"From Machon Puah"

Fertility Extension

Until now, our review of fertility preservation has focused primarily on its use with cancer patients. Our discussion included a review of the halachic implications of fertility preservation as well as the halachic differences between those that apply to married or single patients.
This same technology can and has been adapted for use in other situations that have raised serious halachic concerns. The most prominent application involves unmarried women of advancing age. In this example, a single woman who has no medical indications to require fertility treatments is concerned that she will soon be too old to have children. Freezing her eggs or even sections of the ovary in order to extend her fertility may allow her to mother children later on in her life at a time when she would otherwise be infertile.
Although the procedures are the same as in female fertility preservation, this application is known as fertility extension. Both are elective procedures; fertility preservation is indicated because of other medical concerns (such as cancer or premature menopause) while fertility extension is considered to be a completely elective procedure.
Medically there is no distinction between the procedure of egg freezing for fertility extension or preservation. Similarly, there is no medical difference between a single or married woman. Of course, in the case of fertility extension there is no husband involved. The option of freezing fertilized eggs is not available for fertility extension unless donor sperm is used (which raises additional halachic complications of its own).
Halachically there is a difference between the two applications. Elective surgery is frowned upon by halacha; in certain circumstances it is actually forbidden. This applies to all elective surgery, especially when the surgery involves specific prohibitions such as castration. Ovarian freezing might in some cases be considered to be a form of castration. Even freezing human eggs may have ramifications later on in life. Therefore using these processes are not a simple halachic issue.
As we discussed in previous articles, many poskim allow these procedures for fertility preservation for terminally ill patients on the basis of pikuach nefesh. Having these procedures done strengthens the patient’s desire to fight the illness and can result in a stronger likelihood of recovery. However, fertility extension does not involve this extenuating circumstance. The poskim are more cautious in this case.
The source for permitting any elective surgery is a Tosafot (Shabbat 50b) which states that embarrassment is considered as pain in halacha. Therefore, one who is embarrassed to walk outside due to some disfigurement is permitted to remove it, even if this contradicts certain prohibitions.
The definition of what is considered sufficient and legitimate embarrassment is a matter of debate and each case must be examined individually. However, it is quite a stretch to say that a single woman without children suffers the level of embarrassment that would be seen as “pain” in the eyes of halacha. There is no question that she may suffer great frustration, loneliness and pain. Unfortunately these are not necessarily enough to be considered serious enough for fertility extension to be allowed halachically.
Furthermore, the Poskim have additional societal concerns over this procedure. This will be discussed next week.

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