Dr. Eileen Kummant became interested in what the Church teaches about infertility while she was a missionary doctor in Kenya. She saw that in a culture where polygamy is still the norm, women who were unable to have babies were cast out. After returning from Kenya and finishing her residency requirements, she opened a family practice in Pittsburgh, Pa., that is faithful to Church teaching. She shared some of her thoughts on the pastoral side of infertility care with Our Sunday Visitor.

Our Sunday Visitor: In a world where contraception and abortion are seen not only as normal but sometimes even virtuous, married couples who are open to God's will and want children can get very frustrated when they are unsuccessful. Does God still know what he's doing?

Dr. Eileen Kummant: His goal is possibly different from our goal. He may be saying, "No," or at least, "later." But his goal doesn't change, and that goal is to have us know and love him. He wants to join us to himself. It is essential that when we are hurt or confused about why God lets painful things happen to us that we step back and try to look at his big picture.

OSV: What makes the grief of infertility unique?

Kummant: Emotionally, infertility is at times worse than the death of a child because it is not recognized by others, and it is a repetitive event. Few people lose more than one loved one in a year. An infertile couple goes through the hope and loss cycle every month. It is important to recognize the toll that it takes on you.

OSV: What about married couples who haven't always followed the Church's teachings on contraception or even abortion, but whose suffering with infertility has brought them closer to God and back to the Church?

Kummant: Dealing with guilt is a very important part of the issue. Sometimes we wonder if our childlessness is somehow in retribution for something we did or didn't do.

There are several possible health effects of previous behavior or even age that may affect fertility, but we need to recognize that we live in a fallen world, and that these are natural consequences to our actions, not the punishment of an angry God.

OSV: When it comes to the moral issues surrounding infertility treatments, the average person easily gets confused. Could you sum up the basics of the Church's teachings?

Kummant: To be morally sound, a treatment must have two things. First, it must recognize the sanctity of life from the initial fusion of the sperm and egg. It must not treat that life as an object or inordinately endanger that life. Second, fertilization must result from a loving, faithful and exclusive marital act. This eliminates surrogacy and options that require masturbation.

OSV: The desire for children and subsequent infertility treatment can drive a wedge between spouses. What advice do you have for couples?

Kummant: We must be careful not to use our spouses as a tool to make a baby. We are to be co-creators with God. And as Catholics, we recognize marriage as a sacrament. It is something of great spiritual significance. It is not just a contract.

OSV: Seeing a doctor about infertility can be humiliating.

Kummant: Often, doctors fall into the trap of seeing babies as a product or a measure of our success. Health care professionals need to step back and look at the whole person, spiritually as well as physically, and keep the goal God-centered.

Church-approved reproductive technology

Natural family planning.

Moral medical testing to determine spouses' overall health and any abnormalities in their reproductive organs.

Medication and surgery to provide more normal functioning of the reproductive system.

Low tubal ovum transfer (LTOT). If a fallopian tube is blocked or damaged, the ovum may be transferred past the blockage and into the lower part of the tube.

For more information, see www.usccb.org/prolife/issues/nfp/treatment.htm

Mark Sullivan writes from Pennsylvania.