Blending tradition and technology: From Torah Scrolls to Test Tubes
In a recent conversation with a Jewish OBGYN following the unsettling events of October 7th, he reported a surge in couples inquiring about fertility treatments and assistive reproductive technologies. It is remarkable that when engulfed in calamity, the Jewish spirit instinctively seeks out light to dispel darkness and build new life.
Like our forefathers in this week's Torah portion, as many as one in ten couples experience difficulty becoming pregnant. In recent decades, reproductive medicine has developed advanced diagnostic and treatment methods. Judiaisim champions life and sees procreation as a central mitzvah. In this essay, we will attempt to clarify whether a couple struggling with fertility must undergo fertility treatment to fulfill the Mitzva of Pru uRevu despite the associated costs, possible pain, discomfort, and inconvenience.
The Mitzva of "Pru uRevu"
The Gemara in Yevamos (61b) records a dispute between Beis Shammai and Beis Hillel regarding the parameters of the Mitzva of Pru uRevu. According to Beis Hillel, one has only fulfilled the Mitzva when one has fathered a son and a daughter. Later codifiers rule that the Halacha follows Beis Hillel (Rambam, Hilchos Ishus 15:4).
Is a Woman Obligated in Pru uRevu?
The Mishna in Yevamos (65b) records a dispute between the Tana Kama and R' Yochanan regarding whether a woman is obligated in the Mitzva of Pru uRevu. The Tana Kama holds that she is not the Rambam (Hilchos Ishus 15:2) and other Poskim (see Shulchan Aruch E.H. 1:13) rule per the Tana Kama.
The Meshech Chachma (Bereishis 9:7) famously explains that the reason that the Torah did not obligate a woman in Pru uRevu is because "Deracheha Darchey Noam" (the Torah's ways are pleasant). The Torah never obligates a person to do something that places one in danger. Since women put their lives in danger through pregnancy, labor, and delivery, the Torah does not obligate them to bear children directly.
Though a woman is exempt from Pru uRevu, if she chooses to marry, she has an obligation to bear children. While finding the exact halachik mechanism for this requirement is difficult, the responsibility to bear children may be one of several marital obligations that she undertakes when she is married. (Her husband similarly assumes several obligations that are understood to be a part of his role.)
Fulfilling Pru uRevu through Assisted Reproductive Technology
Rav Shlomo Zalman Auerbach zt" l (cited in Nishmas Avraham 5, p113) ruled that "a couple has no obligation to undergo IVF in order to fulfill Pru uRevu ."No reason is provided for his ruling, and he held that doing so is beyond the extent to which a person is obligated to exert himself to fulfill a mitzvah.
However, it is reasonable to assume that Rav Shlomo Zalman reasoned that the Mitzva of Pru uRevu only obligates a person to engage in a regular manner in which the Torah expects one to bear children. Some say that the parameters of the Mitzva are tied to those of the Mitzva of Onah and, therefore, a person who is only obligated by the Mitzva of Onah to engage in sexual intercourse as a couple and not do so more to fulfill Pru uRevu. Many Acharonim wonders why this would be the case. Still, the most logical explanation is that by its very nature, the Mitzva of Pru uRevu is only an obligation to attempt to procreate. Nobody can determine whether one's efforts in this regard will bear fruit. Therefore, the obligation is only to engage in reasonable, normal Hishtadlus – each couple according to its situation. Perhaps, in Rav Shlomo Zalman's view, this Effort does not include fertility treatments either.
If this is the case, whether the treatment is standard or readily available would likely make no difference. Though today, most couples decide to undergo treatment, it still cannot be described as a natural method of procreation. Therefore, there would be no obligation to do so.
However, treatments that help a couple procreate naturally(such as methods to regulate ovulation) would be considered within the realm of regular, normal Hishtadlus (as they resemble any other form of medical treatment), and the couple may be obligated to undergo them. (See the Chelkas Yoav 1, which rules that if a person can undergo medical treatment that will allow him after that to perform a certain Mitzva, he is obligated to do so, and if he does not, it is not considered an Ones.)
Adapted from https://medicalhalacha.org/2020/06/24/may-a-woman-refuse-fertility-treatment/