Fertility Treatment and Jewish Law

← Back to Jewish Medical Ethics Foundations

An introduction to how halacha approaches male factor infertility, IVF, and surrogacy.

Author: Dr. Menachem Jacobs

Last updated: August 23, 2026

An ancient precedent

The Book of Bereishis tells of the long struggles of Sarah, Rivka, and Rachel with infertility. Near the end of Chumash Bereishis, while Rachel's sister Leah bears child after child, Rachel remains childless. Rashi relates that Rachel eventually conceives, and that both sisters find themselves expecting at the same time.¹ Through ruach hakodesh — divine inspiration — Leah becomes aware that she is destined to bear a son and Rachel a daughter. Leah prays to forgo her own son if it would preserve her sister's dignity.

The Targum Yonatan records the result: a miraculous exchange.² Dinah, originally conceived by Rachel, was carried and born by Leah; Yosef, originally conceived by Leah, was carried by Rachel.

For thousands of years this account had no real-world parallel. That changed in 1978, with the birth of Louise Brown — the first child conceived through in vitro fertilization. IVF involves removing an egg from a woman's body, fertilizing it outside the body, and implanting the resulting embryo into her uterus or another woman's.

What had been purely miraculous became a clinical procedure.

The inherent difficulty

The commandment to be fruitful and multiply — pru u'rvu — is the first commandment in the Torah.³ Fulfilling it, however, has for many never been simple. The World Health Organization estimated in 2023 that roughly 17.5% of married couples experience infertility, with about 30% of cases attributed to male factors and the remainder to female or combined causes.⁴ Modern fertility treatment offers real hope to those couples.⁵

Biologically, the creation of a child occurs in three stages: conception, gestation, and birth. In an unassisted pregnancy these are inseparable — the same woman contributes the ovum, carries the pregnancy, and gives birth, so there is never any occasion to ask which stage establishes the relationship. Reproductive technology pulls those stages apart and assigns them to different people.

Because these technologies are genuinely new, there is often little direct precedent. Poskim — halachic decisors — have had to reason by analogy from sources that were addressing something else entirely. They have not all reached the same conclusion.

Three questions

Almost every halachic discussion of fertility treatment can be understood as an attempt to answer three questions. They recur at each stage of the process, and the rest of this article follows them in turn.

• Is the procedure permitted? Does any step of it involve an act that Jewish law prohibits?
• Is the mitzvah fulfilled? A couple may have a child without having fulfilled pru u'rvu in the halachic sense, if the means fall outside what the commandment contemplates.
• Who are the parents? Halacha does not automatically equate genetic contribution with parental status. This is not a technicality; it determines lineage, marriage eligibility, and status.

Retrieving the male genetic material

The first practical question in most fertility treatment arises before any embryo exists. Nearly every intervention — from intrauterine insemination through IVF — requires that sperm be obtained outside of intercourse. Jewish law prohibits zera levatala, the wasting of seed, and so the retrieval itself must be addressed before anything that follows.

The Divrei Malkiel was among the first authorities to take up the question, and ruled that the act is forbidden.⁶ His concern was that the extraction is purposeless in itself and does not become permissible merely because the material is later used; if the insemination fails, the act is retroactively rendered pointless. He also raised the practical worry of the husband's sperm being accidentally mixed with another's. A small number of other authorities took similar positions.⁷

The large majority of poskim disagree. The central argument, developed by the Beis Yitzchak, is that zera levatala may be understood as the inverse of pru u'rvu — the prohibition concerns seed spent to no reproductive purpose, so seed used successfully toward conception is not wasted at all but is fulfilling the very commandment at issue.⁸ On this reasoning, retrieval undertaken for the purpose of fulfilling the mitzvah is permitted, provided it is handled appropriately. Rav Moshe Feinstein, Rav Ovadia Yosef, and Rav Shlomo Zalman Auerbach are among those who permit it.⁹

This is the accepted position in practice, though the manner of retrieval and handling is generally arranged with rabbinic guidance rather than left to the clinic's default procedure.

Is IVF permitted at all?

A small number of authorities objected to the procedure outright. Rav Eliezer Waldenberg argued that pru u'rvu cannot be fulfilled through IVF, since halachic sources offer no precedent for fulfilling the commandment by such unnatural means.¹⁰

Most authorities rejected that position. Rav Ovadia Yosef permitted IVF for infertile couples where the wife's own eggs are fertilized,¹¹ as did Rav Yosef Shalom Elyashiv.¹²

Rav Shlomo Zalman Auerbach added an important nuance that is often overlooked: IVF is permitted, but infertile couples are under no halachic obligation to undergo it.¹³ The procedure is a permitted option, not a required one.

