"From Machon Puah"

Establishing Constant Supervision

In the past several weeks we have demonstrated the moral and ethical, if not halachic need for maintaining a clear and certified “chain of possession” for genetic materials being processed outside the body until they are reintroduced to the body as part of a fertility treatment. We have also shown that constant supervision is required, in order to be absolutely certain that a child is the genetic product of his parents without the possibility of human error. As such, fertility supervision is necessarily distinct from other types of supervision.

In order to absolutely certify the “chain of possession”, the supervisor needs to have constant and direct access to the genetic material being processed. From the time the genetic material is presented to the lab, she (Puah supervisors are all religious women) must be present in the laboratory at any time the embryologist works with the sperm, eggs, or embryos. She must even maintain direct eye contact with the materials at all times.
She cannot leave the laboratory. She cannot take telephone calls or even go to the bathroom, but must remain in the laboratory continuously. Her sole role is to constantly monitor the work of the embryologists and ensure that there was no mix up.

Of course, it is physically impossible to maintain eye contact with materials being spun in a centrifuge. Nor is it reasonable to expect supervisors to sleep in the lab overnight while a fertilized egg grows in the incubator.

In order to maintain the integrity of “constant supervision”, Puah has invented unique containers and seals to be used at such times. These containers are affixed around the individual vials containing the materials being processed and are then sealed by the supervisor using Puah’s special seals. Once the container is sealed, it is physically impossible to access the genetic materials without completely destroying the seal. The supervisor is permitted to suspend monitoring activities only when the seal is in place.

When the embryologist wishes to resume handling the genetic materials, the supervisor first checks the seal, verifying that it has not been broken. Once that determination has been made, the seal is broken and the supervisor resumes constant monitoring of the materials. This process continues up to the moment that the materials are reintroduced to the womb as part of the fertility treatment.

A single supervisor is generally assigned to each case, so the couples are familiar with their personal supervisor. In fact, the sight of the supervisor accompanying the genetic materials is a welcome sign to Puah couples that the processing was completely error free.

It is very important that the standard of supervision is accepted by all authorities and segments of Jewish society, without question. As such, Puah supervisors are ultra-orthodox women, whose testimony is acceptable to all. Supervisors do not need to have a medical background; such a background may even be a disadvantage since a medically oriented person may be tempted to interfere with laboratory procedures, which is definitely not something within the purview of a supervisor.

Since the overwhelming majority of procedures involve female patients and the large majority of embryologists are women, Puah supervisors are all women.
Supervisors undergo an intensive training program. They are taught the basics of fertility, halacha, and the standards and practices of their job. They are tested and undergo supervised practical training in the laboratories where they will eventually work, all in an effort to ensure that they are familiar with their responsibilities and serve as true guardians for the genetic materials.

We try as much as possible to work with physicians to schedule procedures at convenient times for all involved. However, fertility treatments are precisely timed to coincide with specific things happening within a woman’s body. As such, supervisors are some- times on call 24 hours a day, even on Shabbat and Chagim.

It is not an easy task, and requires personal sacrifice and a significant investment of time and effort. Their ultimate reward is learning that their couple had a child. Yet, they often have no connection with the couple after the procedure and their reward is the knowledge that they played a significant role in ensuring the sanctity and continuation of the Jewish people.

They are the unsung heroes of the Puah Institute.

The Puah Institute is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Puah offers free counseling in five languages, halachic supervision, and educational programs. Offices in Jerusalem, New York, Los Angeles and Paris. Contact: (02) 6515050, (Isr) - 718-336-0603 (US) puahonline.org

• Other "From Machon Puah"
• Supervision - is it really necessary?
• Training Supervisors
• Supervision - Who are the Supervisors