Jean-Marie Le Méné: The vision of Dr Jérôme Lejeune

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The Vision of Dr Jérôme Lejeune, First President of the Pontifical Academy for Life

by Jean-Marie Le Méné, President of Fondation Lejeune

delivered at “Humanae Vitae at 50: Setting the context”, Pontifical University of St Thomas Aquinas, 28 October 2017

Allow me to thank you for inviting me to this conference. It is not often that I am, for once, entrusted with a matter which is “easy” to tackle. It is however evident that “the most serious role of the transmission of human life” (the first words of Humanae Vitae) is not, in itself, such an easy topic, as history demonstrates. But you have asked me to speak to you on the vision of Professor Jérôme Lejeune. This is a very different matter, because it is he who has to take the floor! This French geneticist had the gift of rendering the most complex and delicate matters clear and accessible to all.  As always, on this matter as on others, Jérôme Lejeune was just, a characteristic embodying both a sense of rigour and a sense of measure.

The interventions of Jérôme Lejeune on birth control cover essentially two approaches. Firstly, a somewhat anthropological approach relating to the moral act of the union of the sexes perceived by a physician. Secondly, a more biological approach relating to the nature of contraception and its different methods of action.

The anthropological approach to the sexual union

Having recalled “that we are so made that what concerns the genital directly affects the moral, neurologically speaking, whence perhaps our inability to master the emotional act if the ascendancy of the will is not also, and perhaps first of all, extended to the conscious and deliberate genital act”, Professor Lejeune broaches the question of the moral act of bringing together the sexes.

“In modern civilisations, the deposit of reproductive cells in the interior temple which is the female organ remains the exclusive prerogative of the husband.

“The union of the sexes is an act of liberty, capable of definitively sealing the commitment of the persons. Possibly a number of hours later, a spermatozoon will penetrate an ovum, but this event is then a consequence of cellular physiology and does not require voluntary participation by the spouses.

“It follows that the introduction of the gametes, through the union of persons, properly speaking an ‘act of love’ differs from fertilisation, one might say an ‘act of birth’, of the being newly conceived.

“The intervention of the specialist may hence develop in two different registers:

– If he delivers gametes, in so doing he arrogates to himself, through the interposition of a syringe, the privilege of the husband. In this very real sense, there is substitution of the person.

– Conversely, if he removes the obstacle to union of the reproductive cells by overcoming an anatomical, infectious, hormonal or metabolic impediment, he is acting strictly to assist nature, the function proper to the physician.

“This operational distinction (between the substitutio personnarum and the adjutorium naturae), indeed in full accordance with sound doctrine, may at first sight appear a little over-academic. This is by no means the case, as is apparent from the enlightening reflection of a woman who had just had her embryo transferred after extracorporeal fertilisation. The three specialists had performed the procedure in a respectful atmosphere, to a background of soft music. Moments later, when the specialists had left, to her troubled husband asking how the thing had happened, the would-be mother answered spontaneously: ‘I made love to the three of them.’

“This assertion, which somewhat flies in the face of honesty, is a realistic, or rather surrealistic, evocation, discoverable only by a woman, of the substitution of persons described by moralists.

“On this planet, man is alone in asking himself who he is, where he comes from, sometimes hearing the formidable questions: What have you done to your brother? What have you done to your child?

“Man is also alone in knowing, from the beginning, the mysterious relationship between love and the child. The cleverest and tamest chimpanzee would never be able to understand that a relationship exists between the mounting of his female monkey and the appearance nine months later of a small being resembling it.

“Man himself has always known that voluptuous passion is associated by nature with begetting of the similar; the Ancients, most correctly, represented the passion of Love (Eros and Cupid) with the features of a child.

“This immense discovery vests our amorous acts with a dignity unknown to all other living things.

“The result is that to dissociate the child from love is, for our species, a methodological error:

– contraception, which is to make love without making a child;

– extracorporeal fertilisation, which is to make a child without making love,

– abortion, which is to unmake the child;

-and pornography, which is to unmake love;

all of which are, to varying degrees, incompatible with human dignity.”

The biological approach to contraception

Without again broaching the matter of abortion and the intrauterine device, the abortive nature of which is not in dispute, Professor Lejeune has provided useful information on different contraceptive methods, for which the question of implantation proves a necessary prerequisite

The question of implantation

“Under natural conditions, the mature ovum is ejected from the ovary by rupture of the follicle containing it. The fallopian tube (which links the ovary to the uterus) then accommodates it. Within this fleshy tube, the ovum migrates to the uterus, encountering on the way the spermatozoon which, out of a million others, will fertilise it.

“At the end of the journey, six to seven days after fertilisation, the fertilised egg, having feverishly divided itself and already transformed into a minuscule embryo one and a half millimetres in diameter, settles in the uterine mucus (implantation). Once there, it is firmly implanted through its chorionic villi and continues to grow until birth.”

Therefore, strictly speaking, the contraceptive act has differing significance depending on whether it prevents the encounter of the gametes, that is formation of the embryo which takes place in the fallopian tube, or prevents its implantation in the uterus, thereby condemning it to die.

