Is it permissible to have a test tube baby? What are the conditions of having a test tube baby? Are the methods of determining the gender of the baby permissible?

Details of the Question
Is it permissible to have a test tube baby? What are the conditions of having a test tube baby? Are the methods of determining the gender of the baby permissible?
The Answer

Dear Brother / Sister,

Author: Presidency of Religious Affairs 2009-06-19 

1. What is test tube baby?

In families without children, at least 7-9 egg cells taken from the candidate mother and the sperms of candidate father are fertilized in laboratory conditions and they are kept there for three days so that the embryo will develop. Two or three of the embryos are placed into the uterus. If this first trial causes a successful pregnancy, there is no need for the remaining embryos. They are frozen in order to be used for a future pregnancy, or to donate to other married couples without children or to develop stem cells, based on the choice of the married couple.

The phases of test tube baby (IVF) application are as follows:

1- Some hormones  are injected into the mother and the ovary is stimulated; thus, many eggs are obtained.

2- The eggs from the ovary of the mother are compared with the male sperm cells taken from the father and they are fertilized in the laboratory.

3- Many blastocysts are obtained.

4- A few blastocysts prepared in the laboratory are placed into the uterus.

5- If the woman gets pregnant, the other blastocysts are disposed of or used in researches or the treatment of some illnesses.  

6- If the mother or father cannot have a child, sperms and eggs are obtained from other women or men.  

7- If the uterus is not suitable, a surrogate mother is found.

So far, almost all Islamic scholars have stated that it is permissible for couples that cannot have a baby through normal ways to fertilize the sperm of the husband and the egg of the wife in the outer environment and then to place it in the uterus or to send the sperm of the husband to the uterus of the wife though microinjection; however, they have also stated that test tube baby is not permissible  if some other ways are used by obtaining the sperm or the egg from another person or by using the uterus of another woman because it is a necessity in terms of the general principles of Islam that the sperm, the egg and the uterus belong to the married couple for a legitimate child.

However, the fact that more than one blastocyst is produced in the test tube baby method, and that some of them are placed into the uterus and others are destroyed or used in researches and the treatment of some diseases makes the test tube baby issue debatable again in terms of religion. It is because there are some scientists that regard zygote that forms after the insemination of the egg by the sperm as a human being. Accordingly, the human being should be shown respect from the first moment; his legal rights should be recognized and they should not be violated. 

In order to eliminate this objection, if possible, no eggs more than necessary should be fertilized and they should be preserved through scientific-technological means; only the eggs that are necessary should be fertilized. Otherwise, it will be objectionable to eliminate the fertilized eggs in terms of the religion. 

The Catholic Church does not accept the elimination of the stem cells obtained as a result of test tube applications. 

2. Freezing and Donating Eggs/Sperms

First, the application of freezing the sperm successfully and then thawing it was carried out; after that the embryo was frozen.  As a matter of fact the first pregnancy from the frozen and thawed human egg was realized in 1986 by Chen. After this first success, studies to develop the egg freezing technology in many centers in the world were carried out. Since the egg is a big and complex structure, it is very sensitive toward low temperatures. In the first studies, the eggs that were not mature were advised to be frozen; however, the studies carried out today show that mature eggs are more durable.  The eggs are freed from the cells around them during the process of collecting eggs and the mature eggs that are normal are frozen. It is very important to decide the rate that the temperature is decreased and what preservative substance to be used during the process of freezing. After the process of freezing the eggs, frozen eggs are put into liquid nitrogen (-196°C). The egg can stay in liquid nitrogen for a long time without being spoiled genetically. No malformation or disability is observed in the babies born after freezing and thawing eggs. In the first thawing processes, the rate of living eggs was 60% but today the rate has reached 80-90%.  Besides, the rate of fertilization after thawing was low at first, but after the microinjection method, the rate increased. Since those processes are carried out frequently today, the term bank is used regarding the issue. Therefore, along with banks of sperms and eggs, banks of embryos are often mentioned.

If the eggs of a woman are frozen and then given to that woman again in the future, it is religiously permissible.  However, it is not permissible to transfer those eggs to another woman because the egg has some personal characteristics/genetic code of the mother thanks to its chromosomes. When the egg cell is transferred to another woman, all of her characteristics together with the right of inheritance are transferred. Thus, this transfer will bring about religious, legal, social, psychological and similar problems that may arise in the future. Therefore, it is not permissible to use the fertilized eggs in another woman.  

As for the sperm, it is permissible in obligatory situations to give the sperm that is preserved in the bank to the wife of the man in order to impregnate his wife through test tube method in the future again.  However, if the sperms that are collected in the bank are given to other women who demand them, it is not permissible because it will bring about confusion in determining the father of the baby, which is one of the reasons why fornication is forbidden in Islam. Therefore, both the person who donates his sperms and the one that demands them are responsible. What they do is a sin because they are not married. 

