Tuesday, September 5, 2017

Which Kind of Fertility Treatment is Permitted in the Torah?

Ask the Rebbetzin - Parasha Ki Tavo
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Dear Rebbetzin Chana Bracha,
I am a convert and married late in life, when I was 47. I’m very happy with my husband who also was never married beforehand. Since none of us have any children, we both really want to do everything possible to be able to build our Jewish family, and we are aware that because of my age we need to move fast. According to the doctors, the only way we will be able to have a baby of our own is through in vitro fertilization (IVF) and egg donation. We want to make sure to do everything right according to Jewish law, and we are aware that there are delicate issues involved. Therefore, before moving ahead I’d like your Torah perspective on these various fertility treatments. We are also concerned how to be able to afford fertility treatments and wonder if you may have any advice for us. Please share with us anything else that you believe we need to know before proceeding with the fertility procedure.
Miriam Gutkind (name changed)

Dear Miriam,
First of all mazal tov! I’m happy for you that you are happily married. What a great blessing. I completely identify with your yearning to bear children and raise your own Jewish family. This is not only your personal desire, but also the very first mitzvah in the Torah, “Be fruitful and multiply” (Bereishit 2:22 and 28). We live in very exciting times, when so many new fertility treatments are available to help us fulfill this important mitzvah. I believe that the new research and technology related to infertility, pregnancy, birthing and pre- and postnatal care, is all part of repairing the curse on Chava involving not only difficulties in pregnancy, birth and childrearing, but also includes the pain of the period, as well as the pain of infertility.

Fertility Treatments Need Rabbinic Supervision
I commend you on your wish to undergo fertility treatment according to Halacha (Jewish law). Many intricacies are involved in fertility treatments that need Rabbinic supervision. Halachic supervision is required in all fertility treatments, in order to verify the halachic identity of both the sperm and eggs involved. If it is a third party donation, it is necessary to ensure that the correct donor’s eggs are used as well as the husband’s sperm. We are fortunate in Israel to have PUAH Institute, under the guidance of Rabbi Menachem Burstein, which certifies the genetic integrity of fertility treatments worldwide. It furthermore provides counseling, referrals and support, free-of-charge, to all those seeking professional help, by halachic counselors trained in modern reproductive medicine. I recommend that you and your husband get in touch with PUAH institute, and speak with some of their Rabbis who will explain why IVF is okay according to Jewish law, and the different halachic opinions regarding ovum donation. I personally believe, that the revelation of new discoveries and technology, which help us fulfill the mitzvah of being fruitful and multiply are G-d sent. I’m sure that there is great reward for those who make the extra effort and take on the extra expense for the sake of bringing children into this world.

How Can We Afford Fertility Treatments?
Regarding the finances, this is a tough question. Without the money to finance the costly fertility treatments, it is not easy to undertake the procedures. PUAH Institute advises that a couple considering fertility treatment should review their finances and identify all anticipated costs in advance. The cost of IVF is expensive, and egg donation includes the additional cost of the donor. The procedure furthermore, in many countries might not be covered by insurance. In Israel, socialized medicine (Kupat Cholim) covers the major expenses of IVF and egg-donation for couples who do not yet have any children or have only one child, up until age 54 for the woman. All Rights, a non-profit, collaborative project, has an extensive list of resources about rights and entitlements in Israel, including the financial coverage of fertility treatments. It is good to know that IVF treatments are included in the healthcare basket for first and second children. You will need to complete your Aliyah process and subscribe to a Kupat Cholim in order to qualify for the financial subsidies from the State of Israel.

Who is the Halachic Mother?
There are different opinions regarding the halachic permissibility of egg donation. An increasing numbers of rabbis permit this procedure, when other fertility treatments have been exhausted, and it is clear that the woman doesn’t produce her own eggs or that they are no longer viable. In this case, egg donation is the last resort to enable her to have her own baby. It is vital that you consult either with your personal Rabbi or a PUAH counselor to determine if ovum donation is permitted in your case. There are three different rabbinic opinions regarding who is the halachic mother of the child born through ovum donation: the birth-mother, the donor or both. According to the opinion that the birth-mother is the halachic mother, the child is Jewish even if the egg donor is not. According to the opining that the donor is the halachic mother, the child’s Jewishness depends on the donor. Since the halachic definition of the mother is questionable, most hold by the third opinion, that it is good to be strict in all cases. According to this view, the child is only considered Jewish if both the birth mother and the donor are Jewish. If only one of them is Jewish, the child must undergo conversion to eliminate any doubt regarding his or her Jewish identity. PUAH institute concludes: “In order to satisfy all opinions, the optimum donor is a single Jewish woman. However, such a donor is not always available. Each couple should consult their Rabbi or a PUAH counselor to determine the best option for their specific circumstances.”

The Fruit of our Womb Depends of Hashem’s Blessing
With all the advanced technology, let us not forget that everything is up to Hashem. It all depends on His blessing. By interacting with nature through modern technology, the complex miracle of creating an infant becomes even clearer, making us tremble in hope and pray for the success of each stage. We need to be aware that the fruits of our womb are a blessing from G-d alone. It is included in this week’s parasha among the blessings:

ספר דברים פרק כח פסוק ד בָּרוּךְ פְּרִי בִטְנְךָ וּפְרִי אַדְמָתְךָ וּפְרִי בְהֶמְתֶּךָ שְׁגַר אֲלָפֶיךָ וְעַשְׁתְּרוֹת צֹאנֶךָ:
“Blessed be the fruit of your womb, the produce of your soil and the offspring of your cattle, the calving of your heard and the lambing of your flock” (Devarim 28:4). 

Prayer can make all the difference. While it is important to get your family and friends to pray for you, your own prayer is most important. You need to storm the gates of heaven with your heartfelt supplications, like Chana, the mother of our prayer, who poured out her soul to Hashem (I Shemuel 1:9-15). It is not surprising that it is a segula (spiritual remedy) to recite Pirkei Chana (I Shemuel 1-2:10) every Friday night, which is the Haftorah for the first day of Rosh Hashana. Rabbi Nachman also has special prayers for bearing children (Likutei Tefilot part 1, prayer 21 and prayer 60). Furthermore, in the prayer book for women called תפילת חנה השלם/Tefilat Chana HaShalem – Chana’s Complete Prayer, you will find a beautiful prayer on pp.191-209.

Lastly, here is a prayer I composed when I went through fertility treatments 21 years ago:
“Oh G-d, please answer my prayers. Please grant me fruits of the womb.  I can no longer bear being a barren tree who yields no fruit, year after year after year. Until when? I only want to fulfill my purpose as a woman. If it is Your will that I be blessed after having voiced my prayer, please Hashem help my prayers reach Your inner sanctuary to pull down a new soul into the world!”

I bless you success in each of the stages of your fertility treatments. May Hashem accept your heartfelt prayer to enable you to fulfill His will by bringing children into the world!

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