In their 2024 annual report, the Canadian Fertility and Andrology Society released its Canadian Assisted Reproductive Technologies Register data. This data tracks almost all facets of assisted reproduction in detail (except for sperm donation).
Assisted reproduction occurs in all sorts of ways. In vitro fertilization, for example, takes a human sperm and a human egg, fertilizes them in a petri dish, and then transfers the embryo into the intended mother’s womb. Surrogacy is essentially the same thing, except the embryo is transferred to a surrogate mother who gestates and births the child before giving him or her up to his or her intended parents.
In our policy reports on in vitro fertilization and surrogacy, we’ve noted that these assisted reproduction techniques are morally problematic for all sorts of reasons. There is the philosophical question of whether children should only be conceived through sexual intercourse. There is the intentional freezing and destruction of embryos, which pro-life Christians who believe that life starts at conception must recognize as human beings. There is the high failure rate of IVF, leading to questions about how many unintentional deaths we are willing to tolerate to allow a new life to be born. There is the issue of using genetic testing to discriminate against some pre-born children who are likely to develop disabilities, chronic illnesses, or abnormalities. There is the practice of “selective reduction,” aborting a pre-born child if IVF leads to multiple pre-born children growing in the womb. There are physical risks of IVF to women, including a greater risk of developing ovarian cancer. There is an increased likelihood that children conceived through IVF will have genetic defects or intellectual disabilities. And there is the entire problem that IVF and surrogacy fracture fatherhood and motherhood; rather than one man and one woman laying claim to be the father and mother of a child, the intended father and mother, the genetic father and mother, and the birth mother all can lay some claim to being the parents of the child.
Given all these moral quandaries, we’ve suggested that IVF be greatly limited and surrogacy be banned entirely.
But in the absence of great restrictions on assisted reproduction, how prevalent a problem is it? Are there hundreds of thousands of children being conceived through IVF per year or just a few dozen? What is the survival rate of these children? How many people are turning to assisted reproduction?
Here’s some data.
In Vitro Fertilization
In vitro fertilization is becoming increasingly prevalent. Over 28,000 women visited these fertility clinics in 2023, and just over 20,000 egg (oocyte) retrievals were performed.
Perhaps most importantly, consider the number of live births compared to the number of embryo transfers (ETs). In 2022, approximately 27,500 embryo transfers – the transfer of an embryo from a petri dish into a woman’s womb – occurred, but only 7609 children were born. That is a “success rate” of only 28%. Only 28% of pre-born children survived the transfer. The remaining 72% – approximately 20,000 – pre-born children did not survive the implantation process.i
The following chart breaks this down by the age of the woman and the specific type of IVF. (Fresh ET means the embryos were never frozen before being transferred; FET (no PGT-A) means that the embryos were frozen but not genetically tested before being transferred; FET with PGT-A means that the embryos were frozen and only the embryos with the best genetics were transferred.)
Although the survival rate of the embryos is far higher if they are frozen and genetically selected, there are ethical problems with these two practices. If embryos are human beings, then it is just as immoral to freeze them in time as it would be to freeze an infant, a child, or an adult so that they stop developing. And testing embryos for genetic problems and implanting only the embryos with “good” genes is discriminatory. It avoids children with genetic deformities such as Down syndrome. It is a “transfer – and hence the survival – of the fittest.”
Unfortunately, since using frozen embryos that have been genetically tested and selected has the highest survival rate, an increasing percentage of all IVF treatments use frozen embryos. Almost 80% of all embryos are now frozen before transfer rather than being “fresh.”
But the survival rate of embryos – of pre-born children – is even worse than presented above. Only 28% of embryos transferred to a woman’s womb are born. But that ignores the fact that many more embryos are created than are ever transferred. Just consider the following summary graphic.
Over 85,000 “utilizable” embryos were created in 2023 (plus an unspecified number of embryos that were not considered “utilizable”). But there were only 7609 live births. Doing the math, that means that only 8.9% of all embryos created in a petri dish were born. Over 58,000 embryos that were created but not transferred were either destroyed (killed) or frozen (abandoned), and a further 20,000 accidentally perished in the process.
