New York (VINNEWS/Rabbi Yair Hoffman) It is a topic that is not discussed so much because of matters of tzniyus, but it seems to this author that it should be written about– because it will help bring the Geulah. Rav Chaim Kanievsky zt”l held that the Geulah will come when the requisite neshamos of Klal Yisroel will be brought down here in the world. There are numerous unmarried women in Klal Yisroel that have not acted on the topic because they did not have the pertinent information.

There is a quiet conversation happening in many frum homes today. A young woman is doing everything right. She is davening, she is building herself, learning, working, waiting for the right shidduch. But the clock that governs fertility does not pause to wait for the right circumstances. And so, many families are beginning to ask: is there a way to preserve the possibility of children for later, in a manner that is fully consistent with halacha?

The answer, increasingly, is yes. It is called egg-freezing or as it is known in medical language as oocyte cryopreservation. Egg-freezing is exactly what it sounds like. A woman’s eggs are removed from her body and frozen, so that they can be stored and used even years later after she has found her shidduch.

According to an overwhelming amount of Gedolei HaPoskim, it is correct hishtadlus. The costs are not insignificant and it also requires proper hashgacha. But more on that later.

The science behind it is that a woman is born with all the eggs she will ever have, and both the number and the quality of those eggs decline as she grows older. The decline begins gently in a woman’s twenties and then speeds up considerably around age thirty-five. Egg freezing allows a woman to, in a sense, press the pause button. By freezing her eggs while they are still younger and healthier, she preserves them at that earlier stage, protected from further aging.

The first baby born from a frozen egg arrived in 1986. For years the technique remained limited, but a newer freezing method called vitrification, which flash-freezes the egg so quickly that no damaging ice crystals can form, had dramatically improved the results. By 2012 the American Society for Reproductive Medicine removed its “experimental” label from the procedure for women with a medical need.

How the Process Works

The process is relatively quick and is considered safe. It generally unfolds in a few stages.

First comes a consultation, where a doctor reviews the woman’s health and checks her ovarian reserve, meaning the number of eggs she has remaining. This is done through a simple blood test that measures something called AMH levels, along with an ultrasound.

Next comes the preparation. Normally a woman releases only one egg each month. To make egg freezing worthwhile, doctors use hormone injections, taken for roughly eight to twelve days, that encourage the ovaries to ripen many eggs at once. During this stretch the woman comes in for monitoring, blood tests and ultrasounds, to make sure her body is responding well.

Finally comes the retrieval. This is an outpatient procedure performed under light anesthesia, and it typically takes only five to ten minutes. The doctor gathers the mature eggs with the guidance of an ultrasound, and the eggs are frozen immediately afterward.

The risks are generally small. The most discussed one is a condition called ovarian hyperstimulation syndrome, which in most cases is mild, and which careful monitoring is designed to prevent.

A word about success rates is in order. Outcomes vary, and they depend heavily on age. Studies have found that the chance of a live birth is meaningfully higher for a woman who freezes her eggs at twenty-five than for one who freezes at forty. Fertility is deeply individual, and no doctor can promise a particular result. But the general principle is consistent: the earlier, the better.

The Halachic Dimension

The egg freezing process raises real halachic questions. Once eggs are retrieved and later fertilized and stored, questions of yichus arise. Whose egg is whose? There are questions of ne’emanus and this area especially requires a stellar hechsher. How else can a family be certain, years down the line, that the eggs being used are truly those of the mother and no one else’s? Mistakes and mix-ups in laboratories, while rare, are not unheard of in the wider world. For our community- this is not a small detail.

Every Posaik this author has consulted with has ruled that egg freezing certainly requires hashgacha, a system of religious supervision. Just as we do not rely on a kitchen being kosher without proper oversight, so too the integrity of this process must be guarded by a trustworthy observer who ensures that the eggs are handled, labeled and stored without any possibility of error or exchange. The supervision protects the very thing the family is trying to build.

This supervision was not always available. It came about through real effort. Rabbi Aharon Jacobowitz, a Satmar chossid from Williamsburg, took the initiative to approach hospitals and clinics and persuade them to allow this kind of oversight. Because of that groundwork, frum families can now pursue egg freezing with the confidence that a proper hechsher provides.

