Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Egg retrieval before mikveh

27 November, 2006

Question:

I am undergoing an IVF cycle and it looks like the egg retrieval procedure may fall out on the morning before I am supposed to go to the mikva. This poses several issues. Firstly, the procedure, in which a needle under ultrasound guidance is placed through the wall of the vagina to aspirate follicles from the ovary, creates a small amount of vaginal bleeding. At no time do any of the instruments enter the uterus or the cervix (I am a medical student and in addition to my own previous procedures I have seen many done on others and I know this to be absolutely true). The bleeding comes directly from the wall of the vagina itself. It is minimal and typically lasts a day or two. As far as I can tell, this should constitute a "makah ha yadua sh'motzi dam" and should not render me a niddah. However, would such a makah preclude tevilah? As far as I know, intercourse would be prohibited with such a makah but if tevilah is permitted than at least physical contact would be permissible.

If tevilah is permitted, I would have to do one final bedikah in the morning before the procedure. I believe it would be preferable to do the bathing before the procedure as well, since in theory physicians do not like their patients to bathe/swim following a procedure because of the increased risk of infection. However, I have discussed tevilah with my doctor and she thinks that for a quick dunk in the mikvah the risk is likely very small but a longer bath would certainly raise the risk of infection at least a little bit.

If tevilah with a makah ha yadua sh'motzi dam is not permitted I would have to wait until the bleeding subsided. Would I need to perform another bedika to prove that the bleeding has stopped. Could I rely on the kulah to use a shower as chafifah to eliminate the risk of bathing after the procedure?

Thank you.


Answer:

1) Bleeding following egg retrieval is considered dam makkah (blood from a wound).  Even so, it is critical to have a bedikah on day seven of the clean days.  If your procedure is on day seven, you satisfy this requirement by performing a bedikah the morning of the procedure.  (If not, please get back to us.)  Therefore, you should do one bedikah in the morning before the procedure, and you may ignore the bleeding which follows and immerse as usual. Do not perform another bedikah after the procedure!

2) Dam makkah does not put one in niddah. Therefore, technically you can have relations while bleeding from the procedure. However, since finding blood after relations can lead to a number of halachic dilemmas, it is preferable to avoid relations until the bleeding has subsided, freely engaging in other physical contact. We stress, this is a precaution alone, and relations are not technically forbidden when bleeding from a makkah (if they were, you would not be permitted to immerse either).

3) Regarding preparation for the mikveh, we suggest you bathe before the procedure, taking only a quick shower immediately prior to immersion. Most importantly, be sure to check for any barriers carefully and thoroughly before you actually go into the mikveh.

Behatzlachah!


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