Infertility evaluation and treatment according to Jewish law

The Jewish attitude toward infertility can be learned from the fact that the first commandment of God to Adam was "be fruitful and multiply". When evaluating an infertile couple according to the Halakha (Hebrew law), one should first evaluate the female factor. If pathology is found, one may proceed to investigate the male factor, inadequate or abnormal production, ejaculation, or deposition of spermatozoa. The basic fact that allows in vitro fertilization (IVF) and embryo transfer (ET) to be considered in the rabbinical literature at all is that the oocyte and the sperm originate from the wife and the husband, respectively. For many centuries Jewish religious authorities have discussed the principle involved in artificial insemination from a donor. The discussions are based on ancient sources in the Talmud and the codes of Jewish law is prohibited for a variety of reasons e.g. incest, lack of genealogy, and the problem of inheritance. In the case of egg donation the problem that arises is who should be considered the mother, the donor of the oocyte or the one in whose uterus the embryo develops, the one who gives birth. Jewish law states that the child is related to the woman who finished its formation, the one who gave birth. The Jewish religion does not forbid the practice of surrogate motherhood in the case of full surrogacy. From the religious point of view, the child will belong to the father who gave the sperm and to the woman who gave birth. Creating and inducing a preimplantation in embryo in vitro for fertility research should be allowed if there is a real chance that the sperm owner may benefit and have a child as a result of this research. Nowadays, assisted reproductive technology is a common practice in the treatment of infertility. Nevertheless, different religious arguments of the world's religions impose limitations on the therapeutic approach to infertility.