To put that into context, there were 101,553 abortions in 2023. Approximately 61,104 children in 2022 were in the foster care system. The intentional destruction of an embryo is the moral equivalent of abortion. Although the analogy is far less perfect, the foster care system is likely the most analogous to the long-term freezing of embryos. Both involve parents being unable or unwilling to take responsibility for their children. Many Christians give much thought to the injustice of abortion. Some mourn the brokenness of the foster system. But very few pay heed to the treatment of pre-born children in the assisted reproduction industry. And yet, the sheer number of mistreated embryos is comparable to the number of abortions or foster children.
There is one small piece of good news in this report regarding IVF. In our policy report, we note that, “because of the risks involved in a multi-fetal pregnancy, women are commonly encouraged to ‘reduce’ the pregnancy – that is, they are encouraged to abort one or more of the children to increase the likelihood of a healthy pregnancy with a single child.” As a result, we recommended that only one embryo be transferred to minimize the motivation to have a “selective reduction” abortion.
At the time, we didn’t have any numbers to back up how common it was to implant multiple embryos. But the trend is in the right direction. Combining the rate of single “fresh” and frozen embryo transfers, only a single embryo is transferred 88% of the time. More than two embryos were transferred only in 0.35% of cases, making the circumstance in which there is a perceived “need” for a selective reduction abortion rare.
Surrogacy
The report ends with some statistics on surrogacy (what the report calls gestational carrying). Gestational surrogacy occurs when a woman, unable to bear a child herself, contracts with another woman to carry her child on her behalf. A child is thus conceived by standard IVF practice and then transferred to the surrogate mother.
As demonstrated by the graph below, gestational surrogacy is far less common than standard IVF. In 2023, there were 859 gestational carriers (i.e. surrogate mothers). There were 1237 embryo transfers that resulted in only 428 ongoing pregnancies and 271 live births. That’s a “success rate” of 22%, slightly less than the 28% of standard IVF.
Conclusion
While an increasing number of Canadians are turning to assisted reproduction and more and more provinces are publicly funding the procedure, assisted reproduction is deadly. Far more pre-born children are frozen and intentionally or unintentionally killed than are born. Christians need not only to be aware of the magnitude of this tragedy but also speak up about it with their neighbours and elected representatives.
In vitro fertilization (IVF) is a process that creates a human embryo outside the womb of its mother. A woman’s eggs are fertilized with sperm in a laboratory, resulting in embryos that grow under the supervision of laboratory staff. Between 3-5 days after fertilization, one or more of the embryos are transferred into the birth mother’s uterus in hopes that they will implant and continue to grow into healthy, full-term infants. Excess surviving embryos that are not implanted are frozen, discarded, or donated for research.
Federal and provincial governments in Canada are seeking to improve access to IVF, particularly in terms of helping with the cost. Infertility rates have doubled since 1980 and the IVF industry is booming. In addition to overcoming infertility in opposite-sex couples, IVF is seen as a way for same-sex couples to have children. In the federal government’s latest budget, they incentivized the use of IVF through increased tax credits for expenses related to the process. Various provinces also provide financial incentives and support for those who pursue IVF.
ARPA Canada wants to draw attention to the ethical issues surrounding IVF, especially the relevant moral considerations around the sanctity of human life.
Human Life
Children are a gift from God, and His natural design for how they come into existence is good. Any conversation about IVF must begin from this foundation. Children are meant to be born to and cared for by their biological parents whenever possible, and each embryo is a unique human being that should be treated with dignity and respect.
Unfortunately, the humanity of the embryo is largely ignored in the way IVF is carried out in Canada. To increase the chances of producing a healthy embryo, “extra” embryos are often created, only to be aborted, frozen, discarded, or used for research. Additionally, technology is often used to determine if embryos have various genetic conditions, allowing parents and doctors to reject those embryos. This is ableist, treating some lives as more valuable than others based on their perceived ability.
