Dan: Or maybe had two or three and never gets pregnant. Two or three children, sorry. Two or three children and never gets pregnant again. So it's not only they've never had children. No, they may have a child, one, two, three, and then struggle with infertility. So it can occur at any point.
Jocelyn: It's so crazy when that happens. What? It worked three times.
Janet: Now why?
Jocelyn: Yeah.
Dan: And we've also had others on the other end of it where I've cared for in my career as an OBGYN where people struggled using all kinds of medications, finally got pregnant. The second time it took half the dose.
Jocelyn: And then the dam was opened.
Dan: And the third time no problem. They got pregnant right away. Explain all that.
Jocelyn: Yeah.
Dan: Can't always explain it. And we've always heard these, as we as doctors, would be my doctor told me I'd never be able to get pregnant. Then what's this pregnancy positive pregnancy test?
Jocelyn: It's a miracle.
Dan: It's a miracle. And from an in vitro fertilization standpoint, it's not necessarily the only treatment for infertility or the first line treatment for infertility. So if we identify that there's a potential male factor, we may attempt a different treatment besides in vitro. If we identify there's an ovulatory, she's not ovulating well, there are medications that can enhance that, improve that, besides and or before one would try in vitro fertilization. Alright, but in vitro fertilization can also be used for any of these factors we've talked about, for tubal factors, for severe male infertility, and all the other causes that just don't respond to the less invasive therapy. If you try everything else and nothing works, in vitro fertilization is one of those options.
Jocelyn: So in vitro is the most invasive and the most expensive, probably like the most after you've already tried other methods.
Dan: Typically we'd encourage people to try other methods first, unless you identified something that if you had severe tubal disease and the tubes were blocked and there was no way that was going to happen, then you might move on to in vitro earlier. So part of it depends upon what's the evaluation? What's the cause thought to be the cause? All right, so let's at least think through what in the world is in vitro fertilization? What does it involve? There's a number of steps it involves. Number one, it involves stimulation of the ovaries in the woman with ideally injectable IM medications that cause the ovaries to produce more than one egg.
Janet: Because normally it's one each month.
Dan: Normally, it's typically it's one each month.
Jocelyn: So IM medication, intramuscular. It's a shot into your muscle.
Dan: Yeah. Shot into your muscle and associated with that is daily ultrasounds and daily blood tests to determine how well it's working and is the dose appropriate? Do you need more or less? How are things progressing in the development of the eggs in the woman's ovaries?
Jocelyn: Okay.
Dan: So that's the first step. The second step is then to retrieve multiple eggs from the woman's ovaries. And that is a procedure where a needle is placed vaginally into the ovary and the eggs are then removed from the ovary.
Janet: I'd try other things first.
Jocelyn: Janet is squirming in her seat.
Dan: I can see it in your eyes. Really?
Jocelyn: It's an invasive procedure.
Janet: Yeah.
Dan: It's an invasive procedure. So now what do I have? Now we have eggs, multiple eggs, and how many you have depends upon how many are extracted, removed at the time. So now you have the eggs. In the laboratory, then, and I'm gonna, here's my finger, my air quote quotation, the eggs and the sperm are united together in a test tube in an environment in the laboratory. So conception occurs in the laboratory. And then after cell development to a certain cell stage, number of divisions, and as it progresses, then that new pregnancy, that new human is then implanted back into the woman's uterus.
Jocelyn: That's the process.
Dan: That is the process. Now, the success rates. How successful is it? For those under 35, the ranges of success are probably in the ranges of 40 to 60 percent, and it may involve multiple cycles. The success rate should be quoted by the specialist that you see. So I am not aware of general OBGYNs who are doing, now could be, but I'm not aware of that. The typical person who is doing in vitro is an infertility specialist, a reproductive endocrinologist, infertility specialist who's doing this. And we may say a number. You really want to know the person who's doing your procedure, what is their success rate? They should be able to tell you, right? I've done X number of procedures, X number, here's my success rate. That's what you want to know. What's their rates that they would quote you? The success rates are better under the age of 35, and they significantly decrease over the age of 35. After age 40, the success rates less than 10%. Using 40 year old.
Janet: Eggs and sperm.
Jocelyn: Eggs and sperm, yeah.
Dan: Primarily it's mainly the egg.
Jocelyn: That's the issue.
