Monday, May 25, 2009

Reducing Stress

One of the most annoying things that every woman who has experienced infertility has heard is "just relax and it will happen." Unfortunately, it is not that easy for most women who are experiencing infertility.

However, it has been proven that "stress" does inhibit fertility. Being stressed can inhibit or delay ovulation.  In men, it can reduce sperm counts.

Going through fertility treatments is one of the most stressful things you can go through: early morning appointments for blood tests and ultrasounds, injecting yourself or being injected with drugs everyday.  There is stress along the way worrying if everything is going as it should.  Add to this the financial strain of paying for the treatments and the difficulties of being late to work. And then the worst of all is the 2 week wait when you wait to find out if it worked for if it was all for nothing and you will have to return to square one and start all over again!

Reducing stress is one way to increase your odds of success. 

Some suggestions for reducing stress:

  1. Alternative healers.  Do acupuncture, shiatsu, reflexology.  Whatever you can fit into your schedule without it being more stressful (ie whatever you can schedule conveniently and isn't too big of a stain financially).
  2. Listen to meditative music.  In particular if you are doing an IUI or IVF, take along some music to listen to before/after procedures. 
  3. Listen to (or watch) something funny.  There's nothing like a good laugh to make you feel better.    
  4. Treat yourself when you need to.  


What do you do to reduce your stress levels?

Can you suggest any great meditative music?

Can you suggest any funny podcasts?

Thursday, May 14, 2009

Is a Fetus Alive? (part 2)

Is a Fetus Alive? (part 2) 
 Last week we discussed the position of Rabbi Waldenberg as recorded in his responsa, Tzitz Eliezer, that the unborn child is not considered to be alive in the eyes of the halacha. He based this opinion on the understanding of the Rambam, and particularly the relation between the words of the Rambam and those of the Mishna. 
But another halachic giant held the exact opposite; Rabbi Moshe Feinstein stated that the Rambam was clearly of the opinion that the unborn child is considered to be alive. Therefore, Rabbi Feinstein wrote, the Rambam had to employ the concept of the rodef in order to permit terminating a pregnancy, even when the mother's life is in danger. Since the fetus is alive and the mother is alive and we can only save one and not the other, it is forbidden to kill one person even in order to save another. However if one is a rodef then he must be killed to save the other. Therefore, Rabbi Feinstein held that it is forbidden to terminate a pregnancy under any circumstances, even if the child is ill and even if he will not be able to live afterwards. He was of the opinion that the pregnancy should continue and the child be born even if he will die soon afterwards.  Rabbi Feinstein writes that he felt a need to be strict in light of the large numbers of unwarranted abortions and that we need to take a stand and stop this wherever possible. He writes that he was shocked to see the opinion of Rabbi Waldenberg who allowed the termination of a pregnancy and he felt that one should not rely on this lenient opinion.  There is still, though, a question that remains. How come the unborn child is a rodef before he is born but not after he is born, when he still endangers the mother? Rabbi Feinstein answers that while we may not have a good answer to this it still does not compromise our halachic position since we see that none of the classic commentators on the Rambam disagree or even comment. We can therefore assume that the Rambam had an answer to this question, even if we do not know what it is. [Note that Rambam's word is K'RODEIF, like a Rodeif. Not a real one, but we will consider it so. - Ed.] He does offer one possible answer; that the unborn child is alive and has a soul but not a complete soul, and when we have to decide between saving the mother or saving the fetus, we save her. However when he is born they are on the same halachic level and so we are incapable of deciding who to save and must let nature take its course.  So we see that two halachic authorities of the same generation gave complete opposite psak based on the same Rambam. One allows the termination in certain cases and one does not allow it under any circumstance.  In such a case a person needs to seek specific halachic guidance.   
The Puah Institute for Fertility and Gynecology in Accordance with Halacha is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Puah offers free counseling in five languages, halachic supervision, and educational programs. Puah has offices in New York, Los Angeles and Paris. To contact the Puah Institute please call 1-800-071111 in Israel or in the US 718-336-0603. website: 

Wednesday, May 13, 2009

The Puah Institute left a meaningful impression at the Israel Fertility Association (IFA)

Puah at the Israel Fertility Association conference
May 11, 2009

The Puah Institute left a meaningful impression at the Israel Fertility Association (IFA) annual conference that took place 11-12 of May at the Dan Panorama Hotel in Tel Aviv.

Rabbi Udi Rath of the Puah institute with Dr. Idit Ben-Yair of the Shifra Institute gave an oral presentation at the general forum about a new PCT introduced by the Puah Institute. A PCT is the first test of male infertility that is done by taking a swab from the woman shortly after intercourse. There is absolutely no halachic issue with this test since it is done on the woman.  The problem in the past with the PCT test it is not often a good indication of whether there is an issue with the sperm.  There are many couples who have a poor PCT who go on to have a good SA (sperm analysis), and there are many couples with a good PCT who go on to have male factor infertility.

Dr. Ben-Yair showed a strong correlation between the results of a regular sperm test (that is Halachicly problematic) and the new PCT in providing a good first picture of the male factor condition.