Today the leading address for this supervision is ATIME, whose Institute of Halacha and Tech (the DAAS program) operates what is described as the first program of its kind in the country and the largest in the tri-state area. The scope of the operation is considerable: a team of more than one hundred mashgichim and mashgichos provides coverage at no charge. Their work is carried out under the rabbinical direction of Rav Chaim Aharon Unger shlita, with R’ Yosef Moshe Heilpern serving as Director of Supervision (718-686-8912, x233).

One related halachic point worth mentioning: the procedure itself does not require tevilah, immersion, on the part of the woman.

As with every serious halachic matter, a woman or couple considering this should not rely on a general article. They should bring their specific situation to their own rav or to a posek experienced in these areas, who can guide them according to the details of their case.

For many families, the obstacle to all of this has not been halachic. It has been financial. Egg freezing in the United States has traditionally been expensive. Published figures from various clinics range widely, and a single cycle, together with medication and storage, can run at about twenty thousand dollars. For a young woman looking for a shidduch this can feel out of reach.

It is worth knowing, though, that prices vary considerably from clinic to clinic, and some centers are markedly more affordable than the headline figures suggest. A survey of several well-known programs serving the New York area illustrates the range.

Extend Fertility, a Manhattan clinic that specializes in egg freezing, posts its self-pay prices openly. Its fee for a full freezing cycle, including all monitoring visits, the retrieval procedure with anesthesia, and the freezing itself, is $8,500. The initial assessment and consultation is $250. Medication, paid separately to a pharmacy, runs roughly $3,000 to $5,000, and storage is $800 for a one-year plan. (extendfertility.com/pricing)

Weill Cornell Medicine’s Center for Reproductive Medicine, one of the most established fertility programs in the country, does not publish a flat rate for egg freezing; patients are quoted by a financial coordinator according to their individual plan, and reported out-of-pocket costs for a retrieval cycle have run considerably higher. (ivfoptions.com/clinic/weill-cornell-medicine)

RMA (Reproductive Medicine Associates) likewise does not advertise a single price, and the figure depends on the location; patients have reported a retrieval-and-freeze cycle in the range of roughly seventeen thousand dollars at some branches, plus separate medication and storage fees. Here too, a financial coordinator provides the individualized quote. (rmany.com/resources/financial/fertility-treatment-cost-factors)

The lesson for families is a practical one: it pays to ask, to compare, and to inquire specifically about what is and is not included in a quoted price, since medication, anesthesia, and annual storage are often billed separately. What once seemed uniformly out of reach is, at certain clinics, considerably more attainable than the round numbers suggest.

For more information on the halachic supervision of these procedures, and for guidance from trained rabbonim, ATIME’s Institute of Halacha and Tech can be reached through their website: https://atime.org/institute-of-halacha-tech/

AND NOW TWO OTHER CONTROVERSIAL PARTS

What happens if they did get mized up because there was no supervsion? 

Varied Halachic Opinions

The halachic opinions range quite widely. Some hold that it is the genetic mother who is the real mother. Others hold it is the birth mother. Others hold that it is a doubt as to which one. Others hold that both are mothers and some even hold that there is no mother.

Tzitz Eliezer’s Evolution of Opinion

The Tzitz Eliezer’s position on this matter has evolved over time. In his initial ruling (Vol. 15 Siman 45), he held that when fertilization occurs externally in a laboratory setting, even without egg donation, the child has no relationship to the parents. However, his later writings suggest a shift toward favoring the genetic mother’s claim. This apparent retraction seems to stem from his primary concern about fertility treatments leading to lineage questions (which he termed “mi yeshurenu”). It’s important to note that Rav Ovadya Yoseph in his Yabia Omer (Vol. 2 Even HaEzer Siman 1, Vol. 8 Even HaEzer Siman 21) takes a different stance, stating that children born through fertility treatments do indeed relate to their parents, and fathers fulfill the mitzvah of “peru u’revu” (be fruitful and multiply).

Rabbi Ovadia’s Position

Rabbi Ovadia’s stance on this matter underwent a significant transformation over time. While he initially held that the birth mother should be considered the mother, multiple sources have testified that in his later years, his opinion shifted to favor the egg donor as the mother. This change in position has been documented by both Rishon L’Tzion Rabbi Yosef in his Responsa Rishon L’Tzion Vol. 1 Even HaEzer Siman 5, and by Chief Rabbi Amar in Responsa Shema Shlomo Vol. 8 Even HaEzer.

