This book is based on a conference entitled ‘Fertility, Infertility and Gender’ which was held at Maynooth in 2010 by the Linacre Centre, now the Anscombe Bioethics Centre, Oxford. It consists of papers presented at the conference and others on similar themes, and addresses issues on which Elizabeth Anscombe felt deeply and wrote courageously: she would be pleased by its orthodoxy.

Among the contributors is her daughter Mary Geach, who observes acutely that it was only in the twentieth century that ‘the principle behind all of sexual ethics’ was uncovered: this is that ‘the unitive and procreative aspects of the marriage act were not to be separated.’ Before then many people would probably have been content to say that spouses should be true and loving to each other, and that we should not bring into the world children that will not be cared for. The more radical principle, as Mary Geach calls it, came to light when contraception within marriage became a live issue. It is not surprising, then, that six of the thirteen papers here are given over to defending the Church's teaching on contraception, and a seventh develops arguments that apply equally against contraception and certain forms of fertility treatment. I do not have space to do justice to all this argumentation, but I will outline the general strategy and summarise some of the points made.

Sexual acts are said to have unitive and procreative significance. The words ‘signify’ and ‘significance’ are used in at least three ways. We say that trees in a desert signify water, in that they are an indication or natural sign of it; that the word aqua signifies water by convention, in that it is a word for it; and we can also say that water has significance for us in that we need it for life. The last kind of significance is practical importance. There is no doubt about the procreative significance of sexual acts: it is practical significance, and consists in the fact that intercourse between a man and a woman can result in offspring. On the whole contributors to this book take the unitive significance of sexual acts to be practical also, but it is less obvious in what exactly it consists. Alexander Pruss distinguishes between what he calls ‘formal’ and ‘real’ union’. There is formal union between two people if each desires the good of the other for the other's sake. There is real union, if they actively cooperate. The unitive significance of sexual acts, it is claimed, consists precisely in their being acts in which people cooperate actually in procreating or at least in ‘acts of a generative type’ (p 40). Helping couples psychologically to cooperate in rearing children cannot be the unitive significance, since other things do that (p. 25), and if intercourse joins couples in an enjoyable form of play (comparable to the playful exercise of our natural powers in chess, tennis or – Jorrocks's ‘image of war’– foxhunting) this is an ‘empty pleasure’, not ‘worthwhile on its own’, and such cooperation is ‘a parody’ of the couple's love’ (pp. 25–6). If that is correct, their unitive significance is logically dependent on the procreative – they can produce worthwhile real union only insofar as they are procreative – and contraception deprives individual acts of their utility for this sort of union by the fact of being contraceptive. Contraception must be wrong if this depriving is wrong. Using the safe period, however, is all right because it is ‘cooperating with the natural female cycle of fertility’ (the idea, I think, is that there is an infertile period in order that husbands may abstain during ovulation and thereby acquire self-control) and ‘promotes the dignity of women and conjugal cooperation’ (pp. 154–5). Chastity in marriage is periodic abstinence from sex with your spouse (pp. 40, 125–35).

I did not notice any argument to show that contraception strips sex of its aptitude to bring about formal union, a desire in the couple for each other's good, but of course if contraception is actually wrong, and my wife desires my good, she should want me to refrain from it. Anyhow there are numerous other objections to contraception. If human life is sacred and inviolable, so must be the act by which life comes to be (pp. 150, 152). During intercourse, the couple's organs, as distinct from the couple, are striving for reproduction, and contraception fights against this striving (p. 26). If non-generative sex is permissible within marriage, there is no reason for restricting it to marriage (pp. 40–1). Contraception makes it harder for the ‘moral obligations of marriage to be honoured’ (p. 68). It distorts our minds about sex (pp. 40, 177) and our ‘integrity as moral agents,’ (p. 144), making us likely to ‘form harmful habits of thought and action’ (p. 158). It imitates the marriage act but has neither unitive nor procreative significance (this is Mary Geach's chief objection). It ‘involves a choice against virtuous self-control by abstinence’ (p. 153) whereas refraining from it, as we learn from Humanae Vitae, ‘fosters the fruits of tranquillity and peace in the home’ (p. 132).

Some of these points would come across more persuasively if the contributors had cited more empirical evidence. That cannot be said of the three papers sandwiched between these attacks on contraception. Philip Sutton in ‘Who am I?’ draws on impressive experience as a psychologist and member of the National Association for Research and Therapy of Homosexuality to say what disposes people to be attracted by members of the same sex, why they want relief from this attraction and how relief can be effected. David Paton in ‘Teenage Pregnancy, Sexually Transmitted Infections and Abstinence Strategies’ demonstrates that opposition in the United Kingdom to these strategies is based on factual ignorance. Dermot Greenham in ‘Population Growth and Population Control’, besides showing how attitudes to population have fluctuated over history, deals succinctly with nine problems population growth is currently supposed to cause. These papers seem to me excellent.

The final three papers discuss artificial insemination and embryo implantation within marriage. Mary Geach has rather a tortuous style of argumentation but if I understand her correctly, she holds a wife must not receive an embryo not produced from the couple's gametes because that is receiving an intromission of a kind to make her a mother, and therefore it imitates a marriage act without being one, the defect that makes contraception wrong. This objection, however, may not apply to receiving an embryo produced in vitro from the couple's own gametes or to having an ectopic embryo reimplanted, because then the wife is already a mother. Dignitas Personae has been taken to allow collecting sperm from marital intercourse, using it to fertilise an egg taken from the wife, and inserting the embryo in her womb. Kevin Flannery argues that this procedure is wrong because it conflicts with the teaching that procreation is wrong unless it is ‘the fruit of the conjugal act which is the nota propria of conjugal love’, teaching to be interpreted to agree with the reference in 1949 of Pius XII to ‘that natural act normally accomplished.’ Helen Watt, the editrix of the collection, agrees, and adds that the collecting of the semen mars the procreative and therefore the unitive character of the husband's act.

The contributors to this book offer ingenious arguments in favour of teaching many people find difficult. Except, however, for Mary Geach, whose principal concern is embryo-transfer, the defenders of the ban on contraception are all men and assume that desire for contraception in marriage comes chiefly from husbands; it would have been interesting to see more input on this topic from wives.