Who is the father?

This question is largely settled, and the answer is straightforward: the man who provides the genetic material is the halachic father.

It is worth understanding why the question arose at all, because the answer explains a great deal about how halacha thinks about parenthood generally.

Halacha does not treat biological relationship and halachic parenthood as automatically identical. A ger — convert — is halachically unrelated to their biological family after conversion, even if the entire family converts together. A non-Jewish man who fathers a child with a Jewish woman is not the child's halachic father.¹⁴ In both cases the biology is undisputed and the legal relationship is nonetheless absent. Halachic parenthood is a status, and status is not simply read off genetics.

Given that, it was a genuine question whether fatherhood requires a sexual act or is established by the contribution of genetic material alone. The Chelkat Mechokeik raised the possibility that without a sexual act no paternal relationship is created — which would leave a child conceived by insemination halachically fatherless.¹⁵ A minority of modern authorities, most notably the Tzitz Eliezer, adopted this view.¹⁶

The majority concluded otherwise, and rested on precedents in which paternity was treated as following the genetic material by itself, such as in the case of Ben Sira.¹⁷

On this basis the substantial majority of poskim, including Rav Moshe Feinstein and Rav Shlomo Zalman Auerbach, rule that the donor of the genetic material is the halachic father.¹⁸ This is the accepted position.

Who is the mother?

This question is not settled, and it is the central open problem in this area.

Reproductive technology creates several distinct scenarios in which more than one woman contributes to a child's creation:

• Ovum donation. Where a woman cannot produce a viable ovum, a donated ovum is fertilized and implanted, and she carries and delivers the child.
• Surrogacy. Where a woman produces a viable ovum but cannot sustain a pregnancy, another woman gestates and delivers the child.
• Mitochondrial donation. Where a woman's ovum lacks viable cellular components, donor ooplasm from another ovum is used. The resulting child inherits mitochondrial DNA from one woman and nuclear DNA from another — raising the possibility of multiple maternal contributors in a single embryo.

So: is the mother the woman who provided the ovum, or the woman who carried and gave birth? Can halacha recognize more than one?

The case for the birth mother rests principally on a precedent involving conversion. Ordinarily a convert is halachically “like a newborn child,” no longer related to their biological family. But where a pregnant woman converts, her twins remain halachically siblings to one another.¹⁹ If the maternal relationship were established at conception, conversion should have severed it. That it survives suggests the relationship is established during gestation or at birth.²⁰

The case for the genetic mother rests on sources describing the mother's contribution at conception as the formative one,²¹ and on a Talmudic discussion of a fetus transferred between animals in which the genetic mother is described as the mother and the birth mother is not.²²

Both arguments have well-known counterarguments, and neither has produced consensus.

Why it remains unresolved

There is a specific reason this question has proven so resistant.

Several of the strongest-sounding proofs on both sides are drawn from aggadah — the narrative and homiletical portions of rabbinic literature, as distinct from its legal material. The Talmud Yerushalmi states the governing principle: we do not derive halachic rulings from aggadic sources.²³

This is where the story we began with comes back. The exchange of Dinah and Yosef looks, at first glance, like powerful support for defining motherhood by gestation and birth. But it is aggadah. However rich its ethical and spiritual content, it cannot carry the halachic weight the question demands. The same limitation applies to several of the other narrative proofs offered on both sides.

The majority of poskim therefore treat the matter as halachically unresolvable — a modern teiku, a question left standing. Rav Shlomo Zalman Auerbach and others accordingly rule that one must act stringently in accordance with both opinions at once.²⁴

What this means in practice

Ruling stringently by both views produces concrete requirements:

• If the ovum donor is not Jewish, the child requires conversion.
• Kohanim, who may not marry converts, should not marry a girl born from a non-Jewish ovum donor.²⁵
• If the donor is Jewish, records must be maintained so that the child does not later marry one of the donor's other children.²⁶

These are not hypothetical concerns. They are the practical reason that these matters require rabbinic guidance from the outset.

