In vitro fertilization has helped millions of couples start families. For many, it offers a sense of hope after months—or even years—of heartbreak and unanswered prayers. It’s become so common, so medically normalized, that few stop to ask how it actually works or what it really costs—not financially, but ethically, spiritually and biologically.
In 2023 alone, more than 97,000 babies were born in the U.S. through IVF, according to the Centers for Disease Control and Prevention. That’s roughly 1 in every 40 births. And with that number rising each year, the question is no longer whether Christians should be aware of IVF. The question is whether we’re prepared to think biblically about it.
“Every single child is a gift from God,” said Emma Waters, a researcher and writer who specializes in bioethics and reproductive technology. “And so if they have had a child through surrogacy or through IVF, then praise God, because that is a blessing, right?”
Waters’ words are a crucial reminder that this conversation isn’t about judgment or shame. It’s about wrestling with the deeper ethical and spiritual questions Christians should consider as reproductive technologies become increasingly normalized—and increasingly complex.
“There’s a misconception that IVF creates a life, therefore it’s an unmitigated good,” she said. “We can’t simply say life created no problems here because of all of the embryos that are destroyed or tested or otherwise poorly treated in the process.”
That tension—between the longing to become a parent and the sacredness of how life begins—sits at the heart of the ethical questions surrounding IVF.
In a typical IVF cycle, a woman is given hormone injections to stimulate her ovaries to produce more eggs than usual. In a natural cycle, she would produce just one egg. But with IVF, doctors try to retrieve as many eggs as possible—usually between eight and 15, though some women produce 25 or more. These eggs are then fertilized in a lab using sperm from the intended father or a donor. The hope is that most will develop into embryos.
That hope, however, is rarely matched by the outcome.
“There aren’t any definite studies because we don’t track these numbers in the United States,” Waters said, “but it’s estimated across the board that on average, the success rate for embryos involved in IVF is anywhere from 3% to 15%, which means that about 85% or more of embryos are destroyed in the process.”
For Christians who believe life begins at fertilization, the math is difficult to reconcile. Each embryo is not just a possibility—it’s a person. A soul. A life formed in God’s image. And yet, many embryos are discarded, indefinitely frozen, used for research or lost in the process of implantation.
“If you’re like me and a number of Protestant denominations, if you believe that life begins at that moment of fertilization, then what happens in IVF matters just as much as what happens once that pregnancy has taken root in a woman’s body,” she said.
Even for couples who go into the process with strong convictions, the reality of IVF can quickly become more complicated than expected. Many start with good intentions—planning to use every embryo they create—but find themselves with more embryos than they anticipated. Others experience medical complications, miscarriages or unexpected changes in their family circumstances. Some end up with frozen embryos they don’t feel comfortable discarding, but aren’t prepared to implant.
“The two ways this tends to come up is one, couples who did destroy embryos through IVF, either through pre-implantation genetic testing or a recommendation from their doctor,” Waters said. “And then the second one are couples who have embryos left over that they haven’t used.”
Waters is careful to approach both situations with compassion. For those grieving choices they didn’t fully understand at the time, she encourages them to turn to the hope of repentance and restoration.
“That’s where we have the beauty and the power of confession and repentance with other Christians, with your pastor, to confess to the Lord… and then continue to work going forward to help other couples who are struggling with infertility navigate it well,” she said.
But the question of leftover embryos is particularly difficult.
“As parents, you have a moral responsibility for your children—including the embryonic children that you’ve created and not had a chance to meet yet,” she said.
In some cases, couples consider embryo adoption, but the reality is that an estimated 1 million embryos are currently frozen in the U.S., and very few are ever adopted or implanted.
It’s why Waters encourages Christian couples to think beyond the immediate promise of IVF and instead ask a deeper question: Why is infertility on the rise, and what can we do to address it at the root?
“In IVF and surrogacy, you’re actually bypassing the man or woman’s body and not addressing the underlying conditions,” she said. “So IVF will frequently result in the creation of an embryo, but it does nothing to improve the health of the man or the woman.”
That oversight has real consequences. Couples often assume IVF will solve their fertility issues, only to go through the costly, physically demanding process and experience repeated miscarriages—because the health problems that caused the infertility were never diagnosed or treated.
Waters is a strong advocate for restorative reproductive medicine, a growing field focused on diagnosing and treating the underlying conditions that impair fertility. Conditions like PCOS, endometriosis, hormonal imbalance and low sperm motility are common and treatable—but often ignored in mainstream fertility clinics.
“When you’re looking at infertility, researchers have said that there are about four or more conditions at play in every diagnosis,” she said. “And yet in about 15% to 30% of all diagnoses, people get diagnosed with unexplained infertility… which is just a shorthand way of saying they have no idea what’s going on, which suggests to me there wasn’t due diligence on the front end.”
Instead of jumping straight to lab-based reproduction, Waters believes Christians deserve more complete care.
“It’s not just about having a child,” she said. “It’s also about how do we actually empower men and women with the best medical care that they deserve in order to understand not just their fertility, [but] their overall health.”
The church, too, is beginning to grapple with these questions in a deeper way. Just a few years ago, most denominations had little formal guidance on IVF. But that’s beginning to shift.
“When I first started working on these issues about three years ago, there were very few resources available within Christian denominations that were addressing infertility or IVF or reproductive technology broadly,” Waters said. “And in the last couple of years, we’ve really seen a movement to thinking biblically about reproductive technology.”
The Southern Baptist Convention recently passed a resolution affirming a specific form of life-honoring IVF while condemning broader practices like embryo destruction. The Anglican Church in North America is developing a full-scale bioethics center. The Lutheran Church–Missouri Synod has issued robust guidance, and other denominations are slowly catching up.
“Every generation of the church has a major theological question they’re trying to answer,” Waters said. “At one point it was, who is Jesus? At another point, what is the church and what is salvation? But in this day and age and in this generation, the question for us is, can we preach the good news of biblical anthropology—the good news of what it means to be men and women created in the image of God?”
