When 7-year-old Rosie Buchholtz asks where she came from, her mother answers simply.

“I just tell her, ‘A very nice family gave us you, and you were sooooo tiny. And they put you inside me so you could grow. When it was time to come out, you did. … I have brown hair, and you have blond,’” said Chelsea Buchholtz, an Austin, Texas, attorney. “‘But I’m your only mommy.’”

Neither Chelsea nor her husband, Scott, was able to have biological children. After exploring fostering and traditional adoption, she learned about embryo adoption.

The Buchholtzes attend Providence Church, a church plant that partners with the University Avenue Church of Christ, where Chelsea grew up and her father served many years as an elder. Her youth minister from those years and his wife were the first of several to mention in vitro fertilization by donation.

“It’s the most clear time in my life in which the Holy Spirit has spoken to me,” Chelsea said. “It allowed us to have a family in kind of a traditional way.” 

So she tells Rosie what she believes to be true: “That embryo was created by God, and I’m so glad he created you for us.”

Chelsea’s fertility doctor explained that IVF by adoption could be facilitated through traditional adoption or a contractual agreement. 

“I’m a lawyer. I said, ‘Let’s do a contract.’” They met the donor parents and their children previously conceived through IVF. The family gave the Buchholtzes five embryos, one of which was implanted and became Rosie.

Chelsea, 45, serves as executive director of the Texas Real Estate Commission but said her favorite title is Mom. Scott, 52, works as operations director for the Texas Economic Development Corporation. Though Rosie wishes for a sibling, they don’t plan to have more children.

“We have a dog named Sister!” Chelsea said, laughing.

They would like to give the other embryos to the next family.

How it works — and doesn’t work

The Buchholtz story is typical. And not at all typical. Which is the case for all families who choose IVF. 

Their story is nothing like that of Brent and DeShonna Taylor, a Dallas couple whose 27-year-old quintuplets were born through IVF. And theirs, in turn, is nothing like Jessica Hemenway Knapp’s and her husband, David’s. The Arizona Christians endured three failed IVF attempts and a 14-year sojourn with infertility that included four miscarriages. Their four children were all conceived naturally over that same span of time.

Jessica, who serves as minister of The Seed Gathering, a church plant associated with Churches of Christ on the University of Arizona campus, described the expensive, last resort infertility treatment as physically and emotionally brutal.

“Nobody does IVF without a passion for having babies,” she said.

About 5% of couples with infertility will try IVF, according to the Cleveland Clinic. The total cost can range from $20,000 to $40,000, with insurance coverage varying.

Doctors tailor the process to each couple’s needs. But typically it begins with a regimen of hormones and injections to stimulate the woman’s ovaries to overproduce eggs that are harvested through the first of two surgical procedures. 

Eggs are fertilized in a lab using the father’s sperm. 

Spontaneous abortion, or miscarriage, happens in 10% to 20% of known, naturally occurring pregnancies. Clinically unrecognized loss is likely even higher.

In IVF, as in the womb, some eggs die. Some embryos die. In Knapp’s case, all of them died in the first two attempts before any could be transferred to her womb. A third attempt ended in miscarriage.

Embryos develop to six to 10 cells each within two to three days of fertilization. They are tested for genetic anomalies and graded to assess viability. One or more of the most viable are implanted in a second surgical procedure. 

Chelsea Buchholtz only underwent the second procedure because she was using a donated embryo. And only one was transferred. That one became Rosie.

Today, doctors typically transfer one or two or three embryos to avoid multiple births beyond twins.

But when the Taylors did IVF 27 years ago, doctors commonly transferred multiple embryos, assuming some would not survive. 

Remaining embryos are frozen. Parents may choose to use them later, donate them to other couples, donate them for medical research or allow them to be discarded. 

Moral complexity

IVF was invented in 1978 by British physiologist Sir Robert Edwards. Since then, more than eight million IVF babies have been born. 

People of faith have sometimes felt conflicted regarding the process or its consequences for unused embryos. Yet, IVF has found widespread support for what many call a pro-life practice. IVF allows babies to be born who would not have life without it. 

Studies this year by Pew Research and Gallup indicate that substantial majorities of American Catholics, Protestants and evangelicals believe IVF is a good thing.

But among those reporting weekly church attendance, 54% believe destroying frozen human embryos is morally wrong.

