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In their 2024 annual report, the Canadian Fertility and Andrology Society released its Canadian Assisted Reproductive Technologies Register data. This data tracks almost all facets of assisted reproduction in detail (except for sperm donation). 

Assisted reproduction occurs in all sorts of ways. In vitro fertilization, for example, takes a human sperm and a human egg, fertilizes them in a petri dish, and then transfers the embryo into the intended mother’s womb. Surrogacy is essentially the same thing, except the embryo is transferred to a surrogate mother who gestates and births the child before giving him or her up to his or her intended parents. 

In our policy reports on in vitro fertilization and surrogacy, we’ve noted that these assisted reproduction techniques are morally problematic for all sorts of reasons. There is the philosophical question of whether children should only be conceived through sexual intercourse. There is the intentional freezing and destruction of embryos, which pro-life Christians who believe that life starts at conception must recognize as human beings. There is the high failure rate of IVF, leading to questions about how many unintentional deaths we are willing to tolerate to allow a new life to be born. There is the issue of using genetic testing to discriminate against some pre-born children who are likely to develop disabilities, chronic illnesses, or abnormalities. There is the practice of “selective reduction,” aborting a pre-born child if IVF leads to multiple pre-born children growing in the womb. There are physical risks of IVF to women, including a greater risk of developing ovarian cancer. There is an increased likelihood that children conceived through IVF will have genetic defects or intellectual disabilities. And there is the entire problem that IVF and surrogacy fracture fatherhood and motherhood; rather than one man and one woman laying claim to be the father and mother of a child, the intended father and mother, the genetic father and mother, and the birth mother all can lay some claim to being the parents of the child. 

Given all these moral quandaries, we’ve suggested that IVF be greatly limited and surrogacy be banned entirely. 

But in the absence of great restrictions on assisted reproduction, how prevalent a problem is it? Are there hundreds of thousands of children being conceived through IVF per year or just a few dozen? What is the survival rate of these children? How many people are turning to assisted reproduction? 

Here’s some data. 

In Vitro Fertilization 

In vitro fertilization is becoming increasingly prevalent. Over 28,000 women visited these fertility clinics in 2023, and just over 20,000 egg (oocyte) retrievals were performed. 

Perhaps most importantly, consider the number of live births compared to the number of embryo transfers (ETs). In 2022, approximately 27,500 embryo transfers – the transfer of an embryo from a petri dish into a woman’s womb – occurred, but only 7609 children were born. That is a “success rate” of only 28%. Only 28% of pre-born children survived the transfer. The remaining 72% – approximately 20,000 – pre-born children did not survive the implantation process.ⁱ  

The following chart breaks this down by the age of the woman and the specific type of IVF. (Fresh ET means the embryos were never frozen before being transferred; FET (no PGT-A) means that the embryos were frozen but not genetically tested before being transferred; FET with PGT-A means that the embryos were frozen and only the embryos with the best genetics were transferred.) 

Although the survival rate of the embryos is far higher if they are frozen and genetically selected, there are ethical problems with these two practices. If embryos are human beings, then it is just as immoral to freeze them in time as it would be to freeze an infant, a child, or an adult so that they stop developing. And testing embryos for genetic problems and implanting only the embryos with “good” genes is discriminatory. It avoids children with genetic deformities such as Down syndrome. It is a “transfer – and hence the survival – of the fittest.” 

Unfortunately, since using frozen embryos that have been genetically tested and selected has the highest survival rate, an increasing percentage of all IVF treatments use frozen embryos. Almost 80% of all embryos are now frozen before transfer rather than being “fresh.” 

But the survival rate of embryos – of pre-born children – is even worse than presented above. Only 28% of embryos transferred to a woman’s womb are born. But that ignores the fact that many more embryos are created than are ever transferred. Just consider the following summary graphic. 

Over 85,000 “utilizable” embryos were created in 2023 (plus an unspecified number of embryos that were not considered “utilizable”). But there were only 7609 live births. Doing the math, that means that only 8.9% of all embryos created in a petri dish were born. Over 58,000 embryos that were created but not transferred were either destroyed (killed) or frozen (abandoned), and a further 20,000 accidentally perished in the process. 

To put that into context, there were 101,553 abortions in 2023. Approximately 61,104 children in 2022 were in the foster care system. The intentional destruction of an embryo is the moral equivalent of abortion. Although the analogy is far less perfect, the foster care system is likely the most analogous to the long-term freezing of embryos. Both involve parents being unable or unwilling to take responsibility for their children. Many Christians give much thought to the injustice of abortion. Some mourn the brokenness of the foster system. But very few pay heed to the treatment of pre-born children in the assisted reproduction industry. And yet, the sheer number of mistreated embryos is comparable to the number of abortions or foster children. 

There is one small piece of good news in this report regarding IVF. In our policy report, we note that, “because of the risks involved in a multi-fetal pregnancy, women are commonly encouraged to ‘reduce’ the pregnancy – that is, they are encouraged to abort one or more of the children to increase the likelihood of a healthy pregnancy with a single child.” As a result, we recommended that only one embryo be transferred to minimize the motivation to have a “selective reduction” abortion. 

At the time, we didn’t have any numbers to back up how common it was to implant multiple embryos. But the trend is in the right direction. Combining the rate of single “fresh” and frozen embryo transfers, only a single embryo is transferred 88% of the time. More than two embryos were transferred only in 0.35% of cases, making the circumstance in which there is a perceived “need” for a selective reduction abortion rare. 

Surrogacy 

The report ends with some statistics on surrogacy (what the report calls gestational carrying). Gestational surrogacy occurs when a woman, unable to bear a child herself, contracts with another woman to carry her child on her behalf. A child is thus conceived by standard IVF practice and then transferred to the surrogate mother. 

As demonstrated by the graph below, gestational surrogacy is far less common than standard IVF. In 2023, there were 859 gestational carriers (i.e. surrogate mothers). There were 1237 embryo transfers that resulted in only 428 ongoing pregnancies and 271 live births. That’s a “success rate” of 22%, slightly less than the 28% of standard IVF.  

Conclusion 

While an increasing number of Canadians are turning to assisted reproduction and more and more provinces are publicly funding the procedure, assisted reproduction is deadly. Far more pre-born children are frozen and intentionally or unintentionally killed than are born. Christians need not only to be aware of the magnitude of this tragedy but also speak up about it with their neighbours and elected representatives.