Views of Uncertainty

Several Poskim have expressed uncertainty about this complex issue. These include Rav Shlomo Zalman Auerbach zt”l (see Nishmas Avraham Even HaEzer Siman 1 Letter 1 #11 p. 35) and Rav Elyashiv, whose views are also documented there. Rav Moshe Sternbuch, in Teshuvos V’Hanhagos Vol. 2 Siman 689, and HaGaon Rabbi Asher Weiss cited in Ratz K’tzvi p. 92, have also acknowledged the complexity of determining maternal status in such cases.

The Dual Motherhood Perspective

Some Poskim have proposed the possibility of dual motherhood. Rav Ben Tzion Abba Shaul, in Ohr L’Tzion Yevamot 32b, discusses this concept, though some interpret his position as expressing uncertainty rather than advocating for dual motherhood. Rav Moshe Sternbuch, in Teshuvos V’Hanhagos Vol. 5 Siman 318, suggests that both women might also be legally considered mothers, emphasizing that this is not merely a matter of doubt but potentially a dual legal status.

Advocates for Egg Donor Motherhood

A significant number of Poskim have concluded that the egg donor should be considered the mother. HaGR”M Brandsdorfer presents this view in Kneh Bosem Vol. 4 Siman 95 Letter 1, as does HaGR”Y Rozental in Mishnat Yaakov on Arachim V’Ramim Chapter 1 Halacha 13. Rav Goren elaborated on this position in his book Torat HaRefuah, specifically in the section on ‘Transplanting an Egg from Woman to Woman’ (pp. 176-177), which was first published in HaTzofeh newspaper on 14 Adar I 5744/17.2.84 and later included in Puah Vol. 2 p. 384.

Additional support for this position comes from Rav Avraham Yitzchak Kilav (Techumin 5 p. 267), Rabbi Yaakov Ariel (in both Techumin 15 5755 p. 171 and Responsa Ohala shel Torah Vol. 1 Siman 73), and Rabbi Shlomo Dichovsky (in Responsa Poria ‘Genetics and IVF’ p. 515 and Responsa Lev Shomea L’Shlomo Vol. 2 Siman 43). Former Chief Rabbi Rav Shlomo Amar has also aligned with this view, as documented in Responsa Shema Shlomo Vol. 8 Simanim 1-3.

IS THERE TZEDAKAH HERE?

This author holds is of the position that it would be considered tzedakah to help someone pay for the procedure. How so? Because the cry of a woman who longs for children is no small matter in the eyes of the Torah.

Rochel Imeinu, turned to Yaakov Avinu with anguish and said: “Havah li vanim, v’im ayin meisah anochi” — “Give me children, and if not, I am as dead” (Bereishis 30:1).

Chanah, also poured out her soul before Hashem: “Vatidor neder vatomar, Hashem Tzevakos im ra’oh sir’eh b’oni amasecha” — “And she vowed a vow and said, Hashem of Hosts, if You will look upon the affliction of Your maidservant” (Shmuel I 1:11). Her tefillah became the very paradigm of heartfelt prayer.

And recall the words spoken to the Shunamis by Elisha haNavi: “La’moed hazeh ka’eis chayah at choveket ben” — “At this season, at this time of life, you shall embrace a son” (Melachim II 4:16). The Navi recognized that the embrace of a child is among the deepest of human longings.

From these pesukim emerges a clear truth: the desire of a woman to one day hold her child is woven into the fabric of creation, and the relief of that distress is a matter the Torah treats with the utmost seriousness.

Several mitzvos may be implicated in permitting such an allocation of tzedakah:

First, v’ahavta l’rei’acha kamocha (Vayikra 19:18). One is obligated to love a fellow Jew as oneself, and the Rambam derives from here the duty to be concerned for another’s wellbeing and to spare him or her distress as one would wish for oneself.

Second, the mitzvah of tzedakah itself (Devarim 15:8, “pasoach tiftach es yadcha”). The obligation to give to one in need is not limited to bread and lodging; Chazal teach that one provides “dei machsoro” — that which the person lacks — according to that individual’s particular need and distress.

Third, the mitzvah of lo sa’amod al dam rei’echa (Vayikra 19:16). Where a woman’s window of fertility may be closing, preserving that possibility may fall under the broad concern of not standing idly by one’s fellow’s loss.

Fourth, the concern embodied in v’chai achicha imach (Vayikra 25:36) — that one’s fellow may live alongside him — which Chazal extend to encompass restoring and sustaining the quality and dignity of another’s life.

And finally, won’t it help bring the Ge’ulah? 

The author can be reached at [email protected]