In the political sphere, despite genuine moral complexity and protracted partisan wrangling, support for IVF remains surprisingly bipartisan — even in states such as Alabama and Texas, which have two of the largest concentrations of Churches of Christ. 

In February, a conservative Supreme Court in Alabama ruled that “extrauterine unborn children” created through IVF must be considered exactly the same as in utero embryos. Thus parents could sue clinics or physicians for the embryos’ demise under Alabama’s Wrongful Death of a Minor Act, passed in 1872.

Michael DeBoer, associate dean for academic affairs at Faulkner University’s Jones School of Law in Alabama, said authors of the 1872 bill “didn't know anything about what is termed ‘extra uterine children.’ But a minor child would have been known.” 

By March, the Alabama Legislature passed a bill sponsored by GOP Sen. Bill Melson, a member of the Wood Avenue Church of Christ in Florence, protecting IVF providers and patients from prosecution in the event embryos die before they are implanted.

Three states westward, Texas’ Supreme Court declined in June to hear an appeal challenging a divorce settlement. The lower court held that a contract between both parents and a fertility clinic several years earlier was enforceable. The mother had argued that unused embryos should be the subject of child custody proceedings.

Property vs. personhood is not an abstract legal construct to Jessica Knapp. She and her husband still have two frozen embryos.

“We know they are not viable, but I’m not quite ready to have them destroyed,” she said. “I don’t have an adjective for how it feels.”

‘Blessings we don’t have all the answers for’

Bill Chambers of Tyler, Texas, is retired now, but for 40 years he was an OB-GYN specializing in high-risk pregnancies and a life fellow in the American College of Obstetrics and Gynecology. 

Chambers, a former elder of the Glenwood Church of Christ, said he “had no apprehension in referring couples, for whom we had done every other reasonable thing, for IVF.”

“Man has forgotten to be humble. Man has forgotten that there are many blessings that we don’t have all the answers for,” the physician said. One of those is “the gift of unbelievable technological medicine.” 

Brent Taylor told his own mom something similar — but in West Texas vernacular — when she raised concerns almost three decades ago. 

Both Taylors are nurses and attend Highland Oaks Church of Christ in Dallas. DeShonna is director of heart, lung and vascular at UT Southwestern Medical Center. In 1997, they were living in Snyder, Texas,  a rural community midway between Abilene and Lubbock.

“Mom was old, staunch C of C,” Brent said, “but I told her one day, ‘Mom, God gave these doctors and scientists the ability to figure this out, so what’s the problem?’”

Ultimately, he added, “she doesn’t have any problem. She added five grandkids in three minutes!” 

The 37th Avenue Church of Christ in Snyder marshaled volunteers to work four-hour shifts helping care for the five little ones and their older brother. 

“Even though we love all our kids unconditionally, I wouldn’t wish five kids on anybody ever,” Brent said. 

When the fertility clinic called to ask what the couple wanted done with two remaining embryos, embryo adoption wasn’t yet a thing, DeShonna recalled.

“I’m not sure what I would have chosen — research or adoption,” she said. “Maybe my decision was made rashly — at the time I just remember having all those toddlers who were 2 or 3 years old. We knew we weren’t going to have any more kids. We just told them to let them thaw.”

Grace and redemption

Judges, politicians and ethicists debate whether an eight-celled organism is a human being to be protected or a collection of cells that lacks viability outside the womb.

Knapp believes the church should be part of the discussion, but must be  aware of the legal and medical implications. Because the church has denied science in a lot of places, “we aren’t getting to have a voice about ethical matters like this,” she said.

Meanwhile, physicians sit with patients who arrived in their exam rooms after months or years of pain and prayer in pursuit of a positive stripe on a pregnancy test –– years praying to have a baby. 

“If society wants to prohibit technology, then prohibit the misuse of it,” Chambers said. “But not those aspects that reveal the Creator’s mercy, grace and redemption of one of the most deeply embedded evidences, which is motherhood and fatherhood.”

Perhaps 40 years spent delivering babies informs the physician’s conviction that grace and redemption can be found in IVF. In those 40 years he has seen several IVF babies grow to adulthood and lead Christian families of their own.

Babies like Rosie.

This piece originally appeared at The Christian Chronicle.

Cheryl Mann Bacon is a Christian Chronicle correspondent who served for 20 years as chair of the Department of Journalism and Mass Communication at Abilene Christian University. In retirement, she is enjoying freelance writing and consulting, especially with churches. Contact her at cheryl@christianchronicle.org.