Orthodox and other observant Jews have specific clinical and emotional needs while dealing with infertility. The 
Biblical commandment ‘to be fruitful and multiply’ (Genesis 1:28) can affect Jews of all denominations, particularly Orthodox Jewish couples who want to adhere to religious (halachic) interpretations.
Getting married and having children is a cultural and religious expectation in the close-knit communities in which they live. Not being able to conceive is very distressing, and couples can feel isolated and alone. Accessing effective infertility treatment can be another challenge. Not all clinics have the ability to provide treatment that conforms to halacha and the laws of family purity (taharat ha-mishpacha).
We provide specialized services to members of the Jewish community who want to observe Orthodox rituals and laws.
Halacha and Infertility
These issues surround the laws of family purity, which require the menstruating woman (known as niddah) to avoid physical contact with her husband for that time, plus seven additional blood-free days. Then, she enters the Mikva or ritual bath. The problem occurs when women detect ovulation before they can enter the Mikva. The consulting rabbi may give the couple special permission to enter the Mikva earlier or have intrauterine insemination for procreation.
We evaluate the woman using standard testing procedures, including hormonal and ovarian (egg) reserve evaluation with blood tests. In addition, it includes an exam of the uterus and fallopian tubes with saline ultrasound or radiologic contrast (HSG). Assessing the male is more challenging due to the prohibitions of masturbation and sperm production outside of the woman's body. We can perform a postcoital test to estimate semen quantity and quality. The lab examines a sample of cervical mucus microscopically four to eight hours after intercourse. If there appears to be sperm compromise, we suggest a semen analysis with the special condom (Milex) that does not kill sperm and can be prepared with a small hole in the tip to allow some escape of the sperm.
When fertility treatments such as ovulation induction and intrauterine insemination fail to achieve a pregnancy after a reasonable trial, in vitro fertilization may be considered. IVF is halachically acceptable.
We recommend preimplantation genetic testing for embryos developed in the laboratory, especially if the couple shares adverse carrier states, such as Tay-Sachs, and to ensure the transfer of a genetically normal embryo. Testing not only significantly lessens the chance of miscarriage but also decreases the risk of a multiple gestation pregnancy, making single embryo transfer more acceptable. Multiple gestation carries risks to the mother and the newborns. A rabbi or designated, trained individual may be present in the IVF laboratory at all stages, from procurement of sperm and eggs through the process of embryo transfer and cryopreservation of excess embryos.
In the event of poor oocyte (egg) or embryo quality and if repeated failure of in vitro fertilization occurs, the couple may desire to use an oocyte donor. There is no halachic consensus in this area regarding using a Jewish or non-Jewish donor. The couple must consult with their rabbi about the best path forward.
Treatment
- Ovulation testing
- Sperm collection
- Intrauterine insemination
- In vitro fertilization
- Preimplantation genetic diagnosis/screening
- Supervision
- Egg donation
Our Facility
Bonei Olam has reviewed our facility, and Dr. Blotner has been a sponsor and speaker for this organization. He has also been in contact with several rabbis involved in helping their community with infertility issues. He also has a relationship with PUAH, an organization specifically organized for supervision in in vitro fertilization.