Infertility Treatment for the Jewish Community

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, but 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, in which the menstruating woman (known as niddah) is required to avoid physical contact with her husband for that time period 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. In consultation with their rabbi, the couple may be given special permission to enter the Mikva earlier, or have an 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 as a rough estimation of 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..

Embryos developed in the laboratory may be tested via preimplantation genetic diagnosis, This is recommended if the couple shares adverse carrier states, such as Tay-Sachs, to ensure the transfer of a genetically normal embryo. This 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 its own 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

Our Facility

Our facility has been reviewed by Bonei Olam, 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 designed for supervision in in vitro fertilization.

Resources for the Jewish Community

Puah 

Bonei Olam 

A.T.I.M.E.

Yesh Tikvah, a monthly support group in Long Island

 

“Dr. Blotner and his staff are like family to me. I talk to Dr. Blotner every time I have an appointment. I am confident my care is in good hands and that important details won’t be lost because of poor communication. After driving eight hours to get to this office, I know he will be there at the end of my trip. A lot of clinics say they are with you every step of the way. But Dr. Blotner really lives that motto.”

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