Volume 36 Number 68
                 Produced: Wed Jul 10 21:49:48 US/Eastern 2002

Subjects Discussed In This Issue: 

Fertility Drugs Mandatory? (8)
         [Akiva Atwood, Shmuel Ross, Eitan Fiorino, Deborah Wenger,
David Yehuda Shabtai, Frank Silbermann, Yisrael and Batya
Medad, Leah S. Gordon]
Is being a nida required? (4)
         [Jonathan & Randy Chipman, Ben Katz, smeth, Leah S. Gordon]
Twins/fertility drugs
         [Roger & Naomi Kingsley]


From: Akiva Atwood <atwood@...>
Date: Mon, 08 Jul 2002 13:42:03 +0300
Subject: RE: Fertility Drugs Mandatory?

> This got me to wondering.... do some poskim interpret the issur of
> birth control to mean that if a couple can't conceive without
> fertility drugs, that it is mandatory that she always take them?  This
> seems a bit

I asked a local MD who works with fertility treatment -- he doesn't know
of ANY posek who requires drugs.

He knows several who discourage them.


From: Shmuel Ross <shmuel@...>
Date: Mon, 8 Jul 2002 04:35:43 -0400 (EDT)
Subject: Re: Fertility Drugs Mandatory?

Tzadik Vanderhoof <tzadikv@...> wrote...

> Since this couple has had a string of 3 multiple births (one of which
> was triplets!), I think it's safe to assume that she is using fertility
> drugs.

   I would question this assumption.  You don't say whether these were
identical or fraternal twins/triplets; if the former, drugs probably had
nothing to do with it.  If the latter, while fertility drugs are a
possibility, it's also the case that fraternal twins tend to run in
families.  (Some women naturally release more than one egg at a time,
and there seems to be a genetic basis for this.)

   With that said, your question -- would anybody require the use of
such drugs once the basic "pru u'rvu" requirement is satisfied (assuming
that that is, in fact, the question; you didn't say whether the five
children born to that point included at least one of each gender) -- is
still a valid one.


From: Eitan Fiorino <tony.fiorino@...>
Date: Mon, 8 Jul 2002 08:27:20 -0400 
Subject: RE: Fertility Drugs Mandatory?

> From: Tzadik Vanderhoof <tzadikv@...>
> This got me to wondering.... do some poskim interpret the 
> issur of birth control to mean that if a couple can't conceive without 
> fertility drugs, that it is mandatory that she always take them?  
> This seems a bit extreme, and I'd like to know if anyone knows 
> about this.  The closest thing I've heard to this is a report 
> that a certain rabbi forbids breast feeding longer than 6 months, 
> because it prevents conception.  This "mandatory" use of fertility 
> drugs would seem an even more extreme view.

None of major poskim that have written on infertility treatments have,
to my knowledge, ever indicated that to undergo treatment for
infertility is anything more than an option.  However, the teshuvot that
I am familiar with relate to more invasive treatments rather than simply
taking a medication like Clomid (clomiphene).  It should be noted that
even an apparently "benign" treatment such as taking Clomid entails
health risks (long-term side effects, adverse events, etc.) and it would
seem highly questionable that one could halachically compel someone to
assume such risks in order to achieve a pregnancy.  This is especially
true since there is no certainty that pru urevu will be fulfilled even
if the person is compelled to undergo treatment.

As for the rabbi who has poskined against the the global recommendation
of pediatricians (that breast feeding go one for 12 months because of
meaningful health benefits to the newborn) - that is a psak that I would
not want to have to answer for when I meet my Maker . . .

Tony Fiorino, M.D., Ph.D.
Equity Research Analyst - Biotechnology, Citigroup Asset Management
100 First Stamford Place, Stamford, CT 06902
Phone: (203) 961-6238, Fax: (203) 602-6045

From: Deborah Wenger <dwenger@...>
Date: Mon, 8 Jul 2002 08:03:23 -0400 
Subject: RE: Fertility Drugs Mandatory?

I don't know about all poskim, but a (frum) fertility specialist of my
acquaintance was vehemently opposed to such practices - and I'm sure
that he had consulted with his own posek on this. He told me of a frum
couple with 5 children, who came to him because they were having trouble
conceiving #6. He asked them, "How many children do you want to have?"
They naturally replied, "As many as Hashem wants us to." The doctor
answered, "Well, maybe this is Hashem's way of telling you this is the
number of children He wants you to have," and refused to prescribe
fertility drugs for them.

