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Introduction to Infertility

Individuals undergoing fertility challenges often remark that it seems as if no one else has such issues. Everywhere they turn they encounter families with children, and wonder why they have been singled out with this “rare” condition. Due to changing attitudes and the advent of medical technologies, discussing the topic of fertility has become more acceptable in today’s society. Yet, the associated stigma to fertility issues combined with a feeling of inadequacy can, and often does, lead to a sense of isolation and/or exclusion.
While it may seem that fertility challenges are quite rare, statistics show that approximately 12% of all couples will face some form of fertility issue in the course of  their marriage.
What is Infertility?
Infertility is the inability to achieve a pregnancy and live birth within a 12 month window. This standard is derived by statistical analysis. Statistically, a couple has a 20% chance of becoming pregnant in any given month. Accordingly, until at least 6 months have passed, they remain within the statistical average. Since there are so many unknown factors that can interfere with conception, we require a 12 month period in order to assume that there is a fertility problem.
Are there any exceptions to the 12 month rule?
Yes! There are a few exceptions to the 12 month rule:
  1. AGE – The 12 month rule applies to women under the age of 35. For women who are 35 or older, the the 12 month window is reduced to 6 months.
  2. MEDICAL HISTORY – Whenever there is a medical condition that is known to compromise fertility, a couple should seek professional advice immediately. Examples include irregular periods or no menstrual periods, PCOS, very painful periods, endometriosis, certain genetic diseases, cancer, surgical trauma to the reproductive area etc. The 12 month rule only applies to a couple without any known medical situation. If you are concerned that a medical issue may be impacting your fertility, please call a PUAH  advisor or consult with a your doctor.
The Talmud says that a couple who have been married for 10 years should divorce. Why is the waiting period 12 months instead of 10 years?
First of all, the Talmud is referring to a waiting period before a divorce is required, not to a waiting period to determine whether there is a fertility problem.
Secondly, although people may be familiar with this talmudical statement, many people are unaware of the Rama’s opinion on the matter. The Rama, one the of most eminent halachic authorities of Ashkenazic Jewry, writes that the couple, even though they have lived together for 10 years and have not had children, need not divorce (EH 1:3). Secondly, In the past, there were Poskim who required a 10 year waiting period before allowing certain types of tests to be performed.
Is fertility always a women’s issue?
Absolutely not. The research shows that ⅓ of infertility is contributed to female factors, another ⅓ is contributed to male factors, and the remaining ⅓ of the cases can not be attributed to any one of the partners. This is categorized as a “couples” issue or “unexplained infertility.”
Besides for medical issues, are there other external factors that may contribute to infertility?
There are certainly outside factors that may impair an individual’s fertility. Here are a few examples:
  • Age
  • Smoking
  • Excess alcohol use
  • Stress
  • Poor diet
  • Athletic training
  • Being overweight or underweight

Fertility. Medicine. Halacha.

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