The presentation was marked as outstanding and was one of four candidates for the annual award of the IFA.

In addition Puah counselors presented three medical Halachic posters at the conference. The posters dealt with: egg donation, ovariectomies of BRCA carriers and cryopreservation of ovarian tissue and oocytes – all of which drew attention from medical crowd.

Saturday, May 9, 2009

Is a Fetus Alive?

Last week we saw the words of the Rambam, that the reason that the Mishna permits terminating a pregnancy when the mother's life is in danger is due to the law of rodef, the pursuer. If this is the case, then why does the Mishna forbid killing the half born child to save the mother, surely he is still considered a pursuer the entire time that the mother's life is in danger? The answer to this query on the Rambam can provide an answer as to the halachic status of the embryo; is he considered alive or not? 
Rabbi Eliezer Waldenberg tz"l, the late halachic giant of Jerusalem, the posek for Sha'arei Zedek Hospital and one of the experts in halacha and medicine, was asked whether one can terminate the pregnancy of a fetus who is suffering from a serious congenital condition. In this case the mother was not in any immediate danger and so the case was not analogous with that of the Mishna. Rabbi Waldenberg allowed a termination to be performed based on the Mishna and on his understanding of the Rambam. He claimed that the Rambam was of the opinion that the unborn fetus is not considered alive since he does not have independent life; but once he is born he is considered a full life. The question then remains as to why did the Rambam employ the principle of the rodef? Rabbi Waldenberg answers, quoting a response of the Nodeh Biyhuda, that even though the fetus is not seen in the eyes of the halacha as being alive, still it has the halachic category of a treifa, a living being that does not have independent life. While it is less severe to kill a treifa than killing a person, still it is not permitted. However, since the fetus is endangering the mother and is a rodef, it is permitted to terminate the pregnancy. This would be the same if the fetus was suffering from a serious condition that would be very difficult to treat, in certain cases this would be grounds to terminate the pregnancy. One question remains, how come the fetus is only a rodef until he is born? Rabbi Waldenberg answers that the Rambam did not mean he is a rodef only that this situation is similar to the case of the rodef. He is like a rodef but not really a rodef and thus not all the laws of rodef are applicable. This is not a simple answer since the Rambam brings in this case in the first chapter of the laws of murder where he discusses the laws of rodef and brings this as a prime example. If it is only similar to a rodef then why does he bring this as the example? Also Rabbi Waldenberg understands that the word rodef in the Rambam is a noun, where there is evidence that it may be a verb which changes the understanding of the sentence. Still, Rabbi Waldenberg holds that the unborn fetus is not considered alive. Next week, the other side of the dispute...  

Sunday, May 3, 2009

Saving a Life or Stopping a Pursuer? (From Torah Tidbits)

Saving a Life or Stopping a Pursuer?  Last week we saw the Mishna that states that before the child is born we can abort him in order to save the mother's life, but once he is born or even the majority of the body is out of the mother then we cannot touch him since we do not push off one soul before another. This suggests that the unborn fetus is not considered alive and only receives the soul at birth. It is clear from the Mishna that the reason that before birth we do all that we can to save the mother's life but after birth we cannot interfere is that before birth he has no soul and only receives that afterwards. 
However, the Rambam brings this Mishna in his discussion of the laws of the rodef, the pursuer. It is a mitzva to stop the pursuer and not to be overly merciful. "Therefore" the Rambam writes (Hilchot Rotze'ach 1:9) "the Rabbis taught that when a woman is in danger during childbirth it is permitted to cut up the fetus either by hand or by a drug since he is like a pursuer to kill her. But if his head came out then we cannot touch him since we do not push off one soul for another and this is the nature of the world." The Rambam adds to the issue another element, namely that of the pursuer, and it is for this reason that we are allowed to kill the fetus. This does not appear in the Mishna and this addition changes both the understanding of the Mishna and the dynamic of the question. Since it now appears that were the fetus not a pursuer it would be forbidden to touch him and thus the Rambam appears to be of the opinion that the fetus is considered alive and only when he is a pursuer can he be killed. But according to this, the child is a pursuer for the entire time that he endangers the mother. Why then does the Rambam permit killing him prior to his birth but forbid it when the birth has reached a critical point, namely that of the head emerging? If the child is a rodef before the birth since he could kill the mother, then he should remain so even after until any danger has passed. These questions are not only academic but hold the key to understanding the halachic status of the unborn child. 


Short Film competition

Everyone who goes through infertility has a story. It is really encouraging for couples going through IF to read success stories. There's an inspiring story for everyone. The longer you go through IF though, the harder it is to find a story that inspires you because you are not going to be inspired by someone who went through way less than you did.

So, calling everyone out there who has a success story(the longer the journey, the better the story IMHO) can "win" with your success story.

The contest is sponsored by Fertility Lifelines and Resolve. Do it for your fellow IF sisters because as every IF'er knows $500 or $1000 doesn't go every far when you are paying for treatments.