Dan: That's the real issue. It's the egg that's the issue. And the cost ranges from you can get all kinds of quotes and you should get this quote from your specialist and they'd be telling you how much it costs. It's somewhere in the range of 15, I've heard $12,000, $15,000, all the way up to $30,000, per cycle attempt, per monthly attempt.
Jocelyn: Wow, that's a lot of money.
Dan: So each month, now, the question that came up on the election was does insurance pay for that? All these things, again, what is your success rate for the person that I'm seeing that's going to be doing my procedure? Secondly, how much does it cost? I don't care how much it costs in Georgia if I'm in Minnesota having the procedure.
Janet: How much will it cost me?
Jocelyn: How much will it cost me?
Dan: Me. And thirdly, my insurance pay a percentage, any, all, what is that number? And so those are really things that, being good stewards, we would need to consider. Couples need to find out this information and I really want to make sure, we think all this is happening to the woman, but we really need to say, this is a couple issue.
Janet: Yes.
Dan: This is a couple issue. Now there are possible options that have biblical, moral, and ethical considerations. And I may tell you what I believe. I'm not trying to convince you. I'm trying to make certain you understand what some of these possibilities are because you need to think about this. Are you okay with using donor eggs? Could you use someone else's eggs to create a pregnancy?
Janet: That might be better if mine are older or whatever.
Dan: Absolutely. Or if I knew that in my family, there's a genetic problem.
Janet: Yeah, yeah.
Dan: And there's a 50 percent chance using my egg that my child will get this genetic issue. Would I use someone else's eggs that would not have that genetic potential mutation?
Jocelyn: And there's a big difference between can you and should you. Because that's a huge ethical question, like bringing someone else's body parts into your marriage and the babies that will be produced from it. That's a huge issue.
Dan: It's a huge. And conversely, what about if the husband, I know some couples in our church.
Jocelyn: Yeah.
Dan: He is great, you would never know, and he's got a great wife that would never say he makes no sperm.
Jocelyn: Right. It's just not a possibility. Yeah.
Dan: So, what do we do with that?
Jocelyn: Yeah.
Dan: What do we do with that? These are ethical issues. These are moral, ethical, biblical issues. So those are two. Number three, one of the big ones, and this has changed over the course of years as we've started back in the '80s and '90s and now we're doing things differently. But at least initially the question is I have all of these eggs, how many eggs do I potentially allow to be fertilized?
Janet: Yes.
Dan: If I remove ten, Do I, and by the way, could I freeze the eggs and use them in a later cycle? So you don't have to go through the squirming of getting those eggs, right? So could I do that? And the answer is yes. And maybe there's a little difference in success rate with fresh versus frozen eggs. But I could I do that? But the question now becomes how many eggs? Do I allow to be fertilized? Do I put in the, and even if I allowed 10, will all of them fertilize? And the answer is.
Jocelyn: That means 10 children.
Dan: Unknown. Yes.
Jocelyn: It could possibly mean 10 children.
Dan: Could be. And then what do you do if there are 10 children.
Jocelyn: Right.
Dan: If there are 10 people.
Jocelyn: 10 humans that were created.
Janet: Do I pick which ones I want? Which ones are stronger.
Jocelyn: Or do I choose a certain number of them and not use the other created humans that are not allowed to be grown?
Dan: Correct. This is where the under, see, understanding all this physiology then comes back to, oh, these are the decisions that people have to make. And can you imagine you're 24, 25 years old, you've been married and trying to get pregnant for a year and a half and not been successful. And you're in front of the fertility specialist and he says, how many eggs do you want me to fertilize? And their eyes crossed and what are you talking about? I don't know.
Janet: And if they don't have a biblical worldview, they may not have, they would probably say, hey, the more, the better. You don't have to take them all.
Jocelyn: That's actually. That's what I am thinking.
Janet: They're not even thinking.
Jocelyn: Like I work for an adoption agency with couples who have been infertile for 10 or 15 years and this is their last hope and so their thought would be all of them, get them all, fertilize them all. Like we need to have every chance we can have.
Dan: Now, however, what is the success and odds of 10 children developing in any woman's uterus getting to the point where the children can survive outside the uterus?
Jocelyn: Yeah.
