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

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Fertility Treatment

Difficulty conceiving or carrying a child affects approximately 20% of all couples at some time in their lives. Fortunately, there have been significant advances in the treatment of infertility in recent years.

Medical intervention for the purpose of achieving pregnancy is halachically permitted and even encouraged when needed. In this article, we briefly discuss the most common fertility treatments, along with some of the halachic questions that they raise.

In practice, each individual situation requires direct consultation with a halachic authority who has experience in this area and can work in concert with medical professionals sensitive to the halachic needs of their patients.

As of Spring 2020, Yoatzot Halacha Fertility Counselors provide free consultations to help guide couples through their fertility journey.

Shabbat and Yom Tov

It is best whenever possible to avoid scheduling fertility procedures on Shabbat, Jewish holidays, or fast days, and to share this scheduling concern with one’s healthcare team in advance. In Israel, it is common not to schedule any cycles during the month of Tishrei, since the frequent holidays greatly complicate scheduling.

In general, if there is a way to schedule or move a procedure so that it does not fall out on Shabbat or Yom Tov, that is the preferred course of action. In some cases, a procedure can be moved to the preceding afternoon, or the following night. However, when there is no alternative, it is often possible to permit procedures on Shabbat or Yom Tov under certain conditions in consultation with a halachic authority. This is because a woman undergoing fertility treatments has the halachic status of one who is ill, which means that non-Jews may perform labor for the purpose of her treatment on Shabbat as necessary. Matters to discuss include travel, lodgings, and which procedures may be performed by whom.

Artificial Insemination

Artificial insemination, intracervical (ICI) or intrauterine (IUI), may be used to assist sperm that cannot easily reach the egg (ovum). IUI is more effective and thus far more prevalent in clinical settings. In this procedure, washed sperm are inserted directly into the uterus through a catheter.

Artificial insemination can be performed either with the husband’s sperm or with donor sperm. The latter raises more halachic concerns but may be permitted after individual halachic consultation. There is halachic debate as to whether it is preferable to use sperm from a Jewish or non-Jewish donor. A Jewish donor’s sperm should only be used if the identity of the donor is known, thus preventing the prospect that children of the same anonymous donor could unwittingly transgress the prohibition on incest.

When necessary, insemination is generally permitted during niddah. This follows the view that conception during niddah is viewed negatively only when it is accomplished through prohibited relations.

Artificial insemination during the clean days

There is a range of views on how insemination affects counting the clean days, so a woman should ask an individual question if this situation arises.

According to a number of halachic authorities, artificial insemination creates a pause within the clean days, since sperm is itself a source of ritual impurity. Our founding halachic supervisor, Rav Yehuda Henkin ztz”l, required a 4-day pause in the clean days–the day of the procedure, and the next three days. (For example, if insemination takes place on Monday, which should be day 5 of the clean days, the woman does not count Monday-Thursday. Friday is her new day 5, and she immerses in the mikveh on Sunday night.) This is based on the same halachic principle as the minimum wait before the clean days, see here for a detailed discussion.

Our current halachic supervisor, Rav Kenneth Auman, would apply that ruling to ICI (or to at-home insemination). However, he does not generally require a long delay following IUI, because the insemination is pinpointed into the uterus. He would instruct a woman to pause her count just for the day of the procedure, and to clean herself internally before resuming her clean days. In practice, this would mean delaying mikveh by one night from the original schedule. (For example, if IUI takes place on Monday, which should be day 5 of the clean days, the woman does not count Monday. Tuesday is her new day 5, and she immerses in the mikveh on Thursday night.) If this would place stress on the couple or if there are extenuating circumstances, then he would permit immersion to take place as originally planned, without delay, even when IUI occurs during the clean days.

Assisted Reproductive Technology (IVF, ICSI, etc.)

In IVF (in vitro fertilization), eggs (ova) retrieved from the wife’s ovaries are placed in a petri dish with sperm from the husband and allowed to combine. In ICSI (intracytoplasmic sperm injection), a sperm cell is inserted directly into an egg cell. The embryo resulting from either procedure is then implanted into the wife’s uterus. Egg retrieval and embryo transfer are both permitted during niddah.

Assisted reproductive technology may be used for a number of reasons. For male factor infertility, IVF or ICSI may work where IUI does not. IVF may also successfully bypass structural female factors of infertility.

Supervision: To prevent even a slight chance that egg or sperm cells from different patients might be accidentally switched, some rabbis require additional halachic supervision for procedures such as IVF. Some fertility laboratories have their own supervision (see Halachic Supervision for Assisted Reproductive Technology). Machon Puah can arrange this service world-wide where requested.

Surplus Embryos: ART procedures often produce surplus embryos that will not be implanted. It is halachically permissible to destroy such embryos or to preserve them for future use. They may not be implanted in other couples.

Egg Donation and Surrogacy

To learn more about egg donation and surrogacy, click here.


To learn more about fertility treatments and fasting, click here.

Gynecological Procedures

Some of the procedures involved in infertility treatments may entail significant uterine dilation, or lead to uterine bleeding that may make a woman niddah. In scheduling a procedure, it is important to take into account the possibility that it could cause niddah or make it difficult to count the clean days, to minimize extra time in niddah.

Before and after a procedure, a woman should ask as many halachic questions as necessary, ideally to a halachic authority with a good understanding of the medical issues involved.

To receive an accurate halachic ruling, it is also important to clarify details of the procedure with one’s physician, ideally in advance: what instruments are used in a procedure and their size, what if any bleeding can be expected and for how long, and if there was any specific trauma from the procedure.

Ovulation Induction

In women who rarely or never ovulate, oral anti-estrogens or follicle stimulating hormone injections may be used to induce ovulation. This process is tracked with serial ultrasounds and blood tests. These medications may lead to irregular spotting. Halachic guidance can help women undergoing induction to avoid being niddah at the time of ovulation, or to navigate being niddah at the time of ovulation.

Pregnancy Loss and Neonatal Loss

To learn more about pregnancy loss and neonatal loss, click here.

Semen Collection for Treatment

Procurement of semen for treatment purposes is generally halachically permissible, and not considered hotza’at zera levatalah. For more discussion of methods of collection, see here.

Sperm Donation

In some cases, donor sperm is needed for ART. Some halachic authorities have considered the possibility that, for a married woman, conception with donor sperm would be prohibited (as an extension of adultery), with negative consequences for the child’s halachic status. Current consensus, however, is to permit use of donor sperm without negatively affecting the child’s status, because no act of forbidden relations is involved.

Use of sperm from a non-Jewish donor is permissible, because Jewish status depends only on the mother. A Jewish donor’s sperm should be used only if the identity of the donor is known or listed in a registry, in order to rule out an unwitting future marriage between halachic siblings. (At this point in time, the medical establishment is less concerned than the halachic establishment about the chances of sibling marriage, because the statistical odds are very low.)

Testicular Surgery

Treatment of male infertility may require testicular surgery. Such procedures need to be discussed in advance with a halachic authority.

Updated November 2023.

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All health and health-related information contained within Nishmat's Women's Health & Halacha Web site is intended to be general in nature and should not be used as a substitute for consulting with your health care professional. The advice is intended to offer a basis for individuals to discuss their medical condition with their health care provider but not individual advice. Although every effort is made to ensure that the material within Nishmat's Women's Health & Halacha Web site is accurate and timely, it is provided for the convenience of the Web site user but should not be considered official. Advice for actual medical practice should be obtained from a licensed health care professional.

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