The Children’s Perspectives
The first birth through IVF took place in 1978. Since that time, children conceived by IVF have expressed concerns about the process. One child conceived through IVF recently shared her story:
“A miracle baby. That’s what my parents always said I was. After 12 years of marriage and much agony, I had been conceived. They had never been so happy. I had never doubted that I was wanted. But there it was…right in the baby book my grandmother had put together for me was a photo of me as an embryo in a Petri dish…
Somehow, somewhere, my parents developed the idea that they deserved to have a baby, and it didn’t matter how much it cost, how many times it took, or how many died in the process.”
This addresses the reality that IVF often stems from a belief, spoken or not, that children are a product to which adults have a right, and that parents are justified in using any means possible to obtain children. This story also recognizes the humanity of the lives lost through failed efforts and the unethical treatment of human life at the earliest stages.
Another concern among children of IVF is their lack of connection to their genetic family history. The IVF industry relies on sperm and egg donations. A donor provides their reproductive material and then effectively abandons his or her biological child. These donations are often done anonymously, and children created by IVF are unable to access information about these biological parents. Instead of focusing on what’s best for children, IVF puts the needs of children below the desires of adults.
Updated Policy Report
ARPA Canada has just released our revised and updated Respectfully Submitted policy report on In Vitro Fertilization, expanding on the principle of human life and dignity and on the harms of sperm and egg donation.
Our recommendations focus on respecting human life from its earliest stages, and on putting the best interests of a child ahead of the desires of adults. Children conceived through IVF can be better protected by limiting the number of embryos created, prohibiting the destruction of embryos, and ensuring that children are not created using anonymous donor gametes.
We encourage you to read through the report, send it to your MP, and ask them to read through it as well. If you have any feedback or questions, we would love to hear from you at [email protected].
After each federal election, the Prime Minister’s office releases Mandate Letters for each of the cabinet ministers. These letters explain the Prime Minister’s expectations for each member of his cabinet and lay out challenges and commitments that come with their role. At the same time, these letters are made publicly available so that Canadians can understand some of the priorities that the federal government will focus on over the next few years.
The ministers’ mandate letters were released on December 16, 2021. The basic template of each letter focuses on recovery from COVID-19, climate change, the rights of Indigenous Peoples, systemic inequity of minority groups within Canada, and general expectations for ministers. Many of the objectives and commitments in the letters are similar to what the government had promised prior to the election, so there are no major surprises. However, specific commitments are worth noting as we keep an eye on how they develop over the coming years.
Charitable Status
In line with the Liberals’ election promise regarding charitable status for certain organizations, the Deputy Prime Minister and Minister of Finance has been tasked with the following: “Introduce amendments to the Income Tax Act to make anti-abortion organizations that provide dishonest counselling to pregnant women about their rights and options ineligible for charitable status.” It’s unclear how exactly the government would remove charitable status from pro-life organizations or how far that would extend. However, the possibility is very concerning, and ultimately the government needs to recognize the value and importance of organizations like pregnancy care centres.
Hate Speech
Before the summer break in 2021, the government had introduced both Bill C-10 and Bill C-36, which focused on hate speech and regulating online content. Although those bills died when the election was called, the Liberals are once again focused on regulating and limiting freedom of expression both online and in public. The Minister of Housing and Diversity and Inclusion was given the following task: “As part of a renewed Anti-Racism Strategy, lead work across government to develop a National Action Plan on Combatting Hate, including actions on combatting hate crimes in Canada, training and tools for public safety agencies, and investments to support digital literacy, to prevent radicalization to violence and to protect vulnerable communities.”
In addition, the Minister of Justice will “continue efforts with the Minister of Canadian Heritage to develop and introduce legislation as soon as possible to combat serious forms of harmful online content to protect Canadians and hold social media platforms and other online services accountable for the content they host, including by strengthening the Canadian Human Rights Act and the Criminal Code to more effectively combat online hate and reintroduce measures to strengthen hate speech provisions, including the re-enactment of the former Section 13 provision.” This seems to be a replication of what was previously Bill C-36. However, there is a possibility that this legislation will include positive components around combatting online pornography as well as more negative limits on freedom of expression. ARPA Canada’s analysis of last year’s Bill C-36 can be found here.
