Sometimes premarital counseling includes conversations about having children. But what about conversations about not being able to have children?

You want to have a child, but it’s not happening. The doctor returns heartbreaking news: You or your spouse has reduced fertility. Any chance of having a biological child means a long, hard, and expensive course of treatment.

But which of the dozens of treatment options are moral and life-affirming, and which are not? Few Christians ask, much less take the time or moral energy to wrestle through, that tough question.  Too many pastors and Christian advisers lack the ethical training to advise couples.

Now, my wife and I know nothing about the pain and disappointment of infertility. But my friends who do describe it as simply brutal. Our first response to them should be with care, understanding, and prayer.

But guidance is needed too, as technological options continue to accelerate and become even more controversial. I’ll admit that well-informed Christians who study bioethics can come to different conclusions. For example, I recently interviewed my friend Dr. David Stevens, the long-time CEO of the Christian Medical and Dental Associations, on the BreakPoint Podcast. When it comes to in-vitro fertilization we agree on much, but not on everything.

Even so, there’s enough, on the basis of Scripture and the defense of human life, that should be clear cut, where there should be no debate.

First, surrogacy and gamete donation are not options. Period. Both deviate from God’s plan for marriage and childbearing by bringing a third party into procreation. As the Center for Bioethics and Culture’s Jennifer Lahl put it on a recent podcast, God said “’The two shall become one flesh,’ not the three, not the four.”

Not to mention, renting wombs and selling eggs makes women a part of a commercial transaction that leaves them vulnerable to financial exploitation, and places them in morally compromised situations; for example, those surrogate moms who have been sued by couples for not aborting their so-called “extra” babies.

Not only are surrogate mothers treated purely as a means to an end, the children they bear face a lifetime of confusion about who to call “mommy.” To intentionally create this situation—to bring children into existence to intentionally give them up—should be unthinkable for Christians.

This isn’t like adoption, in which existing brokenness is redeemed. And adoption is in an echo of what God, Himself, does for us in our broken state through salvation. Surrogacy and gamete donation create virtual orphans in order to gratify our desires for children.

Much of that same ethical framework applies to in-vitro fertilization, too. I’m against it wholesale for many reasons, chief among them is theological: God designed children to be the result of the sexual oneness between husband and wife, not the product of a lab technician. Some Christian ethicists, like Stevens, would say it’s okay to assist fertilization if the embryos are produced from mom and dad (remember, no third parties), and if the couple commits to give all embryos produced a chance at life.

And that’s one thing every Christian should agree on. Producing more embryos than you intend to raise as children is wrong, but it is normal IVF procedure. By some estimates, 750,000 embryos are stored in fertility clinic freezers across the United States alone. Most will never be allowed to develop. Christians who do try IVF cannot do it the typical way.

This subject is far bigger than one commentary can cover. But you can go in depth through three recent interviews on our BreakPoint podcast: with Jennifer Lahl, with David Stevens, and with Professor Helen Alvaré.

Above all, silence on assisted reproductive technologies is no longer an option. Pastors and churches must make this a part of premarital counseling for all Christian couples. Why? Because these are questions to ask before the hard news of infertility hits, so that we can do the right thing, even and especially when it’s hard.

Untangling Assisted Reproductive Technology: Some Clear Moral Stands

To get further insight, information, and different perspectives on this private, yet very much in-the-public discussion topic, listen to the BreakPoint podcast interviews with Dr. David Stevens, Professor Helen Alvaré, and Jennifer Lahl. You can access those links in the Resources section.