In short, it is both haram and a social disaster to donate sperms to a sperm bank – except for one’s wife because one of the five common targets of the divine religions is the protection of the generation. It is one of the most important reasons why fornication is forbidden. This application is not permissible because it may degenerate generations, cause the birth of children whose parents are not known, cause the spread of some diseases strategically through sperms, cause many social problems, etc. However, if the sperms of a man are frozen due to some medical reasons and are given to his wife later, it is permissible.

3. Are stem sells and using them in treatment possible?

Stem cells are the cornerstones of life and the main cells that form the human body. Stem cells have the possibility ability to divide endlessly, to transform into all kinds of body cells and to undertake new duties. Stem cell research is the most important and the most controversial issue today. Apart from its superior potential in renewing tissues and organs, expectations about the treatment of many diseases and disorders caused by the destruction and/or elimination of tissues through stem cells in the world of medicine are great.

One of the sources of stem cells is the tissues obtained from the bone marrow of adults. However, researches put forward that the ability of such stem cells found in the differentiated tissues of the adults are quite limited. The sources that can be used for embryonic stem cells, which can meet the expectations fully, are controversial as it is stated above. They can be the embryos that are left after test tube applications or the tissues obtained from the fetus after the termination of pregnancy. Some people regard it as intervention in human life to obtain stem cells from human embryos; besides, the possibility that the researches carried out regarding stem cells can pave the way for cloning humans cause ethical, legal and lawful discussions in the world public about when human life started. These discussions have started to limit and even to prevent stem cell researches in the Western countries; consequently researches in this field have started to move to developing countries like South Korea.  

The point reached today in stem cell researches really gives hope for the future. If stem cell researches develop in the desired way, some diseases will be able to cured in the cellular level and a new source for the transplant of cells and organs can be provided. It is expected that basic scientific researches to be carried out on stem cells will bring about new approaches for many diseases that cannot be cured clinically. Thus, the diseases that appear due to the loss of cells that have no ability to renew or repair themselves will be cured. Among those diseases are Parkinson disease, Alzheimer disease, multiple sclerosis, paralysis that occur as a result of accidents, other diseases regarding the breakdown of nerve cells, cardiac failure that form as a result of a heart attack, osteoarthritis, or cartilage and bone losses that occur due to various reasons, cancer, diseases related to immune system and diabetes.  

Stem cells are cells that divide and renew themselves, that can be differentiated to form specialized cells like blood, liver and muscle. Those cells are studied under two headings: totipotent (that have the ability do differentiate in every aspect) and pluripotent (that have the ability to differentiate in a multi-pronged way. The totipotent stem cells that are present in embryo in the early period are called embryonic stem cells, which are developed in vitro; however, they are obtained from redundant embryos or from pregnancies that are terminated willingly.  They are totipotent like the embryonic stem cells obtained from adults or adult stem cells that can be reproduced through certain methods. They are stem cells that exist in bone marrow, umbilical cord blood and blood, that can be reproduced in the adult through special methods and by the help of certain growth factors and that can be transformed into blood cells as a result of the development. From embryonic stem cells, any of the 200 different types differentiated cells that form the human body can develop but from adult stem cells, only one or very limited number of types can develop. 

In many countries, primarily in the USA, England and Australia, the experimental researches regarding embryonic stem cells were completed; experiments on animals have been carried out for a long time.  There are some electronic data regarding applications on human beings but there are not any successful applications confirmed by scientific authorities yet. While the stem cells are produced in vitro, they can sometimes undergo some unwanted genetic mutations that can harm the organism. In addition, stem cell researches seem to be far away from giving products that can be used in treatments.

As for the religious evaluation of the issue of stem cells, we learn new things about stem cells every day. As we learn, the things that were known about the issue in the past become controversial; so its religious dimension assumes special importance. When the situation that exists is taken into consideration, many issues including test tube baby need to be evaluated again. 

The Christian world does not have a unanimous view regarding stem cells but they have similar opinions. 

According to Catholics, human embryo is valuable and the zygote must be treated like a human. They cannot be disposed of, preserved or used in researches. They do not support the application of test tube, which is a technology of in vitro fertilization, due to the same reasons. However, the Church gives full support to the use of adult stem cells. 

According to the Evangelist and Catholic Bishops Churches, the use of embryonic stem cells is definitely forbidden in Germany in order to protect the baby that is developing. However, the decision of the German parliament to permit the import of stem cells produced by killing human embryos depending on certain conditions shocked the Evangelist and Catholic Bishops Churches; they have stated that the fetus is regarded a human being beginning from the moment it is fertilized and that human life needs to be preserved.    

According to Jews, there is a potential that supports life in the embryonic stem cell; therefore, the researches need the support of the state; on the other hand it is understood that it poses a threat to the life of American people or the future generations. Therefore, it is necessary to support stem cell researches as long as they are checked strictly. According to Jewish scholars, the stem cell in vitro is not regarded a complete human being; hence, it does not have to be protected. To sum up, embryonic stem cell researches need to be continued if they preserve human life for more success and if they do not threaten life.