Dan: Zero. So they'll be like, oh, we can't put them all. We could not put all ten. We could put, we could choose and over the course of time, this has evolved. Right now, they're, some are only putting, some are only fertilizing one egg or two eggs. So the most you could potentially have would be twins because our success rates are better with each of them. And they may say this egg, I do not know how they make this distinction, but this egg looks better than this egg. So we're going to fertilize it, not this one. And again, I'm not in the weeds of that component of this. How many eggs do you fertilize? And what do you do with them? Because what has happened in the past is if I get, if I fertilize eight eggs, I'll put three back in. What do I do with the other five? I freeze them. I freeze them. I cryopreserve them. I freeze them to the point that they no longer are reproducing. They're no longer developing as they normally would. There's a, you go from 2 to 4 to 8 to 16 to 32 to 64 and on. You stop that process by freezing the eggs.
Jocelyn: So there's a human in a freezer.
Dan: They're frozen.
Jocelyn: They're frozen humans.
Dan: Humans.
Jocelyn: Yeah.
Dan: And I'm like, I don't know. I prefer not to be a frozen human.
Janet: Right.
Jocelyn: It just has so many questions and lots of people, like we've had people on our show that have talked about embryo adoption and snowflake babies and things like that. It's a lovely opportunity for an infertile couple that would like to adopt an embryo. But when you're talking about the creation of those embryos as a different, that's a different matter.
Dan: Those are two different components, right? So we say if something's already happened, yeah.
Janet: Let's adopt those embryos.
Dan: And we can adopt them.
Janet: For sure.
Dan: Super.
Jocelyn: Yeah.
Dan: But would I do something?
Jocelyn: Would you do it on purpose?
Dan: Unbiblical?
Janet: Yeah.
Dan: Immoral? Unethical? In order for something good? And the answer would be.
Janet: No.
Dan: We would never do that. So these are the things that you have to think about beforehand. You don't want because I've gotten calls in the past, we did in vitro and now I have four or five babies in and they say they will not survive. So what they want to do is they want to go in and selectively reduce, selectively kill, place medication within each of these new humans, or a couple of them so that instead of having five, we only have two.
Janet: So I'll have a better chance of the two living. I will kill the other three.
Jocelyn: And we need to say what selective reduction actually is that's selective abortion.
Dan: Yeah.
Jocelyn: Selective reduction is selectively choosing which ones you're going to kill.
Dan: Correct. Correct. And now there's even the technology continues to develop and develop. Of course. So that we can test these early humans before they're even implanted, do they have any genetic defects or do I want a boy or girl? Or.
Jocelyn: It's out there. People are using, people are doing that.
Dan: It's available. It's available. It is available. These are the kinds of questions that my 24 year old couple who like what do I do? How do I think about this? And do I just take the advice of my doctor and say listen, five can't survive.
Jocelyn: It's like prenatal eugenics. That's crazy.
Dan: Yeah. Yeah. So we do want to say, listen, talking about this morality is thinking about all of these choices and options and saying, this is what makes it, could it be a yes, it's moral, ethical, and biblical? I believe the answer is yes. Could it be no?
Jocelyn: Could be. Yeah.
Dan: And could it be no? First of all, we just need to say this, you don't have to pursue any of these options.
Janet: Right.
Dan: There's no reason. You don't have to. We're never commanded that I have to have a baby.
Jocelyn: And we're never commanded that if I have a baby, it has to be my genetic offspring. There are lots of ways to be invested in the next generation without ensuring that it's my genetic offspring.
Dan: Correct. Because could you adopt a baby that's been born?
Jocelyn: Yes.
Dan: Could you adopt a child at a year? Could you foster to adopt?
Jocelyn: Yeah. There's all sorts of children that need families to live in.
Janet: And to Dan's point though, we don't have to do any of those, meaning some people, even if it's adoption, I will go into debt. I will have nothing. So to say, when does it move from a wonderful Godly desire to something else because I must have it and I end up going down a path.
Jocelyn: And you're willing to sin to get it or to live unwisely or to do unbiblical things.
Janet: Yeah. For a good thing.
Jocelyn: For a good thing that you want.
Dan: What we think is a good thing.
Janet: Correct. From our perspective. Yes.
Dan: Correct. Because, and again, what you have just, what we've just talked about, could having a baby become an idol?
Janet: Absolutely.
Jocelyn: For anyone, it could be an idol.
Dan: Cause and I'm going to do whatever it takes, whatever the options choices are, I don't it's what I'm looking for, what I'm hoping for, what my whole life revolves around is having a baby.