Deborah Wenger

From: David Yehuda Shabtai <dys6@...>
Date: Mon, 8 Jul 2002 16:34:05 -0400 (EDT)
Subject: Fertility Drugs Mandatory?

Breast feeding is not a fail safe way to inhibit conception, there are
many cases where women have become pregnant while nursing a child.  As
such, it seems a bit extreme to prohibit an action that is SO beneficial
to the child (there are many studies about how valuable breast feeding
can be when it is possible) since it may limit conception during that

David Shabtai

From: Frank Silbermann <fs@...>
Date: Mon, 8 Jul 2002 07:51:04 -0500 (CDT)
Subject: Re: Fertility Drugs Mandatory?

In v36 n62 Tzadik Vanderhoof heard a report that "a certain rabbi
forbids breast feeding longer than 6 months, because it prevents

Breast feeding does not eliminate fertility; it merely reduces it.  The
same could be said for taking a job as a traveling merchant or sailor,
which the Torah did not forbid.

Of course, the sailor travels in order to make a living so he can better
provide for his family; but likewise a mother breastfeeds, say, her
nine-month old child in order to better provide for its needs.

Is there are Torah distinction between beneficial practices
(e.g. traveling on business) that have a by-product of reducing
fertility by reducing sexual behavior, versus beneficial practices which
happen to reduce fertility without reducing sexual behavior
(e.g. breastfeeding)?

If not, what would be the basis for such a prohibition?  (Or is a
halachic basis even required for a prohibition that a rabbi believes
would benefit his community?)

Frank Silbermann
New Orleans, Louisiana

From: Yisrael and Batya Medad <ybmedad@...>
Date: Mon, 08 Jul 2002 16:46:42 +0200
Subject: Re: Fertility Drugs Mandatory?

1- some people want more than five children, so they use fertility
medication if necessary.
2- Babies should drink human milk for more than six months.  It's
healthier.  Any rabbi who demands weaning at six months to increase human
reproduction shouldn't be trusted in anything else.  Women are not baby
machines, and nothing should be done that could adversely affect the
health of the baby.  Rabbis are neither pediatricians nor gynecologists.
3- Sometimes rabbis make specific decisions for people, specifically and
exclusively for them.  These decisions are not meant for anyone else.


From: Leah S. Gordon <leah@...>
Date: Mon, 08 Jul 2002 17:11:20 -0700
Subject: Fertility Drugs Mandatory?

1. From my understanding, women would *never* be halakhically mandated
to use fertility drugs; we women are not even obligated to have
children, as this is a case when it would make it then a mitzvah to
endanger our lives.  (The reproductive obligation falls on men.)

2. The situation in (1) is the rationale for women to use birth control
in a wider set of circumstances than immediate lifethreatening
pregnancy, by those who permit it.

3. I have never heard of any rabbi recommending, let alone demanding, a
shortened breastfeeding term.  The Torah/gemara sources I remember
recommend a weaning age of 4yo or 5yo for sickly children.
Breastfeeding is widely known to be the default, natural way to feed
babies and toddlers.  Formula, for that matter, may be forbidden because
it can endanger lives (both maternal, from breast cancer, and child,
from diarrhea).  By the way, breastfeeding is not a contraceptive in any
reliable way.

--Leah Gordon


From: Jonathan & Randy Chipman <yonarand@...>
Date: Wed, 03 Jul 2002 16:58:07 +0300
Subject: Re: Is being a nida required?

In v36n50, Seth Lebowitz <SLebowitz@...> asks:

<<I recently read in the paper that some physicians are recommending to
female patients that they use certain medical methods to cause them to
menstruate less frequently (such as a few times a year or even
indefinite suspension of menstruation).  These methods also prevent a
woman from getting pregnant.  I thought that this raised an interesting
halachic issue.  Assuming there is a married woman who is
halachically required to use birth control indefinitely (say that
becoming pregnant would definitely endanger her life).  Is this woman
permitted to do what was discussed in the newspaper article --i.e. use
birth control pills in such a way that prevents her from menstruating at
all?  In other words, is there any requirement that a married woman
become a nida so that all the associated laws restricting contact with
her husband will apply, or do these laws just apply if a woman does
become a nida?>

Withot answering the question as such, I know of cases where Orthodox
women used regular birth control pills (i.e, estrogen) beyond the usual
20 days so as to prevent menstruation for specific occasions (e.g., a
wedding and/or honeymoon trip, a long-planned romantic vacation with
their spouse, etc.), for a limited time (a week or so).

