FAITH OR FAMILY? - Devout Catholic couple defies church, turns to science to have a baby

FAITH OR FAMILY? - Devout Catholic couple defies church, turns to science to have a baby
By Manya A. Brachear
Copyright © 2009, Chicago Tribune
April 5, 2009
http://www.chicagotribune.com/news/local/chi-catholics-ivf-05-apr05,0,6702066.story


Annette Levine, an ultra sound technician, checks on the baby inside Alicia Malnati while her husband, Joe Malnati, looks on at their pediatricians office in Hoffman Estates. (Stacey Wescott, Chicago Tribune / March 30, 2009)

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Six months after they met, Alicia and Joe Malnati discussed baby names. Faithful Roman Catholics, they waited to make a lifetime commitment before they consummated their relationship.

But after two years of marriage—one of them spent trying to get pregnant—the young Streamwood couple still had not conceived.

" 'Let nature take its course.' We heard that a lot," said Joe Malnati, 29. "Wait. Just wait."

The Malnatis soon discovered they were waiting for a moment that would never arrive—not without a little help from science. After ovulation accelerators, sperm-count enhancers, inseminations and acupuncture failed to work, they pursued in-vitro fertilization.

Doing so put the couple at odds with their church. In December, days after Alicia Malnati surprised her husband with balloons and a positive pregnancy test, the Vatican reinforced decades of opposition to IVF, saying the procedure of fertilizing an egg in a petri dish should not replace the loving union between a husband and wife.

"The difference between assisting nature and ... manufacturing something that takes the place of nature is very significant," said Rev. Kevin O'Rourke, resident bioethicist for the Loyola University Health System. "Not everybody is going to have children."

Discouragement from the church did not quell the Malnatis' passion to be parents. It also did not stop their Catholic fertility specialist, who believes her profession does not contradict the church's ethic of life, but instead embodies it.

As battles over embryonic stem cell research and abortion reach a fever pitch, the Malnatis' journey illustrates a different kind of clash between Catholic teaching and reproductive rights. Thousands of Catholic couples desperate to build families find themselves torn between the church they love and the children they yearn to adore. Like the Malnatis, many do not question the morality of modern medicine and side with science.

"What part of what we did is wrong?" Joe Malnati said as he showed off the ultrasound image of his unborn daughter on his iPhone. Alicia Malnati, 28, said only God can judge.

"I don't think God uses children as an example," she said.

Dr. Jane Nani, 49, the reproductive endocrinologist who has walked the Malnatis through the arduous process toward parenthood, regards her role as vital and virtuous in this modern world.

"Some individuals will not get pregnant without in-vitro," Nani said. "You've changed their lives in the sense of having a family. In my own mind, I'm doing what is right. That's what I'm responsible for—doing it for the right reasons."

According to the Centers for Disease Control and Prevention, more than 2 million married women face infertility, meaning they can not get pregnant for 12 consecutive months. The Society for Assisted Reproductive Technology reports nearly 133,000 IVF attempts in 2007, up from nearly 113,000 in 2003.

Of course, factors that lead to infertility "cut across all religions," Nani said, but quite a few Catholics struggle with it.

"Many couples think it's a natural part of married life. ... It's a good thing to have children," Nani said. "When they can't have a single one, it's incongruent in their mind."

One of six children, Nani was educated in Catholic grammar and high schools and attended the University of Notre Dame. Every year, she declines invitations to her alma mater's medical ethics conference because she suspects they will not welcome what she has to say.

"The field is so controversial," she said. "The point of view of the Vatican is based on a very old Catholic tradition. They've been slow."

O'Rourke said the church considers assistance such as enhancing egg production or boosting sperm count perfectly acceptable. But moving the act of procreation from the bedroom to a laboratory bypasses the natural process, he said. The church objects to IVF based on that and other principles, he said.

"Children should be generated through an act of love," O'Rourke said. "When you introduce technology into the generation, you're introducing other people and very seldom are those people acting out of motivation of love as they manufacture fetuses or the zygote."

The church also objects to the destruction of embryos that are not implanted. On that point, Nani agrees.

She encourages all of her patients to freeze viable embryos for the future or for adoption and struggles when a patient insists on discarding them.

"We are not in the business of destroying embryos," she said. "These embryos created, we very much hold them in high esteem. … That's my moral stance on that. But it's not up to me. Not everyone shares my philosophy on life."

Nani insists that the loving union between a man and a wife does indeed factor into the IVF process. She points to the Malnatis as a model couple supporting each other through a painful process.

"As a partnership, you deal with each other's strengths and weaknesses," she said. "Those are the hardships that come along with being a married couple. You take care of yourselves to take care of each other."

Indeed, Alicia and Joe Malnati have held each other's hand through many hopeful moments that ended in heartbreak.

Five years ago Joe proposed to Alicia on her 24th birthday. Sporting her new diamond at dinner, they dreamed out loud about having children.

"When you meet the right person, you know you want the family," he said.

They married in 2005. Alicia Malnati fulfilled her maternal instinct working as a nanny. Joe worked toward a promotion at AT&T.

Once they were comfortable living together and felt financially secure, they purchased a three-bedroom home and started working to fill the other two bedrooms.

When Alicia didn't conceive after a year, Joe submitted a semen sample. The sperm count came back low, prompting their doctor to refer them to Fertility Centers of Illinois in Hoffman Estates. There, Nani discovered that Alicia Malnati also had an inverted uterus, making it difficult for the sperm to reach the egg in the first place.

A bevy of drugs and hormones and five unsuccessful inseminations later, IVF emerged as the last option.

Joe Malnati's employment benefits did not cover IVF. Few insurance providers do. So in spite of help from her parents and discounts from Dr. Nani, the couple racked up a $27,000 credit card bill.

Fearing criticism, the couple kept it from many people, including their priest.

"Our way of talking to anybody was praying," Joe Malnati said. "As a married couple we're going to make the decision together. I'm not married to the guy giving sermons."

It has been those conversations with God and confidence in each other that sustained the couple when the first IVF attempt failed.

"People don't really know the roller coaster," Alicia Malnati said. "I was a different person for over a year."

Joe Malnati said there were times when he pleaded with God.

"Natural versus unnatural is the biggest thing to deal with," he said. "You want a child so bad, but I also want my wife."

O'Rourke said couples who invest in IVF run the risk of treating their child as a possession, and he questioned the motives of fertility service providers.

"People who offer in-vitro fertilization very often have that conviction that they're helping the parents," he said. "They look upon the child as something the parent should have. In God's plan, it might be that the parents will not have children."

But Catholics such as the Malnatis and Nani believe what they are doing is right.

"I pray I'm doing the will of God," Nani said. "It's more sinful to be negligent when you can help and have not."

She believes adoption is a powerful way to make a difference in children's lives. But she recognizes the power of the genetic bond between parent and child too.

When she looks at her own daughter, she sees the face of her late husband who died of cancer at 45.

"I understand how couples would want their own children because I've done it myself," she said. "It's part of living in the modern world. … What a blessing."

mbrachear@tribune.com