KNOXVILLE, Tenn. (AP) — Dr. John Gordon, a reproductive endocrinologist, has been a man of faith for years. When he began to have doubts, they were not about his God, but his life’s work.

He chose to be an infertility specialist to help people. Thirty years later, scientific advancements made that easier than ever but created more ethical dilemmas.

As co-director of a fertility clinic in suburban Washington, D.C., Gordon grew troubled over helping create surplus embryos, which would often languish in storage or be discarded. With the expansion of genetic testing, couples could choose the sex of their baby. They could screen out painful or fatal diseases, but also milder impairments like hearing loss.

“It’s too morally problematic,” Gordon thought. “I don’t know where you draw the line.”

In 2018, his wife pushed him to change how he practiced. They both believed in the sanctity of embryos as part of their Christian faith. But as Allison Gordon looked around the home where they had raised four children, their comfortable life now seemed bought by “ill-gotten gains.”

John Gordon soon bought a practice in Knoxville, Tennessee, and aligned it with his evolving faith-based views. His Rejoice Fertility clinic does not discard viable embryos, genetically test them or donate them to science. It also limits how many embryos it creates.

His career pivoted alongside a growing debate over in vitro fertilization. Recent legal decisions have prompted questions about IVF, from the U.S. Supreme Court ending federal abortion rights to the Alabama Supreme Court designating embryos as children. IVF remains popular in polling though, and President Donald Trump has taken steps to expand access.

Trump’s conservative Christian base is less supportive of IVF. The Catholic Church has long opposed IVF, and evangelicals are increasingly grappling with it. In 2024, the Southern Baptist Convention, the largest U.S. Protestant denomination, called for IVF restrictions when it destroys “embryonic human life.”

Gordon believes his practice addresses many moral concerns. He was 55 when he made this intimidating shift: “I don’t like changing toothpaste brands.”

But, he said, “I need to practice in a way that I can live with the decisions I’m making.”

The discarded embryo dilemma

Rejoice draws patients from around the country. Evangelical brochures and a wooden cross sit in the waiting room. Outside the recovery area, a Bible verse reads: “Do not be afraid or discouraged, for the Lord your God will be with you wherever you go.”

In January, Maggie and Cade Lichfield, Latter-day Saints in Knoxville, held an ultrasound photo, their second since a pregnancy was confirmed after three failed embryo transfers. They understand IVF’s controversies but appreciate that Rejoice does not genetically test or discard embryos.

“You’re still letting God be God,” Maggie Lichfield said. “He is in control.”

Domenic and Olivia D’Agostino thought they would forgo IVF for religious reasons until they found Rejoice, nearly two hours by car from their Tennessee home.

They didn’t know a non-discard facility existed. “That was the biggest one for me because in my eyes there’s not much difference between discarding an embryo and abortion,” Domenic D’Agostino said. “We just weren’t really willing to do that.”

It felt providential. Gordon shares the couple’s interest in Reformed theology and the idea that God is sovereign over all things — including the vagaries of fertility treatments.

“My favorite thing that he does is he prays with us before transfers,” Domenic D’Agostino said. “He focused in on the sovereignty of God in it and submitting to God’s will in this process.”

A conversion experience

Gordon was raised Jewish outside Boston, the son and grandson of physicians. He received a premier education: prep school followed by Princeton, then medical school at Duke and residency at Stanford.

He met his wife at Duke, where she earned a doctorate in engineering. Allison Gordon grew up Christian in a small North Carolina town. A minister and a rabbi presided at their wedding; for years they maintained an interfaith marriage.

It wasn’t until their oldest son was in third grade and hospitalized with a life-threatening ailment that Gordon had a conversion experience. “I got down on my knees, and I said, ‘OK, you’ve got my attention, Lord.’”

After their son recovered, the couple joined a mainline Presbyterian church, where Gordon was baptized in 2000. Today they are part of the conservative evangelical Presbyterian Church in America. Elders of their church, Christ Covenant, support Rejoice’s mission.

Rejoice does not require employees or patients to share Gordon’s religious beliefs. Sarah Coe Atkinson, Rejoice’s senior embryologist, said, “I don’t necessarily believe in everything he believes in, but I believe in what we’re doing in terms of helping these embryos become lives.”

She oversees the lab, which accepts almost any embryo, no matter its condition. “Sometimes the ugliest embryos make the prettiest babies,” she likes to say.

When a couple received a donated embryo that had been frozen for nearly 31 years, Rejoice provided their care. The child, born in 2025, broke what is believed to be a record for the longest-frozen embryo to result in a birth.

To train others, Atkinson created a library of antiquated embryo storage devices and how to open them, cataloged in a binder with plastic sheet protectors. Instructions for an old glass ampule recommend a face shield with the warning: “Might explode.”

A Christian approach to IVF

Medical experts estimate about 1.5 million frozen embryos are stored in the U.S., though advocates say that number could be higher.

Gordon strives not to add to that. He tailors treatments around patients’ ideal family size. He specializes in offering IVF cycles with less fertility medication, which is more affordable and generally results in fewer eggs. Patients can also fertilize fewer eggs. Other clinics offer these options but Rejoice is unusual in prioritizing them.

The downside is if patients go through their small number of embryos and need another IVF cycle, which typically costs between $8,000 and $10,000 at Rejoice. Despite that expense, Gordon said his patients largely want to create fewer embryos because of their beliefs.

Emily Martin is haunted by the handful of embryos she has in storage. “I would wake up in the middle of the night just like, ‘Oh, what have we done?’ And just this heaviness,” she said.

An anti-abortion Christian in Knoxville, she wishes she had found Rejoice before making more embryos than she would use at another clinic. “That portion is something that’s not being talked about enough,” she said.

In rare cases when his patients have unused embryos, Gordon asks them to be placed for adoption. Embryo donations are known as embryo adoptions within conservative Christian circles, which view embryos not as property but as children.

The clinic recently launched Rejoice Embryo Rescue, which Gordon calls an “orphanage.” Rejoice stores donated embryos and works with agencies, most of them Christian, that specialize in coordinating embryo adoptions.

Adrienne and Colby McKnight had considered traditional adoption before they heard about adopting embryos through their homeschooling community in Augusta, Georgia.

They adopted an embryo they named Gloria, which had been frozen 11 years. When the embryo transfer did not end in pregnancy, they grieved but remained grateful.

“Really it’s just giving her a chance at life and just freeing her from being frozen,” Adrienne McKnight said. “Either way she gets to continue on. She gets to be with the Lord.”

Through Rejoice, they recently adopted two more embryos.

Bridging the worlds of IVF and religion

“It’s hard to be torn between your faith and your work,” Gordon said. Invoking a biblical passage, he said Christians are called to show “faith through our works.”

Rejoice has allowed him to reconcile those two things, though it’s been challenging. His relationship with the physician he bought the clinic from deteriorated, resulting in legal disputes.

Gordon has also faced criticism from other Christians and anti-abortion activists who believe any form of IVF is unethical.

“He’s moving in the right trajectory,” said Matthew Lee Anderson, a Christian ethicist at Baylor who opposes IVF. “It’s impressive that he’s taken the steps that he has to change how he is doing business, and I hope for more.”

Gordon does not regret starting over and plans to bring on more doctors.

One Sunday after church, he was back at the clinic. In the lab, Atkinson prepared a North Carolina couple’s frozen embryo so it could be transferred that afternoon.

As the embryo thawed, it unfurled in a culture dish, its cells plumping with rehydration. There in the lab was a chance at life, soon to be sent off with hope — and at Rejoice — a prayer.

Four weeks later, there was welcome news: The patient was pregnant.

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