Thinking Biblically About Infertility

1. Outline of the Problem

Many married couples have a strong desire for children but struggle with infertility. They often turn to artificial reproductive methods, like in vitro fertilization (IVF), if unable to conceive naturally. This technology has made it possible for many couples to achieve their dream of conceiving a child of one’s own progeny. In 2023, approximately 95,000 babies were born using IVF, representing roughly two percent of total births nationally. Public opinion is likewise favorable toward ARTs: seven in ten Americans supporting use of IVF to achieve pregnancy.

The second Trump administration has made coverage of IVF a policy priority. On October 16, 2025, President Trump announced an executive order that permits employers to offer standalone benefit packages to employees to cover IVF and other fertility treatments. The order also includes an agreement with a drug manufacturer to lower the cost of fertility medications.¹ Fertility medications are also one of the drugs available at a discounted price through Trump Rx. 

Christian denominations currently vary significantly in how they think about IVF; there is no one, single ethical framework. However, denominations can and should develop an ethical framework for their congregants to assess ARTs. While many Christians are beginning to reckon with the ethical implications of IVF and are abstaining from its use, many nevertheless view it as a miracle technology that has enabled many couples to conceive children who were otherwise unable to do so naturally.

Guidance on whether or not couples should use IVF for themselves is something denominations are clearly more equipped to provide than the federal government. But, since IVF is considered a medical procedure coverable by health insurance, and since the federal government regulates and operates health insurance plans, the federal government does have a role to play. This paper will therefore examine current federal approaches to IFV coverage and how Christians should think about policy related to IVF, and infertility broadly, through the frameworks of creation, fall, redemption, and consummation.

2. Worldview

VF presents certain challenges for Christian moral reasoning because its end, the creation of new life, is lauded and mandated throughout Scripture. Genesis 1:28 directs Adam to “be fruitful and increase in number, fill the earth and subdue it.” New life is also sanctioned and directed by God. Over and over again, God shows his glory and satisfies the desires of hurting couples by providing them a child. The birth of Isaac is an example (Gen.21). God delights to help families in this way and everywhere affirms the desire for children.

Yet, throughout the whole story of Scripture, God judges his people when they attempt to circumvent him in the pursuit of gifts, even good gifts. God promises Abram that his descendents will be as numerous as the stars in the sky, despite Abram and his wife Sarah’s advanced years. Abram and Sarah rejoice in this promise, and Abram’s faith in God is “credited to him as righteousness” (Genesis 15:6). In the next chapter, though, Sarah attempts to take matters into her own hand. She complains that “the Lord has kept me from having children” and suggests her husband “go, sleep with my slave; perhaps I can build a family through her” (Genesis 16: 1-2). God’s mercy is on display as Ishmael is, ultimately, blessed despite Abraham and Sarah’s lack of faith, but God also does not bless Abraham’s actions. The story of Abraham, Hagar, and Ishmael helps to illustrate how procreation outside God’s plan of procreation within marriage leads God’s people away from full dependence on him. It also shows the depths to which sin has permeated even something as God-ordained as the creation of new life, and how the Fall affected procreation.

The ability to bear children is uniquely given to women. Like all aspects of the created order, this ability was altered by the Fall. As Emma Waters argues, 

when sin entered the world, Eve and future women bore the punishment for sin in the pain of childbirth. Yet this “pain in childbirth” refers not only to the physical pain of labor. It includes the uncertainty, fear, and death that will unnaturally go with each aspect of childbearing, from the desire to have children (or its rejection), to conception, pregnancy, labor, and even the care for one’s children outside the womb.”² 

Waters goes on to say that, given the centrality of fertility to God’s command to bear fruit and multiply, “to experience infertility is not a sin in and of itself, but it is the consequence of sin entering the world.” 

Because, therefore, infertility is a product of the Fall, policy solutions by themselves will never entirely reverse this problem. We must await the coming Redemption, in which God will make all sad things untrue and gloriously unite His people to Himself. We are faced in the interim with many partial, less-than-perfect solutions. The most discussed and utilized solution to infertility is IVF. 

A range of viewpoints toward artificial reproductive technologies are represented in the American church today. More theologically liberal denominations, like the Episcopal church, emphasize the role of personal judgment in making moral decisions whether to use IVF, and certainly view the use of IVF as permissible. The Lutheran Church Missouri Synod (LCMS), by contrast, has developed the most comprehensive guidance on reproductive technology. They reject the use of IVF for Christians because it separates the act of procreation from marriage. Emma Waters again suggests that “by distinguishing between procreation and reproduction, the [LCMS] papers emphasize the temptation of reproductive technology to present children as a project, or an act of the will, rather than as a gift that is received in marriage.”³

It is clear that much more theologically rigorous analysis is needed for pastors to effectively shepherd their flocks on this issue. While the desire to bring solutions for infertility is good, Christians should not just unthinkingly embrace artificial reproductive technology, given its troubling ethical implications. For most issues debated in the public square, proponents of both sides are arguing that their actions are good and will provide for human flourishing. The task Christians must face in the public square is to determine if the alleviation of infertility is Good if it is pursued by improper means.