The Protestant Church does not think differently from the other churches regarding the human embryo; it has declared that it supports the continuation of the researches on stem cells.

The religion of Islam encourages all kinds of researches that can be beneficial to man and the community. However, Islam does not approve of them being taken to a point where they pose problems to legal, ethical and spiritual values. It demands necessary precautions to be taken regarding the issue. In fact, science and law authorities hold the view that technology needs to be used for the benefit of humanity. Therefore, Islam does not find it objectionable to make researches on genes in terms of biology and medicine unless they are harmful to man, the environment, ecological balance and community. On the contrary, Islam appreciates and encourages those kinds of researches and similar ones that aim to serve humanity. What matters is to use the scientific results for the benefit of humanity. 

As it is stated above, the fetus is regarded to have the right of inheritance if it is born alive according to the Islamic law. This issue was also declared by the science of human embryology in 1883 and the same view is accepted today. Therefore, man should be shown respect as an individual; his legal rights need to be recognized and they must not be violated.  

Therefore, if the researches about the specialized adult cells taken from the body organs reveal the result that they can function like the embryonic stem cells and if they can be used in the treatment, the stem cells that have the potential to be human beings will not be used like spare parts. Then, the world of medicine needs to concentrate on the use of specialized adult stem cells that have no ability to become an independent living being in treatment. It will be no different from the organ transplant in terms of religion and ethics. 

However, if stem cells that have the properties of  embryonic stem cells cannot be obtained from specialized adult cells and if there is no other way of treatment, the blastocysts remaining from test tube baby applications can be used in treatment as long as measures to prevent all kinds of commercial and vicious  use are taken.

4. Determination of Gender:

The egg that is fertilized by a spermatozoid with a “Y” chromosome that determines the male gender yields a male baby;  the egg that is fertilized by a spermatozoid with a “X” chromosome that determines the female gender yields a female baby. That is, the gender of the baby becomes certain during fertilization; the gender depends on the gender chromosome carried by the spermatozoid that enters the egg. It is possible to determine the gender of the baby by the science of medicine.

However, determining the gender of the baby to be born may cause some other demographic and ecological  problems that cannot be predicted today and it may disturb the balance of the distribution of the genders that exists now; therefore, it is not appropriate to determine the gender unless there is something obligatory. As a matter of fact, in Asian and Eastern countries, families generally want male children. The situation is not different in our society. It shows that the balance in the world can be upset in favor of male children. It is contrary to the Sunnah of Allah. The following is stated in the Quran: “To Allah belongs the dominion of the heavens and the earth. He creates what He wills (and plans). He bestows (children) male or female according to His Will (and Plan). Or He bestows both males and females, and He leaves barren whom He will: for He is Full of knowledge and power.” (ash-Shura 42/49-50)

In many international papers, for instance, in the report of the Bioethics Commission of the European Council and in the resulting program of action of the International Conference on Population and Development held in Cairo with the participation of 238 countries, the issue was dealt with; the application of determining the gender of the baby except for medical reasons was not approved and it was stated that measures had to be taken against it.   

Therefore, it is not religiously appropriate to determine the gender of the baby unless there is a medical obligation.

5. What is Preimplantation Genetic Diagnosis?

Thanks to Preimplantation Genetic Diagnosis, the chance of pregnancy is increased and the possibility of miscarriage is decreased in couples that have experienced test tube treatment but have not had any children. Thanks to this application, some of the genetic diseases that can arise in the baby are detected before embryos are placed into the uterus and can be treated; thus, the birth of disabled children are prevented.

6. Abortion:

Although there are some scholars who hold the view that pregnancy can be terminated before the fetus is forty days old, most of the Islamic scholars do not approve of the termination of the fetus even if the it is not forty days old through drugs or other methods or abortion. It should not be forgotten that terminating the pregnancy due to any reason except saving the life of the mother is haram and it is regarded like a murder after the fetus is forty days old.

In conclusion, it can be said that it is permissible and possible to control birth when it is not wanted by using contraception methods. However, it is not permissible to terminate the life of a living thing through miscarriage or abortion after pregnancy unless there exists a legitimate and justifiable reason like risking the life of the mother. 

It is permissible for those who do not have babies to have a child through test tube method, but it is not permissible to take one of the embryos so that the child/children to be born will be healthier. In order to attain a fast result, more than one embryo is transferred so that another attempt will be successful if one is not. It is more appropriate to transfer one embryo or at most two embryos and then to try again. Thus, the removal of the embryos in the uterus will be prevented even though this method will take longer.     

7. What are the rights of the embryo and the baby in the uterus?

In the Islamic law, the fetus is regarded to have the right of inheritance if it is born alive. In the Turkish civil code, the beginning of the personality is the moment the bay is born alive and fully. The baby makes use of the civil rights beginning from the moment it goes into the uterus as long as it is born alive.

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