The Minister of Canadian Heritage is expected to “reintroduce legislation to reform the Broadcasting Act to ensure foreign web giants contribute to the creation and promotion of Canadian stories and music.” The previous version of this legislation, Bill C-10, also included the possibility of regulating social certain private social media content that was determined to be a ‘broadcast.’ Further information around Bill C-10 can be found here.
We will be keeping watch to see what exactly is included in this type of legislation if and when it is introduced.
Pre-born Children
The government often speaks of ‘sexual and reproductive health’ to refer to abortion access. The recent mandates encompass that, and also specifically include issues such as in vitro fertilization and surrogacy. The Minister of Health is mandated to: “work to ensure that all Canadians have access to the sexual and reproductive health services they need, no matter where they live, by reinforcing compliance under the Canada Health Act, developing a sexual and reproductive health rights information portal, supporting the establishment of mechanisms to help families cover the costs of in vitro fertilization, and supporting youth-led grassroots organizations that respond to the unique sexual and reproductive health needs of young people.”
The Minister of Finance and the Minister for Women and Gender Equality and Youth are tasked with “expand[ing] the Medical Expense Tax Credit to include costs reimbursed to surrogate mothers for IVF expenses.”
One issue here is the clear plan to continue pressuring the province of New Brunswick to fund abortions in private clinics, something they are the only province not to do. More on that topic can be found here.
The focus on in vitro fertilization and surrogacy raises questions and concerns about how far these procedures might become commercialized in Canada. For further information on these issues, you can read ARPA Canada’s policy reports on both in vitro fertilization and surrogacy.
Gender and Sexuality
Regarding issues of gender and sexuality, the mandate letters only speak in broad terms, especially since Bill C-4, which banned so-called ‘conversion therapy’ was passed before the mandate letters were released. There is a lot of language around efforts to promote equality and remove discrimination for minority groups both in Canada and around the world.
The Minister of Justice is told to: “Build on the passage of Bill C-4, which criminalized conversion therapy, [and] continue to ensure that Canadian justice policy protects the dignity and equality of LGBTQ2 Canadians.”
The Minister for Women and Gender Equality and Youth is directed to “launch the Federal LGBTQ2 Action Plan and provide capacity funding to Canadian LGBTQ2 service organizations” and “continue the work of the LGBTQ2 Secretariat in promoting LGBTQ2 equality at home and abroad, protecting LGBTQ2 rights and addressing discrimination against LGBTQ2 communities, building on the passage of Bill C-4, which criminalized conversion therapy.”
It is hard to say what ‘building on the passage of Bill C-4’ looks like exactly because specifics are not provided. However, Bill C-4 is concerning on multiple levels, and building on it will likely follow in a similar vein. Further information on Bill C-4 can be found here.
Child Care
Child care continues to be an issue the federal government is pushing. The Minister of Families, Children and Social Development is tasked with concluding negotiations with provinces that have not yet signed an agreement with the federal government (Ontario and New Brunswick), and ensuring that $10-a-day child care is available throughout Canada. They also plan to “introduc[e] federal child care legislation to strengthen and protect a high-quality Canada-wide child care system.” You can read more about a Christian perspective on universal child care here.
Drug Use
The Minister of Mental Health and Addictions is tasked with advancing “a comprehensive strategy to address problematic substance use in Canada, supporting efforts to improve public education to reduce stigma, and supporting provinces and territories and working with Indigenous communities to provide access to a full range of evidence-based treatment and harm reduction, as well as to create standards for substance use treatment programs.”
This is not a new issue but there seems to be a new emphasis on it. Bill C-5, a reiteration of Bill C-22 from the previous Parliament, seeks to move increasingly towards treating substance abuse as a health issue instead of a criminal issue.