Janet: Yes.
Dan: So these are just the kind of the questions. I also would say that if your conscience says, I don't because it was very fascinating talking to the college kids. They were like I, we have some objections and we just don't believe this is moral. We don't believe this is ethical. We don't believe this is biblical.
Jocelyn: Don't do it.
Dan: Okay. Don't do it.
Jocelyn: Yeah.
Dan: And so.
Janet: Follow that.
Dan: That's okay and that's okay. But if you believe, if your conscience says, this is not moral, ethical, biblical. This is not a right. This is not God honoring. Then to go ahead and do it is sinning against your own conscience. Please don't do that.
Jocelyn: And both people in the marriage need to be an agreement. Like it needs to be, they need to be on the same page.
Dan: Right.
Jocelyn: Not just one person.
Dan: Not the page of, I'm going to tell you what we're going to do.
Jocelyn: Sounds like you might've heard that before.
Dan: Never. I would recommend, and there are individuals in the Christian community who say, IVF is moral. There are individuals who say it's not moral and not ethical, not biblical. I would recommend an article to you. It came from the Journal, Christian Living, April 25, 2019 written by Wayne Grudem. Where he talks about can in vitro fertilization be morally right? Can it be morally right? And he brings out a number of points that I would just like to cover really quickly. He has four points he brings out. He says, number one, overcoming infertility is pleasing to God. Again, he talks more about that. I'm just going to talk about the points. He says, number two, modern medicine in general is a divine blessing that's morally good. And again, you can take exception to all this. No problem. I'm just presenting what he's saying. Number three, we should treat an unborn child as a human person from the moment of conception. And that talks both to the infertility in vitro fertilization, the abortion issue, which is another huge topic that people don't talk about abortion and they talk about reproductive rights.
Jocelyn: Yes.
Dan: I'm gonna change the scenario. I'm going to change the narrative. I'm going to change the topic. We're not talking about abortion. We're talking about women's rights. And so.
Jocelyn: Which gets people's standards all up because how dare you take rights away from women like but what we're actually talking about is access to abortion.
Dan: Absolutely. And fourthly children should only be conceived by and born to a married man and woman. And I, again, I like that. And there are some people who would say, listen, because you had talked about this issue of donor eggs and donor sperms, that's going outside the marital relationship. Some people would say that's morally unacceptable. We would only stay within the marital unit. And if we can't do that within the marital unit, then we'll.
Jocelyn: We won't.
Dan: And we'll pursue adoption. We'll pursue something else.
Jocelyn: I learned that by listening to you, Dan, like 10 years ago at a BCTC session.
Dan: He goes on to say, if IVF is used by a married couple and if care is taken to prevent the intentional destruction of embryos. Now the point is to say listen, if we go through in vitro fertilization and we fertilize two eggs, and we put two eggs back inside, they develop and put two eggs back inside the uterus. Does that guarantee that you will not miscarry?
Jocelyn: No.
Janet: Not at all. There's no guarantee.
Jocelyn: It just guarantees I didn't kill a baby on purpose.
Dan: Correct.
Jocelyn: And you're probably statistically more likely to miscarry in an IVF situation? There's more stuff going on, isn't there?
Dan: It's probably, it's very similar. The numbers would be pretty similar, but it's not a hundred percent either way. Does that mean that I couldn't have a complication during pregnancy?
Jocelyn: No.
Dan: And unless I did some pre implantation, putting it back If I did not do any testing before putting this pregnancy human back inside the uterus to say, is there a genetic defect? Could there be a genetic defect?
Jocelyn: It could be. And then it, the Lord would allow that child to be miscarried.
Dan: Correct or born early with an anomaly or something. And could I have a complicated pregnancy? The answer is, of course, all these things.
Jocelyn: But all those things are different than saying, I will destroy embryos that I don't prefer to keep.
Dan: Correct. So prevent the intentional destruction of embryos then it's a morally good action that pleases God because it violates no scriptural guidelines, achieves the moral good of overcoming infertility, and brings the blessing of children to yet another family. Again, it does not mean that couples have an obligation to try in vitro fertilization. Only that it's morally acceptable. That's what he says in his article.
Jocelyn: So it's not automatically a no.
Dan: It's not automatically.
Jocelyn: And these are the reasons why.
Dan: Correct. Correct.
Jocelyn: If we can, we'll link that article in our show notes.