      I find it hard to believe that habitual use of such methods, which
wreak havoc with the woman's natural hormonal balance, may not have
deliterious, unexpected effects on her overall health.  But I'm not a
doctor, and if control experiments show otherwise (a point that must be
checked) who am I to argue?  As for the major question raised: I've
never heard of such a requirement.  After all, in midde age the state of
nidah ceases entirely, and middle-aged andf older people have perfectly
proper halakhic marriages, without the bother and frustration of niddah,
tevilah, etc.  But that's an off-the-cuff answer, and I have not checked
out the teshuvot, etc.  

Rav Yehonatan Chipman, Jerusalem

From: Ben Katz <bkatz@...>
Date: Fri, 5 Jul 2002 14:35:00 -0500 (CDT)
Subject: Re: Is being a nida required?

        I can't imagine that a woman is required to be a niddah.  There
are many reasons that a woman may not menstruate -- e.g., she has her
uterus removed for bleeding during childbirth or cancer.

From: smeth <smeth@...>
Subject: RE: Is being a nida required?

Seth Lebowitz asks if being a niddah is required (his example: is a
woman who is hallachically permissible to use birth control permitted to
use one which prevents her from menstruating entirely).

Sevara [logic] says no.  If it was required, post-menopausal woman would
have to take a drug which MAKES them menstruate.  Clearly
post-menopausal women are not required to do so.

From: Leah S. Gordon <leah@...>
Date: Tue, 02 Jul 2002 17:33:04 -0700
Subject: Is being a nida required?

I would be shocked if there were a source disallowing the cessation of
menstruation for the following reason: the current anthropological
belief is that until relatively recently (a few hundred years), it was
rare for a woman to have very many periods.  She might have one or two
irregular ones at first and a relatively late (by our standards)
menarche, then spend much of her life pregnant or lactating, then have a
relatively early (by our standards) menopause.  Meanwhile, lactating
would (in these times of less abundant food and no formula supplmenting
at all) usually cause lack of menstruation.  Also, remember that the
original nida laws were much stricter for disease-type emissions than
for menstrual-type emissions.

If there were some requirement to menstruate, then what would happen in
the not uncommon case today when a breastfeeding woman doesn't
menstruate for up to a couple of years, or when an athletic woman stops
getting [regular] periods?

By the way, an interesting aside is that birth control pills seem to be
associated with a large increase in women's health (lower risks of lots
of diseases)...thus perhaps there is a halakhic requirement to use them
instead of e.g. an IUD in cases of permitted contraception?

Leah Gordon


From: Roger & Naomi Kingsley <rogerk@...>
Date: Mon, 08 Jul 2002 18:13:15 +0300
Subject: Twins/fertility drugs

<< I just heard about an Orthodox couple who just had twins.  Their
previous births were twins and triplets.  Now it's a medical fact that
multiple births are exceedingly rare without the use of fertility drugs.
Since this couple has had a string of 3 multiple births (one of which
was triplets!), I think it's safe to assume that she is using fertility
drugs.  It would also seem that she took fertility drugs even after she
already had 5 children. ......>>

Just addressing the BIOLOGICAL part of the above post, twins occur in
one/80 normal births [without fertility drugs]. However, once a couple
has had twins [or even if he/she comes from a family with twins], they
are much more likely to have more twins [or triplets]. Thus,
'exceedingly rare' is perhaps too strong [we all know families with
twins, and they are by no means all - or even most - from the use of
fertility drugs], and it is certainly unwarranted to assume the use of
such drugs just because there are 3 sets of multiple births in this
family. It is more likely that whatever biological factor(s) predisposes
to twins is unusually strong in this family.

Naomi Kingsley


End of Volume 36 Issue 68