Conclusion
The issues presented here are priorities of the federal government, and they also raise various questions and concerns about what changes to legislation and regulations on these topics will look like. Stay tuned for further resources and action items as we see how these issues develop over the next few years.
The report has been distributed to lawmakers across the country. Sikkema says there hasn’t been any response indicating that anyone wants to take up the cause, but ARPA will be undertaking a lobbying campaign in the New Year to get lawmakers to address the fact that there are “a lot of gaps” in current legislation on this issue.
You can find a full copy of the policy report online here.
Reproductive medicine has changed drastically in the past decades with the development of technology that allows for in vitro fertilization (IVF). IVF is the assisted fertilization of a human egg cell by a human sperm cell – thus creating a new human being – outside of the female body. Now more than ever there are more avenues to treat childlessness and to start a family. The medical assistance in the creation of human life involves serious questions of medical ethics, particularly in the way we treat life from its beginning. Canada’s law in this area has not kept up with scientific advances nor does it fully protect life and promote its sanctity.
ARPA Canada’s policy report on the In Vitro Embryo includes an explanation of what IVF is and the often-ignored (and usually avoidable) costs associated with assisted human reproduction, including the intentional destruction of human embryos. The report also addresses the industry around IVF such as gamete donation or commodification and discrimination against those with disabilities through pre-implantation genetic diagnostics.
Parliament is tasked with the responsibility of protecting the weak, respecting human dignity, and mending the moral fabric of our nation. In order to assist them in fulfilling their mandate, we have included eight recommendations that can be implemented into Canadian law that will enhance assisted human reproduction in a way that fully respects the in vitro embryo as an equal member of the human family. Check it out here, and consider engaging your Member of Parliament on this issue.
Refusing to perform a “fetal reduction procedure” (aborting one of two or more children in the womb) is not unlawful discrimination, according to an Ontario Human Rights Tribunal decision earlier this year.
The Tribunal decision summarizes the facts as follows:
In May 2015, the applicant was pregnant with twins following in vitro fertilization (IVF). The applicant decided that she did not want to have twins and wished to reduce the pregnancy to one fetus. Her obstetrical specialist advised her that this was a complex procedure that was not generally performed. On May 6, 2015, her treating specialist wrote to an obstetrician colleague at Mount Sinai Hospital to see if that hospital would be able to perform the procedure. The Mount Sinai physician advised that the respondent hospital would not be able to perform the procedure because the circumstances did not fit with the hospital’s policy regarding fetal reduction surgery. 1
In 2010 the Synod of the Netherlands Reformed Congregations in North America approved a report on In Vitro Fertilization, which was a 75-page, scientific and Biblical analysis of this so-called reproductive technology. The Reformed Pro-Lifer has asked one of the co-authors of this report to summarize the document. Read the summary article here.
In 2010 the Synod of the Netherlands Reformed Congregations in North America approved a report on In Vitro Fertilization, which was a 75-page, scientific and Biblical analysis of this so-called reproductive technology. The Reformed Pro-Lifer has asked one of the co-authors of this report to summarize the document. Read the summary article here.
ARPA Note: The EFC intervened in this case. Read their concerns and suggestions for follow-up here.
Brian Lilley, Toronto Sun Dec 22 2010 – OTTAWA: The Supreme Court has delivered a split advisory ruling in a case involving the regulation of in vitro fertilization, cloning and the creation of human-animal hybrids. While the ruling is technically only an advisory opinion, it has the effect of striking down several sections of the Assisted Human Reproduction Act. Read more
The Commission on Parenthood’s Future today released internationally the groundbreaking report My Daddy’s Name is Donor: A New Study of Young Adults Conceived Through Sperm Donation, co-investigated by Elizabeth Marquardt, Norval D. Glenn, and Karen Clark. The report reveals stunning findings about the lives of adult offspring of sperm donation, one of the most common reproductive technologies and one that has been practiced widely in the U.S. and around the world for decades. [Read more here.]