There are other means besides IVF, though, of bringing redemption to infertile women. Restorative Reproductive Medicine, or RRM, is a field of medicine that attempts to treat the underlying issues in both men and women that may contribute to infertility. These methods seek to restore the natural body, not to circumvent it, and thus should be given serious consideration by infertile couples who are considering IVF. 

Since infertility is a consequence of the Fall, policy solutions should be ordered toward restoration and redemption. In his book, Creation Regained, Al Wolters writes that

salvation in Jesus Christ, conceived in the broad creational sense, means a restoration of culture and society in their present stage of development. That restoration will not necessarily oppose literacy or urbanization or the internal combustion engine, although these historical developments have led to their own distortions or evils. Instead, the coming of the kingdom of God demands that they be made answerable to their creational structure, and that they be subjected to the ordinances of the Creator.⁴ 

IVF must be used in a way that is answerable to our created structure and subjected to the ordinances of the Creator.

With that framework in mind, we will now examine how current federal approaches to IVF might fit into a biblical framework.

3. Different Approaches to Solving the Policy Problem

Policymakers from both the Republican and Democratic parties have introduced legislation in an attempt to make IVF more affordable. A single round of IVF, that may or may not lead to the birth of a child, typically costs between $5,000 and $30,000. The exact nature of the policy varies–some bills, such as H.R. 1427, would establish a refundable tax credit for couples who pursue IVF, while other bills, like the Right to IVF Act, require Medicare, Medicaid, and commercial insurers to cover fertility treatments. This approach is nominally rooted in the biblical idea of justice as fairness. By breaking down barriers and lowering the cost of IVF, more people would be able to have access to it. 

Another policy approach, as detailed by the Southern Baptist Convention’s Ethics and Religious Liberty Commission, would require the government to set up ethical guardrails for the use of IVF. The ERLC urges the federal government to clarify definitionally that every embryo is a child and to create rules to accredit, certify, and monitor IVF facilities.⁵ It also urges the government to ensure women and families are informed of the risks and alternatives to IVF; require facilities to meet standards ensuring frozen embryos are treated with care; limiting IVF procedures to only fertilize one egg; and encouraging providers to tell women that IVF is not a fertility solution and does not address underlying fertility concerns; and prevent the disposal of an embryo due to genetic testing results or sex selection, recognizing that both are forms of discrimination. The ERLC also does not believe federal tax dollars should be used for IVF and would support robust religious freedom guarantees.

Outside of policy narrowly tailored toward IVF, there are also policy options that seek to promote reproductive restorative medicine. Another bill proposed in the Senate to address this problem is the Reproductive Empowerment and Support through Optimal Restoration (RESTORE) Act. Introduced by Senator Cindy Hyde-Smith (R-MS) and cosponsored by three other Republicans, this bill addresses reproductive health conditions that often contribute to infertility and painful medical cycles, including endometriosis, polycystic ovary syndrome (PCOS), uterine fibroids, blocked fallopian tubes, and thyroid conditions. Among its provisions, the bill would direct HHS to develop educational tools for women seeking information about reproductive health conditions and RRM, provide training opportunities for medical professionals to learn how to diagnose and treat reproductive health conditions, and direct HHS to collect data on the access women and men have to restorative reproductive medicine and infertility care through proper testing, diagnosis, and treatment of reproductive conditions. This bill also directs HHS to update the diagnostic and procedural codes related to infertility so that insurance companies would be able to cover RRM.

Federal actions related to IVF should be directed toward policy that provides restoration and healing to women, and does not allow life to be discarded. Since creation is ultimately directed toward restoration, but stymied by the fall, it would be right for Christian policymakers to support and pursue policy to this end.

¹ Jennifer L. Colvin and Sheri L. Giger, “State Laws Aim to Reverse Baby Bust and Cut IVF Costs,” The National Law Review, December 9, 2025.
² Emma Waters, “Protestant Denominations Need Stronger Leadership on Assisted Reproductive Technology,” The Heritage Foundation, December 9, 2025.
³ Emma Waters, “Protestant Denominations Need Stronger Leadership on Assisted Reproductive Technology” (June 24, 2024). https://www.heritage.org/marriage-and-family/commentary/protestant-denominations-need-stronger-leadership-assisted
⁴  Albert Wolters, Creation Regained (Grand Rapids: Erdman’s Publishing, 2005).
⁵ Ethics & Religious Liberty Commission, “IVF Policy One-Pager,” December 2024.