IMPERMISSIBLE
CASES OF ARTIFICIAL
INSEMINATION
BY
HUSBAND (AIH)
Explanation
of Terms and Procedures
Artificial
insemination by husband (AIH),
also called homologous artificial insemination,
is “the technique used to obtain a human conception through the transfer into the
genital tracts of a married woman
of the sperm previously collected from her
husband. (l)
Policy
Methods and uses of artificial
insemination by husband (AIH) which replace the act of sexual intercourse
between spouses are not permissible.
Sources
of Policy
This
principle is presented in the Instruction
on Respect for Human Life in Its Origin and on the Dignity of Procreation (Donum
Vitae) from the Vatican
Congregation for the Doctrine of
the Faith (1987):
Homologous artificial insemination within marriage cannot be
admitted except for those cases in which the technical means
is not a substitute for the conjugal act but serves to facilitate and to
help so that the act attains its natural purpose. (2)
Artificial insemination as a substitute for the conjugal act is
prohibited by reason of the voluntarily achieved dissociation of the two meanings of the conjugal act. (3)
See also the entry General Policy
on Assisted Reproductive Technologies (ART), principles 3 and 4.
____________________
1.
Congregation for the Doctrine of the Faith, Instruction
on Respect for Human Life in Its Origin and on the Dignity of Procreation
(Washington, DC: United States
Catholic Conference, 1987), II, p. 22.
2. Ibid.,
II.B.6, p. 31.
3.
Ibid., II.B.6, p. 32.
COMMENTARY
IMPERMISSIBLE CASES OF ARTIFICIAL INSEMINATION
BY HUSBAND (AIH)
The
Procedure of AIH and Its Uses
The
procedure of artificial insemination by husband consists in placing the
husband’s sperm (either the entire seminal ejaculate or that which has undergone
special preparation in the laboratory) within the wife’s vagina, cervix, or
uterine cavity. (1) The accumulated
rate of pregnancy after three cycles of intrauterine inseminations is usually
greater than the natural expectancy of pregnancy which couples have during the
same period of time. (2)
Artificial
insemination by husband may be considered medically when the husband is
incapable of vaginal ejaculation because of psychogenic or organic impotence;
when the semen shows deficiencies in the number of spermatozoa, in its mobility,
or in its morphology; when there is an unfavorable cervical factor which cannot
be overcome by medical treatment; and in the case of cryopreservation (freezing)
of sperm before cancer treatment or vasectomy. (3)
Through
the freezing and storage of a husband’s sperm,
it is now possible for a woman to become pregnant when her husband is
geographically removed from her, or even after her husband’s death.
Moral
Differentiation of Types of AIH
The Vatican Instruction on Respect for
Human Life in Its Origin and on the Dignity of Procreation
does not contain a blanket condemnation of the procedure of artificial
insemination by husband. Rather, it
distinguishes two types of artificial insemination
by husband: AIH which facilitates the
conjugal act or helps that act to
attain its natural purpose, and AIH which replaces the conjugal act. (4)
Methods of AIH which facilitate the act of sexual intercourse between
spouses or assist it to achieve the
objective of conception are considered morally permissible. (5) On the other
hand, methods of AIH which replace the act of sexual intercourse between spouses
are not morally permissible. (6)
In judging forms of AIH which replace the
conjugal act to be morally impermissible, the Vatican Instruction relies on
the principle that unitive and procreative functions of the act of sexual
intercourse ought not to be separated:
…This
teaching is not just an expression of particular
historical circumstances but is based on the Church’s doctrine concerning
the connection between the conjugal union and
procreation and on a consideration of the personal nature of
the conjugal act and of human procreation. “In its natural
structure, the conjugal act is a personal action, a simultaneous
and immediate cooperation on the part of the husband and wife,
which by the very nature of the agents and the proper nature
of the act is the expression of the mutual gift which, according to the
words of Scripture, brings about union ‘in one flesh’.” Thus moral
conscience “does not necessarily prescribe the use
of certain artificial means destined solely either to the
facilitating
of the natural act or to ensuring that the natural act normally performed
achieves its proper end.” If the technical
means facilitates the conjugal act or helps it to reach its
natural objectives, it can be morally acceptable. If, on the
other hand, the procedure were to replace the conjugal act,
it is morally illicit.
Artificial insemination as a substitute for the conjugal act is
prohibited by reason of the voluntarily achieved dissociation of the two
meanings of the conjugal act. Masturbation, through which the sperm is normally
obtained, is another sign of this
dissociation; even when it is done for the purpose of procreation, the act
remains deprived of its unitive
meaning: “It lacks the sexual relationship called for by the moral order,
namely the relationship which realizes ‘the
full sense of mutual self-giving and human procreation
in the context of true love’.” (7)
For further discussion of the inseparability of the unitive and
procreative aspects of the act of sexual intercourse, see the entry General
Policy on Assisted Reproductive Technologies (ART).
Applications
Methods of artificial insemination by husband which facilitate the act of
sexual intercourse or help it to reach its objective of conceiving a child are
considered morally permissible. Thus theological opinion has allowed procedures
involving the temporary exteriorization, processing, and reinsertion of sperm
after an act of sexual intercourse in order to enhance the chances of conception
taking place. For example, theologians have allowed semen to be removed
from the vagina and centrifuged to bring about a greater concentration of
spermatozoa, and then reinjected into the vagina. (8) In another procedure
considered permissible, semen is removed from the vagina and washed to eliminate
sperm-agglutinating and sperm-immobilizing antibodies, and then reinjected into
the cervical canal. (9) See the
entry Theological Opinion on Permissible
Assisted Reproductive Technologies.