Janet: Yeah, we will.
Dan: Good. And we would talk about, we've talked a little bit about the stewardship of finances. There are some people who would say, no matter what.
Janet: Yes.
Dan: It doesn't matter how much it costs. I don't care how much debt I'm in.
Janet: I have to have a baby.
Dan: And by the way, do you think when you have a baby that it's the financial.
Jocelyn: It's not like you are going to get more money.
Dan: Let us tell you, it gets worse.
Jocelyn: I think that's a significant factor to talk about though because $30,000 is a lot of money. And if we remember stewardship, every single penny that we own belongs to Jesus Christ and He expects us to use it His way and He's going to call us into account about it.
Dan: And this is the stuff that should be talked about, thought about, decided on before. Not talked.
Jocelyn: During.
Dan: During.
Janet: Not right.
Dan: 90 percent into this. Not getting your hopes up. Cause again, you get your hopes up and then all of a sudden they're dashed by, oh, how do we get this?
Janet: Now what?
Jocelyn: And you could spend $30,000 on a completely failed IVF and be in debt with no children to show for it. That is a possibility.
Dan: Correct. Correct. The realm of possibilities. And again, we just have to encourage individuals to say, hey, think about this. Teach about this. Talk about this. Couples are going to see the fertility specialist, many times not having thought anything about this and then are presented with, okay, what do you want to do?
Janet: I want a baby.
Jocelyn: I didn't even know it was a spiritual issue.
Dan: Didn't know, didn't know.
Janet: No, and especially, when you go to see the doctor, you're seeing the expert. So I'm listening to the expert who's not telling me any of this biblical worldview. Who's not saying that means we may kill babies. They're not giving me that picture. I remember even when, you know, Dan, you were my doctor and I moved away and I had a series of miscarriages and with the second one, they wanted to do a procedure, and they just said it in the office. We want to protect you from any additional pain. We're going to do this procedure. And there was something in me that was like, I just went home and called you. I don't know if you remember that, but I called you and said, they want to do this procedure. I needed to talk to someone who understood medicine who had a biblical worldview. Because what you said is, I understand that the baby has probably died, but probably is not good enough for me and I could not do that procedure. And I was like, that's what I needed to hear. Like I wasn't, if there's a chance this baby's alive, but they weren't concerned about the baby, only me. So they didn't give me those options. They didn't say I could do this, I could do that. They just said do this. And that by the grace of God, I just thought I just need to talk to somebody else before I do that. And I think, I look at that and go, you're already vulnerable. You trust your doctor. They need to think about these things before they walk into the specialist's office, like you said.
Jocelyn: And they need to have godly people in their lives that they can talk through things with.
Janet: Yeah.
Jocelyn: And hash decisions out. And have biblical minds involved in the decision making process. So that's one of the big encouragements is to get other people involved in these decisions early that do love the Lord and are biblically sound.
Dan: And I think unfortunately many times these issues of we've been trying to get pregnant for a year and haven't been successful. So do you have couples in your churches who have lots of kids? Sure. Do you have couples in your churches who don't have any children?
Janet: Yes.
Dan: Are they struggling with infertility? Are they okay with it? This is just not something that we talk about.
Janet: And I would say, you're right. I don't feel comfortable. I feel like it's none of my business, and yet we need to be asking, not why don't you have kids yet?
Jocelyn: Or when are you going to have kids?
Janet: But how are you guys doing? Is this, and yet we're not comfortable having those conversations or starting them.
Jocelyn: And I think like you have to read the room, read the situation, but just like you and I have talked about so many times, like , we have to be very open in talking about sex. We're talking about our kids, like when we talk about this, but I just don't think there's any topics that are ultimately off limits in the church. We have to be able to have open conversations about things with each other from the viewpoint that we want to honor the Lord with every component of our body, every component of our life, and we want to help each other. And A, don't be afraid to talk about it if you're struggling. And B, don't be afraid to be the friend who does talk about it with someone who looks like they might be struggling.
Dan: Yeah. Because who's got this all solved correctly? None of us do. We all struggle. We struggle because we're cursed by sin and we're most interested in me.
Janet: Yes. Our default.
Dan: 99 percent of the time, right? Our default is me. Our default is me. There's and you will, at times, find objections to in vitro in some of these procedures. One objection is it's not a natural process. And isn't the natural process of conception through sexual intercourse, isn't that the natural process? It assumes the definition of natural excludes modern medical means from what we consider part of nature. Is not the question, is not the lab equipment used for IVF made from resources God planned in the earth?