The question of contraceptive pills (which prevent formation of the embryo)

These fall into two types: the combined pill which contains both oestrogen and progesterone (mini-dose) and the progestogen pill (micro-dose) which contains progesterone only.

These pills act at three levels: thickening of the cervical mucus forming a barrier to spermatozoa, the possible prevention of ovulation, thinning of the endometrium (uterine mucus) rendering it hostile to implantation. The contragestive, hence abortive, effect is predominant in the progestogen pill, known as the mini-pill, which contains no oestrogen.

Hence this comment from Professor Lejeune: “No clear boundary can be claimed between contraception and abortion. This reflection applies to the majority of pills, from mini-pills (containing no oestrogen), whose anti-implantation action is preponderant, to the RU, which is exclusively abortive.”

– The question of the abortive pill RU 486 (contragestive, which makes gestation impossible)

“The RU 486 product is a curious poison which is not a habitual toxin, but a specialised pesticide to be applied to the youngest of human beings. It does not in fact directly attack the human being in the process of development in the womb of its mother. This being has on average 15 days to one and a half months of intrauterine life, but its survival is under attack because this product is comparable to a false key which blocks the lock which is progesterone, a hormone indispensable to continuation of the pregnancy. This is not a direct attack on the tiny cosmonaut in its survival bubble, but the RU 486 cuts off its vital fluids. A man cannot survive on the moon because there is no atmosphere. A being as young as this cannot survive unless fed from the placenta. What the RU 486 pill does, through a complicated biological mechanism, is to cut off the supply of vital fluids and provoke intrauterine death. As always when there is intrauterine death, this triggers the secretion of another product, prostaglandin, which generates uterine contractions. It is proposed to use the RU 486 pill to prevent the infant from surviving and the death of the infant will then spontaneously trigger uterine contractions. This eliminates the infant in 80% of cases and it is now proposed to add more prostaglandin to achieve a 95% level.”

The question of the so-called emergency morning-after pill

This high-dose (progestogen only) pill triggers several types of mechanism, expressed successively depending on the moment in the woman’s cycle. If absorption precedes ovulation, this will be blocked as in any simply contraceptive action, in fact preventing fertilisation.

On the other hand, if the woman has ovulated, because the spermatozoa take only 30 minutes to reach the place of fertilisation, the molecule cannot avoid encountering masculine and feminine gametes. Under these circumstances, the morning-after pill (NorLevo or EllaOne) sets in place a mechanism which is primarily one of anti-implantation (high-dose) by changing the wall of the uterus. On leaving the fallopian tube through which it has migrated for approximately one week, the young embryo will be unable to find favourable territory in which to implant, and will be expelled. It is this typically “interceptive”, that is abortive, effect of the product, which is therefore at work here. It must be remarked that a woman who ingests the morning-after pill will never know whether she has provoked an early abortion of a baby conceived.

In an announcement which caused a great stir in Italy, when it had recently authorised the morning-after pill, the Pontifical Academy for Life was compelled to remind people that pregnancy begins at fertilisation, not from the moment of implantation of the embryo in the uterine wall. The consequence is that the anti-implantation action of the morning-after pill is, in reality, nothing other than an abortion achieved by chemical means. Not to say this is neither logical, nor scientifically justifiable.

This is what, at a much earlier date, Jérôme Lejeune had expressed in these terms:

“To the best of my knowledge, and after consultation with highly competent colleagues, there is no method capable of preventing a pregnancy which does not provoke possible abortion.

“Indeed no process exists which makes it possible to prevent in vivo conception if competent spermatozoa are in the presence of a mature ovum. All the hormonal preparations proposed (including the RU 486 pill) have the effect of destroying the capacity of the uterus to accommodate implantation of the fertilised egg.

“It is only if spermatozoa are deposited at the outset of the ovarian cycle, perhaps before the 10th day, that a brutal hormonal treatment could prevent ovulation (as does the conventional contraceptive pill), but a mechanism of this kind is highly problematic.”

Conclusion

The pharmaceutical authorities more or less explicitly acknowledge the anti-implantation function of the morning-after pill, even of other pills, but refuse to include the product in the abortive category. Why this denial?

Quite simply because a definition, adopted by the World Health Organisation, states that pregnancy does not begin until the embryo has already implanted in the uterine mucus. Fertilisation is hence no longer correlated to conception or the union to procreation.

This conceptual sleight of hand makes a mockery of the actual biological reality and the objectivity of embryological data. We are confronted with yet another case of nominalist instrumentalisation of language, designed to refute the abortive categorisation of “interceptive” practices.

In conclusion, these citations of Professor Lejeune emphasise, in essence, to what point human love is a gratuitous, free and uncalculated act, in its very nature:

“The physical union which alone is capable of rendering the commitment of persons valid and definitive is an act desired and intended by the spouses. Fertilisation of the ovum by a spermatozoon will survive possibly for hours thereafter, but the union of reproductive cells is then a consequence of corporal physiology and no longer under the conscious and deliberate control of the spouses.”