Many Christians found themselves at a crossroads when the Alabama Supreme Court’s decision in a high-profile in vitro fertilization case sparked a national debate on IVF, an assisted reproductive technology where doctors use sperm to fertilize a woman’s egg in a petri dish.

Other articles outline many of the moral and ethical concerns inherent in how IVF is routinely practiced. Today, I will discuss IVF from the perspective of a biblical theology of infertility.

The Blessing of Fruitfulness

If you are a Roman Catholic, you likely know that the Roman Catholic Church has opposed the practice of IVF for decades. Formal opposition, however, has not stopped some Roman Catholics from using IVF. Nor does it mean that they understand how Scripture talks about procreation and infertility. For Protestants Christians, no denomination has offered a firm teaching on IVF, unlike abortion, where most orthodox denominations are unapologetically firm in their commitment to protecting preborn life in the womb (Job 10:9-11; Psalm 41:5, 139:13-17; Jeremiah 1:5; Luke 1:41-44).

Many Christians feel perplexed about how to think about IVF. Abortion takes life, but IVF creates life, so it must be good, right? Unfortunately, this line of thinking fails to account for the millions of embryos created each year in the United States who are either destroyed, frozen, or fail to implant. As other articles consider the ethical implications, I will consider how the Bible talks about infertility and procreation.

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Of course, for those who rely on sola Scriptura, a flip through one’s concordance will not yield results for “in vitro fertilization.” Neither will most theology books, but that is a separate issue.

In Genesis 1, we see the “what” purpose of man and woman. God blesses them to be fruitful and take dominion of the earth. This fruitfulness applies to childbearing and all other work (Genesis 1:28-30). God blesses Adam and Eve with fruitfulness as a gift. The Bible describes children as blessings from God (Psalm 127:3). Yet the creational reality of fruitfulness is not a command that gives parents the right to create children by any means, especially if the process violates other core teachings of Scripture.

The Bible also shows us the “how” of procreation. “Therefore, a man shall leave his father and his mother and hold fast to his wife, and they shall become one flesh” (Genesis 2:24).

Scripture places procreation in and through this unbroken bond of marriage. Indeed, many passages in the Old and New Testament present this biblical vision of marriage, sex, and procreation as an unmediated “package deal” (Genesis 1:27-28, 2:23-24; Psalm 127-128; Malachi 2:15; Mark 10:7-9; Luke 20:27-40).

In Genesis 3, we see the “why” of infertility. “I will surely multiply your pain in childbearing; in pain you shall bring forth children” (Genesis 3:16). The baggage that accompanies this verse could fill an entire cargo ship. What is important to note here, however, is that the word “pain” is the same word used in the next verse referring to Adam. It does not only reference the physical pain that can accompany labor. It is much broader than that. It refers to the emotional, mental, and physical pain that, due to sin entering the world, accompanies each aspect of procreation. It influences our desire, or lack thereof, to have children, as well as the anxiety of conception, pregnancy, labor, and caring for our children.

The desire to control or overcome infertility is one of the oldest recurring stories. For example, throughout Israel’s history, one of the primary false gods to which they turned was Asherah, the goddess of fertility. The Israelites would perform sexual acts in front of the idol to conceive children or reap a bountiful harvest.

Notably, each of the big three patriarchs dealt with infertility: Abraham and Sarah, Isaac and Rebekah, and Jacob and Rachel. Abraham and Sarah suffered greatly in their failure to trust God, turning to another woman to circumvent their infertility. Isaac and Rebekah prayed fervently, and God granted their request for a child. Jacob and Rachel used mandrakes, which is a fertility stimulant, and Rachel’s maidservant to bear children. Ultimately, Rachel did have two children of her own, but she still did not have as many children as her sister Leah.

Save Us From All False Choices

Infertility is not fair, and even our best attempts to have children do not always work out. Indeed, as with the Israelites, Abraham and Sarah, and Rachel and Jacob, many of the options before the Christian to address infertility, although culturally normal, may be false options. It was normal in the ancient Near East to worship multiple gods in hopes of reaping maximum benefits from each; yet it resulted in sin and death for Israel. It was normal to use one’s maidservant to bear more children, yet it violated God’s vision for marriage, and such actions brought suffering, envy, and strife.

The desire to have children comes from God; fertility is his idea, not ours. Such children, however, are a gift from God and not a right for adults. When we make children our goal, we run the risk of sinning in our attempt to achieve a child by any means necessary.

Protestant Christians who are orthodox are unwavering in their support for the preborn and their commitment to upholding the sanctity of marriage. Why should IVF, which deals with the creation of human life itself, receive an exemption? Indeed, the Bible has a lot to say about the ability to circumvent infertility with a technology that routinely destroys, tests, and selects the “best” embryo.

From Scripture alone, it seems clear that as additional degrees of separation are placed between each aspect of marriage, sex, and procreation, more opportunities for sin arise. What God has brought together in that “package deal,” let no human separate (Matthew 19:6). Infertility, miscarriage, and stillborn births introduced the experience of separation between these realities, and the pain of this unnatural loss is immense. Reproductive technologies such as hormonal contraception, Plan B, chemical abortion pills, and even IVF can similarly sever the natural relationship between marriage, sex, and procreation.

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This is not to say that it is necessarily a sin to use nonabortive contraception. Still, the routine use of these technologies often results in the destruction of embryos.

Many faithful Christians conclude that IVF, when used within marriage and without the destruction of embryos, is an acceptable and even miraculous technology. If the news stories in recent weeks are any indication, it may be much harder to practice “pro-life” IVF than many Christians think. As IVF separates sex from procreation, couples experience heightened temptations to view children as an act of the will and not a gift received. I often wonder how many Christians end up destroying or indefinitely freezing their embryonic children. Few pastors or lay people have the courage to ask a couple struggling with infertility what happened to each of the embryos they created in IVF.

Still, God does not leave his children empty-handed. As Psalm 127 and Psalm 128 show, God empowers men and women with wisdom. Godly wisdom does not free one from the firm teachings of Scripture, but it does compel Christians to pursue restorative reproductive technology that addresses the underlying causes of infertility.

In many cases, doctors can restore the man or woman’s body such that they can naturally conceive and bear children. This technology, not IVF, should be the first course of action for Christians struggling with infertility. Not only does it avoid the high financial costs, ethical and moral dilemmas, and difficult treatments, but if the couple still chooses to seek an ethical way to practice IVF, their chances of success are much higher than before.

Infertility is a tale as old as time. So are the possible abuses when Christians ignore the blessing of marriage, sex, and procreation in the pursuit of a child. It is time for Protestant denominations to train their congregants to think biblically about infertility and the use of artificial reproductive technologies.

The creation of human life is central to what it means to be human. It deserves the highest moral and biblical scrutiny.