You are a young woman who is pregnant finally after years of trying. The pregnancy is a result of assisted conception and you are carrying multiple embryos.[1] The doctors tell you that it is possible that all the embryos will die unless you agree to a 'selective reduction' in their number. Is this abortion? What determines which embryo should be saved? Do you have an obligation to try and save at least one life even at the expense of the others? Should you not have considered these possibilities prior to agreeing to the fertility treatment?

This sort of dilemma is becoming increasingly common in today's obstetric practice although unfortunately many do not even see that it raises some difficult moral questions, preferring simply to close their eyes to the means which achieves the end.

In some ways I would not be surprised if you agreed, at least in part, with the proponents of the 'look the other way and pretend it's not happening' brigade. I certainly find it frustrating to realise that just when I thought I had sorted out what I believe on a particular issue, modern technology raises yet another dilemma for me to consider. Yet that is not an excuse to ignore the events of the world, merely an acceptance of our limitations as humans. We should still manage at least to have considered for ourselves the basic biblical principles which apply in such areas for it is only then that we can manage to argue our case effectively with those who disagree. As yet no-one has persuaded me as to how selective reduction should be considered differently, from a Scriptural viewpoint, than the termination of a single fetus.

I hope that I have made it clear that, whilst it is impractical to expect us to have thought through every possible implication of the current advances in fertility treatment it would be negligent of us not to at least consider the underlying biblical principles. After all as infertility affects one in ten couples in England it is likely to affect some of us personally as well as professionally.

Also underpinning the whole dilemma is the area of abortion and the status of the embryo which is certainty something which we should all have considered, particularly in view of the growing tendency to see termination as simply an alternative form of contraception.

In considering such issues we must remember firstly that God is sovereign. It is he who has the right both to give and take away life. Children are a sacred gift from God, a fact that was clearly appreciated by the women of biblical times such as Elizabeth:

'The Lord has done this for me, she said. 'In these days he has shown his favour and taken away my disgrace among the people.' Luke 1:25 (NIV)

In accepting God's sovereignty however, we should not exempt ourselves from responsibility. God made man in his own image to act as stewards over his creation (Genesis 1:27-30). Everything that we have is a God given gift and, as such, should be used only in accordance with his standards of right and wrong. These are clearly revealed to us in God's Word and faithful, prayerful study of the Scriptures will enable us to follow the ways of the Lord. Clearly such considerations may lead us to unwelcome conclusions that what we are doing falls short of that which God expects from us but that is true of the whole of our Christian pilgrimage. We should commit such dilemmas to the Lord (Philippians 4:6) and he will help us to reconcile our actions with our beliefs.

Many people claim that part of the current crisis in infertility results from our own sins, such as the increasing number of abortions (the ratio of terminations: live births is currently 1:1 in West Lambeth) and sexually transmitted diseases which result from the present trend against monogamous heterosexual relationships. Whilst that may be true in some instances there are certainly some couples whose predicament is clearly no fault of their own. Also, fortunately for us, God does not repay us as we deserve (Psalm 103:10) and we should seek to follow his example of being gracious and forgiving rather than trying to apportion blame. If we decide to judge others for their sins then we have no-one but ourselves to blame when we are so judged, for all of us fall short of the glory of God(Romans 3:23).

There are many other arguments which can be applied to the question of infertility treatment and I do not propose to cover them all here. I hope merely to have encouraged you to think about this issue for yourselves, even if it is one which does not immediately seem relevant or important. As the Human Fertilisation and Embryology Authority (HFEA) invite public consultation on the use of donated ovarian tissue, it is at least an issue which should be in our prayers. Needless to say fertility is an emotive issue; in a recent ad-hoc survey at Guys' 8 out of 10 people who would terminate a pregnancy with Down's Syndrome said that they would abort a female fetus without a uterus, even if that was the only abnormality. Fortunately prenatal diagnosis has not reached that stage, as yet.