Jocelyn: Sounds like someone has really thought through this.
Dan: Far more than we would ever, right? But I'm thankful some people do think like this. And the other thing as well, it separates sex from conception. And the answer is, but think about the infertile couple. That's true. It has.
Janet: It already has.
Dan: It already has. They've gone a long time, and they could be, they could have a very satisfied, happy, fulfilling sex life without achieving pregnancy.
Janet: For sure.
Jocelyn: And even in that year of attempts that there have been lots of things that have been brought into the sex life that are not natural and satisfying
Dan: Correct. And the other part about it is that you destroy all these embryos. And the answer is you don't have to.
Janet: But we would all agree that should not happen.
Dan: That should not happen.
Jocelyn: That should never happen.
Janet: That's right.
Jocelyn: But if you do IVF, it doesn't have to include multiple embryos that need to be destroyed.
Dan: It doesn't have to.
Jocelyn: Yeah.
Dan: Now somebody say, but your success rate may not be quite as good.
Janet: That's right.
Jocelyn: And it might cost more because you have to do more cycles.
Dan: But you have to say what's most important.
Jocelyn: What's the cost? Yeah.
Dan: What's most important?
Jocelyn: A human life versus another $10,000. There is one that is not worth.
Janet: One is sinful and the other one is not.
Jocelyn: One is sinful and one is just expensive.
Janet: Yeah.
Dan: And we have taught and done a number of things in the past about infertility and Amy Baker and I have done things in the past separately and together related to this. One of the things that she says, which I would just make sure that we cover this. And this is one of those sentences that sometimes we talk a lot and sometimes it's the little things that we remember the most. They're the hardest, but they get to us the most. What she said is the greatest gift of all is not having a child, but being His child.
Jocelyn: You should say that again.
Dan: That's hard because we don't think like this. And I've got to rethink and change the way that I think. The greatest gift of all is not having a child, but being His child.
Jocelyn: Every parent needs to understand that.
Janet: Yes.
Dan: So thank you for the opportunity to just walk through and talk through and think through some of these issues, which I think are important to hear and listen and to think about critically, to try to understand, and say this really will never impact me. And it may impact people who are around you that if you were aware of, you could be assisting, helping, guiding, leading them in a correct biblical way as opposed to leading them out on their own, making these decisions without any help.
Jocelyn: And I think there are a lot of medical issues other than women's reproductive health issues that include huge ethical questions that should be discussed in community. There's a lot of medical procedures that we may not be in favor of if we really understood it more and so it's important to talk through decisions as you're making them in community, in the church community.
Dan: Yeah, I remember way early in my career, a couple who had twins delivered early, and the twins were struggling in the intensive care, in the neonatal intensive care unit. What are we going to do? How much do we do? How many times do we revive? How many times does this baby coded and we continued.
Jocelyn: Intervening.
Dan: Intervening. I remember one Sunday night, after church, a group of us because this is not just a pastor issue, this is not just a doctor issue. This is where it's really best we work together, sitting down saying, what are we going to do? What's the right thing to do?
Jocelyn: What a loving gift to that family.
Dan: Incredibly hard.
Janet: Yeah.
Dan: Because they're sometimes life and death decisions. But sometimes God puts us in those situations where we have to make those decisions.
Janet: Right.
Jocelyn: And what a gift to have people involved that love the Lord and are thinking biblically and in a big picture way. What does honor the Lord with these decisions and how can we love that person practically by walking this path with them?
Janet: Yeah.
Jocelyn: I'm so thankful you could come talk to us, Dan. I just think it's so interesting to know something so fundamental as basic anatomy helps to understand this. So a listen in health class and be like learn how God made our bodies to function, learn what is statistically normal and learn what's statistically not normal, and then make informed decisions, not just based on what you want, but what will honor the Lord and also be a good representation of His values.
Janet: And in the midst of a very painful topic, with lots of heart, I loved the quote from Amy. The hope that we can leave with is, it's not wrong that we desire to have a child, and in that way we want to show the values of God to this child, but the greatest gift is not having a child, but being His child. So to think about our desire for a child differently. That first let me rejoice in the fact that God wanted me, chose me as His child. The hope that is there in the midst of the pain. Thank you for saying that.
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