Information Sheet: Religious Infertility

Halachic Infertility refers to a case where a woman ovulates prior to immersion in the mikveh. Since studies have shown that relations must occur before ovulation in order to result in conception, this “early ovulation” results in infertility. What are the causes of “early ovulation” and what can be done within halacha to treat this issue?

There are two scenarios that result in early ovulation:

• Short Cycle
• Long Bleeding

Normal or Average Menstrual Cycle

On average, a regular menstrual cycle occurs every 28 days and lasts from 2 to 7 days. In most cases, women ovulate 14 days prior to their upcoming menstruation, or on the 14th day of her monthly cycle.

According to halachot of nidda, women cannot immerse in the mikveh until at least 12 days (11 days according to other opinions)  from the onset of menstruation.

On average, a woman will therefore immerse (depending on the duration of bleeding) anywhere from the 12th day of her cycle to the 14th day of her cycle. Most women will ovulate after immersion, an optimum time for fertility. Women who have an average 14 day cycle and bleed for a full 7 days will ovulate on the day of immersion, a situation which is considered to be borderline and may result in infertility.

Short Cycle

Short cycle infertility is defined as a case where even a woman with the shortest duration of bleeding cannot immerse in the mikveh prior to ovulation. Women whose cycles are 25 days or less will not immerse until at least the 12th day after the onset of monthly bleeding. Since ovulation generally occurs 14 days before the onset of monthly bleeding, we can calculate that ovulation in such cycles will occur on or prior to the 11th day of the monthly cycle. Such women cannot immerse prior to ovulation, which results in infertility.

Women whose cycles are 26 days are considered to be borderline cases; some may ovulate prior to immersion while others may ovulate after immersion, depending on the duration of her bleeding period.

Long Bleeding

Long bleeding is defined as a case in which either the duration of menstrual bleeding or occurrences of irregular bleeding lead to an inability to immerse in the mikveh prior to ovulation.

Any instance where the duration of bleeding combined with the mandatory minimum 7 day waiting period after the cessation of period leads to immersion after ovulation. For instance, a woman with a 27 day cycle will ovulate on day 13 of her cycle. If her period lasts for 7 days, she will immerse no earlier than day 14.

Please note that a monthly period lasting for longer than 7 days may require medical attention. A physician should be consulted.

Solutions

The above calculations are explanatory in nature and should not be relied upon to calculate the date of ovulation. There are methods to determine the exact date of ovulation which should be used to determine if religious infertility is indeed the case. If it is determined that a woman is indeed suffering from religious infertility there are methods within halacha to address the situation.

The following solutions are not general in nature. Each case must be evaluated and treated on an individual basis in consultation with a Rabbi or Puah Rabbinic Counselor.

• Short Cycle Solutions: Short cycles can be caused by excess stress or dietary issues. In such cases, dietary changes (eating 3 healthy well balanced meals each day), relaxation techniques and/or moderate exercise may result in the extension of the cycle to normal levels. If these solutions are not effective, there are natural remedies as well as pharmacological remedies that may be prescribed. This should only be done in consultation with a fertility professional and/or Puah Rabbinical Counselor.

• Long Bleeding Solutions: The Puah Institute has found that many cases of long bleeding are the result of unnecessary stringency in the observance of the laws of niddah. The responsibility in this area is placed on the woman herself and the natural inclination when in doubt is to err on the side of caution. As such, there are women who postpone their immersion date in error and can actually halachically immerse earlier than they think.
  
  If there is any question as to the determination of a stain or spot halachically, a Rabbi should be consulted for a definitive halachic ruling. Furthermore, if long bleeding is suspected, an expert Rabbinic authority in this area or Puah Rabbinic Counselor must be consulted. Puah can refer you to a Rabbinic expert in your geographical area for halachic consultation when necessary.
  
  There are also natural remedies that may be employed to shorten the duration of a menstrual cycle. For example, in some cases, drinking the juice of one lemon each day of menstruation has been shown to be effective in shortening the duration of a period.
  
  Pharmacological remedies may also be employed and have proven to be effective in such cases. As always, this should only be done in consultation with a fertility professional and/or Puah Rabbinical Counselor.

• IUI (Intra Uterine Insemination): When all other solutions have been exhausted, some authorities allow for the performance of an IUI on the day of ovulation (prior to immersion). This is only permitted with the halachic approval of a personal Rabbinic authority.
  
  Since the IUI is being performed prior to immersion, it is impossible to halachically obtain a fresh sperm sample. Accordingly, a halachically obtained sperm sample must be provided and frozen during a previous cycle under Puah halachic supervision.

Summary

• Ovulation must take place after immersion in the mikveh in order for a couple to conceive.
• Halachic infertility is the result of ovulation occurring before a woman's immersion in the mikveh. This can be the result of
  • Short Cycle
  • Long Bleeding
• Cases of religious infertility can be treated in a halachically appropriate manner in consultation with Rabbinic authorities.