On the other hand, methods of artificial insemination which replace the
act of sexual intercourse between spouses are not
morally permissible. As noted in
the Instruction, one way in which this
can occur is by the method used to
obtain the sperm for insemination, for example, when the sperm is obtained
through masturbation. (10) Or
again, through the freezing and storage of a husband’s sperm it is now possible
for a woman to become pregnant when her husband is geographically removed from
her or even after his death. The
very absence of the husband indicates that this is a use of artificial
insemination which replaces the act of sexual intercourse between spouses. (11)
The practice of freezing sperm “prior to initiating cancer therapies
likely to destroy future sperm production has been utilitzed for some
years.” (12) The sperm
may subsequently be used for intrauterine insemination (one form of artificial
insemination), conventional in vitro fertilization, or in vitro fertilization
with intracytoplasmic sperm injection (ICSI). (13)
Most likely, the artificial insemination of a wife with her husband’s
preserved sperm will take place in a clinical setting, apart from interpersonal
acts of sexual intercourse. On a
common sense level, this clinical procedure is intended to substitute for the
conception of a child through acts of sexual intercourse since the cancer
treatments have adversely affected the husband’s fertility.
1. International Federation of Fertility Societies, “International
Consensus on Assisted Procreation,” Artificial Insemination, http://www.mnet.fr/iffs/a_artbis.htm.
2. Ibid.
3. Ibid.
4. Congregation for the
Doctrine of
the Faith, Instruction
on Respect for Human Life
in Its Origin and on the
Dignity of Procreation (Washington,
DC: United States Catholic Conference, 1987), II.B.6, pp. 31-32.
For the relevant texts, see
Policy Statement, “Sources of Policy” and note 7 below. Following this moral distinction, sometimes a terminological
distinction has also been made. Methods
of AIH which facilitate the conjugal act have been referred to as assisted
insemination while the terminology artificial
insemination (or totally artificial
insemination) has been reserved for forms of AIH which replace the conjugal
act. See, for example, Orville N.
Griese, Catholic Identity in Health Care:
Principles and Practice (Braintree, MA: Pope John Center, 1987), pp. 41-2,
481; Donald T. De Marco, “Catholic Moral Teaching and TOT/GIFT” in
Donald G. McCarthy (ed.), Reproductive
Technologies, Marriage and the Church (Braintree, MA: Pope John Center,
1988), pp. 123-4.
5. Congregation for the Doctrine of the Faith, Instruction
on Respect for Human Life in Its Origin and On the Dignity of Procreation; for
the relevant texts, see Policy Statement, “Sources of Policy” and note
7 below.
6. Ibid.
7.
Congregation for the Doctrine of the Faith, Instruction
on Respect for Human Life in its Origin and On the Dignity of Procreation
II.B.6, pp. 31-2.
8.
Griese, Catholic Identity in Health Care: Principles and Practice, p. 45;
John W. Carlson, “Interventions Upon Gametes in Assisting the Conjugal Act
toward Fertilization” in Kevin William Wildes, S.J. (ed.), Infertility:
A Crossroad of Faith, Medicine, and Technology (Boston: Kluwer, 1997), p.
112.
9.
Griese, Catholic Identity in Health Care, p. 49, n. 86; Carlson,
“Interventions Upon Gametes in Assisting the Conjugal Act toward
Fertilization,” p. 112.
10.
See note 7 above. Methods of
obtaining sperm other than sexual intercourse or masturbation have been
developed. In the procedure of microsurgical
epididymal sperm aspiration (MESA), the epididymis is exposed through an
incision in the scrotum, and then an operating microscope is used to dissect
individual epididymal tubules. Specially
prepared micropipettes are then used to aspirate sperm from these tubules. Sperm
can also be obtained through testicular biopsy. MESA or testicular biopsy are
sometimes employed to obtain sperm for use in the procedure of in vitro
fertilization with intracytoplasmic sperm injection (ICSI). (University of Iowa
Hospitals and Clinics, Advanced Reproductive Care, “Microsurgical
Epididymal Sperm Aspiration,” http://www.uihc.uiowa.edu/pubinfo/ arc.htm)
However, should sperm be obtained from a husband by such methods for
placement into his wife, we would again have a case in which AIH replaces the
conjugal act.
11. This
point would
hold true even if the
sperm were
originally obtained in a morally licit
way, e.g., collected in a perforated condom during an act of sexual
intercouse.
The Instruction on Respect for
Human Life in its Origin and On the Dignity of Procreation explicitly states
that “the artificial fertilization of a woman who is…a widow, whoever the
donor may be, cannot be morally justified.” (II.A.2., p. 25).
As noted in the document this case also violates the principle that human
procreation must always take place within marriage.
12. Michael
S. Opsahl,
Edward F.
Fugger, Richard
J. Sherins, and
Joseph D. Schulman, “Preservation of Reproductive Function Before
Therapy for Cancer: New
Options Involving
Sperm and Ovary Cryopreservation,” The
Cancer Journal from Scientific American (1997) available at http://www.givf.com.
13. Ibid.