My answer, originally published on Quora.
Q: Infertility: Do you think that using IVF, IUI, or other artificial forms of reproduction is selfish?
Some people feel that infertile couples who turn to artificial methods of reproduction are selfish because there are numerous children without parents who could be adopted. Not to mention IUI and IVF can lead to multiples being conceived and have health problems such as prematurity, mental disabilities, heart issues, and so on.
I don't think it is any more selfish than reproducing the traditional way. In both cases, you bring a new life into the world and don't adopt.
You do have a good point about the medical risks to children conceived with IUI and IVF, however all of the risks you mention are related to MULTIPLES being conceived. If a singleton child is the result of an IUI or IVF procedure, his/her health risks are essentially the same as any other normally-conceived child.
There are procedures and precautions that couples undertaking IUI and IVF can do, in order to reduce the chance of multiples. For example, with IVF you can limit the number of fertilized embryos transfered back to the uterus. For IUI, you can undertake selective reduction.
But back to the core of your question, should fertile couples also be considered selfish for not adopting?
As an adoptive parent, I think you should only adopt if you really and truly are ready to embrace a child as your own who is not of your blood. Otherwise it is not fair to the child -- s/he deserves better.