Artificial Insemination, Egg Donation, and Adoption

Rabbi Elliot N. Dorff

The Blessing of Children, the Pain and Prevalence of Infertility

Children are seen within Jewish sources as one of God's chief blessings. Moreover, Jewish law understands propagation not only as a blessing but as a commandment. One fulfills that duty when one has two children, but one was supposed to have as many children as possible, for, as Maimonides says, "whoever adds even one Jewish soul is considered as having created an (entire) world."

Couples, though, cannot always have the children that both they and the Jewish tradition would like. This is not new. In the Bible itself, Sarah, Rebecca, Rachel, and Hannah all have trouble conceiving and bearing children. In our own time, one in seven couples in the United States is infertile, where "infertile" denotes a couple that is actively trying to have a child over the period of a year and cannot conceive.

Since Jews go to college and graduate school in percentages far exceeding the national norm, they generally do not even try to have children until their late twenties or thirties. That compounds the problem for Jews yet further, for infertility increases with age: 13.9% of couples where the wife is between 30 and 34 are infertile, 24.6% where the wife is between 35 and 39, and 27.2% where the wife is between 40 and 44.

As many as 1.2 million patients are treated annually in the United States for infertility problems, with approximately one billion dollars spent each year on their care. Even so, for as many as one in five infertile couples, a cause is never found, and as many as half the infertile couples seeking treatment are ultimately unsuccessful, despite trying various avenues of treatment.

When couples cannot conceive, they often feel anger, dismay, and even guilt and shame. Contemporary fertility techniques provide new hope to such couples, and we certainly rejoice with them when they succeed in having the children they want.

Whenever we can do something new, though, we must ask the moral and legal question of whether we should do so. The new methods of achieving conception come with some clear moral, financial, communal, and personal costs which must be acknowledged and balanced against the great good of having children.

Artificial Insemination

Infertile couples may take advantage of fertility drugs and other techniques which may help them have children. When such interventions do not work, artificial insemination is permissible, but it is not required. The commandment to procreate ceases to apply to those who cannot do so through sexual intercourse.

Masturbation may be used to procure the semen for artificial insemination. If the husband's semen can be used, he fulfills the commandment to procreate through artificial insemination and is the father in all respects (e.g., in regard to the child's priestly status).

If the husband's semen cannot be used, donor insemination (D.I.) is permissible. The donor is the father according to Jewish law; the social father is his agent. The social father, though, fulfills many other commandments by raising children conceived through D.I. Because of the lack of genital contact, D.I. does not constitute licentiousness or adultery, and so the child conceived is fully legitimate.

Children born through D.I. and raised in the same home are prohibited to each other as sexual partners and as candidates for marriage. If their mother is the same woman, the Torah itself prohibits this since they are biologically half-brother and half-sister. If they do not have the same mother or father (i.e., both the egg and the sperm were donated), the Conservative Movement's Committee on Jewish Law and Standards (CJLS) prohibits such marriages under the rabbinic category of relatives of the second degree in recognition of the strong influences of growing up in the same household.

The donor may insist on confidentiality, but as much as possible about his medical history and personal characteristics should be revealed to the social parents and to the child. This will avoid the genetic and halakhic problems of potential incest in the next generation and will give the child a strong sense of his/her genetic and personal history.

In considering whether to use donor insemination, the couple should understand the psychological pitfalls of the procedure. Because the wife is typically both the biological and the social mother of the child, while the husband is only the child's social father, the asymmetry in biological parentage sometimes causes problems for the couple. Furthermore, D.I. children have some of the same questions that adopted children do about their biological history and the character traits of their biological fathers, questions which become especially acute in the child's teenage years. Consequently, couples and/or their D.I. children may need some counseling.

Egg Donation

Egg donation is permissible. Since there is some evidence, however, that stimulating the ovaries to produce multiple eggs for donation increases the woman's chances of contracting ovarian cancer and other diseases, a woman may not donate more often than is medically safe for her. In order to avoid selective abortions as much as possible, a maximum of three eggs or zygotes may be implanted in the bearing mother at any one time.

As with D.I., there is no adultery or licentiousness involved in egg donation because of the lack of genital contact. Similarly, as much as possible about the medical history and characteristics of the donor should be conveyed to the social parents and to the child, and counseling may be advisable for the couple and/or the child. Until the CJLS rules definitively on which woman is halakhically the child's mother, the child should be converted unless it is known that both the donor and the bearing mother were Jewish.

Even though the husband fulfills the commandment to procreate if his sperm is used, the couple is not obligated to use egg donation to have children. This is important to remember, for egg donation and other technologically advanced procedures such as gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT) can be quite expensive ($8,000 to $10,000 for each try), and they only have a ten-to-fifteen percent success rate for producing a baby (and not just a pregnancy) during each try. That means that it would take from $40,000 to $50,000 to produce a 50% chance of having a child -- and, indeed, half of infertile couples never do. Aside from these financial costs, the emotional roller coaster which couples undergoing these procedures experience can be exceedingly difficult to endure. Some marriages end in divorce due to the tension engendered by continued, unsuccessful attempts to have children. Thus, infertile couples thinking about using these procedures need to get appropriate counseling and to think very hard about whether they want to try these methods. Again, the CJLS has ruled that according to Jewish law, they are permissible but not obligatory.

Adoption

Adoption does not fulfill the command to procreate, but Jewish tradition lauds people who adopt for fulfilling the many other commandments involved in child rearing and for their act of faithfulness and loving-kindness (hesed) to the children they adopt. This praise applies equally, or perhaps even more, to the adoption of children beyond the age of infancy, of non-Caucasian children, and of disabled children. Couples who adopt or who use D.I. or egg donation, however, should seek counseling so that they are aware of, and can better handle, the special psychological problems for both the parents and the children in these situations.

A Final Word

We would urge Jews to consider marriage and children earlier than many now do. The financial and time constraints of graduate school and of establishing oneself professionally are real, but so are the biological facts of infertility. Earlier marriage is not always possible, but if it is, young people need to remember that it can help insure that they will be able to have the children they desire.

For those who need help in having children, we hope, along with them, that artificial insemination, egg donation, or adoption can afford them the blessings of children.

Editor's Note: The above article represents a summary of the responsum presented by Rabbi Dorff to the Committee on Jewish Law and Standards on March 16, 1994. The paper passed by a vote of 21-0-1.

©1996-2000USCJ.ORG