For patients and families seeking support

Families navigating fertility treatment may also need financial assistance, medical advocacy, emotional support, laboratory supervision, or halachic guidance. JMAR maintains a growing Jewish Fertility, Pregnancy, and Reproductive Health Resources directory, including Bonei Olam, ATIME, and the PUAH Institute.

Further reading

Clinical background

• Santoro N, Polotsky AJ. Infertility Evaluation and Treatment. N Engl J Med. 2025;392(11):1111–1119.

Primary sources

• Paternity in Halacha — Sefaria source sheet gathering the primary texts discussed above.
• Steinberg A. Encyclopedia of Jewish Medical Ethics, Artificial Insemination.

Books and articles

• Broyde MJ. The Establishment of Maternity and Paternity in Jewish and American Law.
• Weiner J. Jewish Guide to Practical Medical Decision-Making, Part 6.
• Grazi RV. Overcoming Infertility: A Guide for Jewish Couples.
• Ryzman Z. Ratz KaTzvi: Laws of Fertility.

Audio and video

• Sinensky T. Who Is My Daddy? Paternity in Halacha.
• Neuburger YB. The Male Side of the Story: Sperm Retrieval and Male Infertility.
• Segelman E, Herman J. Pregnancy and Halacha, nine-part series.

Related topics

• Sprung Y. Orphaned by Design: On Posthumous Paternity.
• Bleich JD. Posthumous Paternity.
• Halperin M. Post-Mortem Sperm Retrieval. Assia, vol. 4.
• The Halacha Headlines Podcast: Preserving the Memory of Fallen Soldiers.

Organizations

• PUAH Institute — fertility guidance for Jewish couples.

Related JMAR resources

• Jewish Medical Ethics Foundations
• Fertility, pregnancy, and reproductive health resources for patients and families
• Cultural Context for Jewish Patients

References

1. Rashi, Bereishis 30:21.
2. Targum Yonatan, Bereishis 30:21.
3. Bereishis 1:28.
4. World Health Organization. Infertility Prevalence Estimates, 1990–2021. Geneva: WHO, 2023.
5. Santoro N, Polotsky AJ. Infertility Evaluation and Treatment. N Engl J Med. 2025 Mar 13;392(11):1111–1119. doi:10.1056/NEJMcp2311150. PMID: 40073310.
6. Divrei Malkiel [siman to be supplied].
7. Mishpetei Uziel, Even HaEzer 19; Yaskil Avdi vol. 5, Even HaEzer 10.
8. Beis Yitzchak vol. 1, siman 50, based on Tosafot, Sanhedrin 59b.
9. Igrot Moshe, Even HaEzer vol. 1, siman 71; Yabia Omer vol. 2, Even HaEzer [siman to be supplied]; Rav Shlomo Zalman Auerbach, Noam, 1958, pp. 145–166. For the Rebbe's position, see Assia, vols. 61–62, 1998, p. 47.
10. Tzitz Eliezer 15:45.
11. Teshuvot Yabia Omer vol. 8, Even Ha'ezer 21.
12. Cited in Nishmat Avraham 5:113.
13. Cited in Nishmat Avraham 5:113.
14. Mishneh Torah, Hilchot Mamrim 5:9–11.
15. Chelkat Mechokeik, Even HaEzer 1:8.
16. Tzitz Eliezer vol. 9, 51:4:1,8.
17. Beit Shmuel, Even HaEzer 1:10, based on the Bach, Yoreh De'ah 195; see Chagiga 15a. The account of Ben Sira appears in Likutei Maharil siman 5 and Teshuvot Tashbetz vol. 3, siman 263. See also Rabbeinu Peretz, quoted by the Bach and Beit Shmuel.
18. Igrot Moshe, Even HaEzer vol. 1, 10, 71; Nishmat Avraham, Even HaEzer 1:5.
19. Yevamos 97b.
20. Rav Zalman Nechemia Goldberg, Techumin 5:252. For a counterargument, see Rav J. David Bleich, Contemporary Halakhic Problems 4:251–258.
21. Nidda 31a; Ramban, Vayikra 12:2.
22. Chulin 70a.
23. Yerushalmi, Chagiga 1:8.
24. Cited in Nishmat Avraham 4:186.
25. Techumin 10:280.
26. Techumin 10:273–281.

Disclaimer

This article provides general background only and is not a halachic ruling. Jewish practice varies, and the application of these principles depends heavily on individual circumstances. Specific questions should be directed to a qualified posek.