Artificial Insemination, IVF, Cloning, and Sperm Selection

In this article I will discuss methods of reproduction for problematic couples. I will divide the subject matter into three categories. The first is artificial insemination.The second is in vitro fertilization. The third is cloning, or producing an offspring through an egg without a sperm. I will explain the halachik guidelines pertaining to these categories, and the relationship of the donors to the offsprings produced under these categories.

Nature's process of pregnancy begins with the maturation of the female's eggs and production of the male's sperm. The ovaries do not produce eggs after birth. The woman is born with about two million eggs that degenerate and deplete themselves with the progress of years. By puberty, the woman begins her reproductive years with about 400,000 eggs. At each monthly ovulation, about one thousand eggs begin the maturation process in a fluid filled sac called follicle. The one that matures first or the most will be released into the Fallopian tubes for possible fertilization. The rest of the eggs will not enter the Fallopian tubes and will wither away.

It is the age of the eggs that causes fertility to decline sharply after age forty. Older women who receive eggs from younger women, become pregnant at rates comparable to the age of the egg donor, not the age of the recipient.

The male, however, constantly produces sperm at the rate of one thousand per second. Some defects in sperm are "pinheaded" sperm which lack a full compliment of DNA, and two headed freak sperm, and sperm that cannot swim in a straight line.

The egg which is now matured and in the Fallopian tubes, sends a chemical signal to the sperm. The most energetic swimming sperms, usually one dozen out of the couple of hundred million, are able to break through the final barricade. The first sperm to make contact with the egg with its narrow tip, unleashes a carefully timed sequence of biochemical salvos. The first dissolves the jellylike veil surrounding the egg. Then another softens the egg's tough outer shell, preparing it for penetration. The instant the sperm tunnels its way past the egg's outer layer, an electric charge fires across the membranes and a signal from the sperm causes the eggshell to close, blocking entry to any of the other sperm that lagged behind. The sperm then releases its tightly coiled DNA, which fuses with the egg's DNA, and the egg is now fertilized and alive. If, however, the egg was fertilized by two sperm that reached it at the same time from different angles, the embryos are destined to die within a few days. Therefore, a human being can have only one biological father and only one biological mother.

Category one, artificial insemination. This method was developed to induce pregnancy where the male has a low sperm count. The original method was to gather enough sperm from enough ejaculations and inject them into the vagina or uterus. Later developments allow using sperm from low sperm counts and injecting them directly into the cervix. Another method is to remove a sperm with a micro-needle and micro-injecting the sperm directly into the egg. If the couple have sperm allergy problems the sperm is first stripped of some of its chemical antigens that trigger the allergic reaction and then injected into the egg.

Another method used for a healthy male who must undergo radiation treatment or chemotherapy which can destroy his stem cells that produce sperm and cause him permanent infertility, is to remove some of his spermatogonial stem cells before the treatment and freeze them. After completing the treatment, the stem cells are thawed and implanted back into the testes. They will now generate not only new sperm but also new stem cells that are genetically identical to the ones found before undergoing the treatment. This method is natural insemination and not artificial insemination. The stem cells are not sperm until they are transplanted into the body; afterwards, when they become part of the recipient's body, they produce sperm. Therefore, even if his stem cells would be implanted into another male, the recipient of the other male's sperm is the father and not he stem cell donor.

Another method is GIFT (for, gamete intra-Fallopian transfer) in which some eggs and sperm are removed with a micro-needle and put into separate dishes in order to avoid fertilization. A catheter loads the eggs and leaves an air space and then loads the sperm and thereafter inserts them into the Fallopian tube. Fertilization takes place naturally in the Fallopian tube and not in the dish.

Most of these treatments have been replaced by a group of techniques using IVF (for, in vitro fertilization). The eggs are prepared by injecting chemicals into the body for ovarian stimulation. Then the eggs and sperm are removed and placed into a dish with chemicals that help fertilize the eggs and sperm. The ripe eggs meet the sperm in the dish and fertilization occurs creating an embryo. When the sperm lacks strength or enzymes, a micro-needle is used to inject a sperm into an egg to start fertilization, creating an embryo. An alternative method is PZD (or partial zona drilling) where a tiny hole is made in the eggs protective shell to allow a sperm to enter easily. There is also a method in which the egg is first ripened in the dish and then the sperm is put into this dish. Another method used for women who cannot ovulate or produce eggs that can be fertilized, is to take large doses of hormones.

After fertilization in the dish, there are two methods used to implant it into the woman. The first, is to wait two days after fertilization when it is multi celled (6-8 cells), it is then called an embryo, and at this stage the embryo is transferred to the uterus. If the PZD procedure was used, the odds are five times better that it will attach to the uterus wall and successfully implant there.

The second method is ZIFT (for, zygote intra Fallopian transfer). One day after initial fertilization, when it is still only a single cell, it is then called a zygote. At this stage, the zygote is placed into the Fallopian tube, and from there it makes its way to the uterus.

The cloning method, as described below, has produced a sheep named Dolly which had health problems and died prematurely. The process removes the female egg and sucks out its nucleus with its DNA but leaves other cellular components necessary to produce an embryo, when another full complement set of DNA is introduced into the egg. A cell of the body contains a full complement set of DNA, therefore, a cell is taken and placed into a culture with very low concentration of nutrients. The starved cell stops dividing and switches off its active genes. The emptied egg and the starved cell are placed next to each other. The first electric pulse causes them to fuse together. The second electric pulse mimics the burst of energy at natural fertilization, jump-starting cell division. Six days later the embryo is implanted in the uterus of the biological mother of the egg-cell combination, and thus she reproduces herself without a male.

There is another cloning process that uses an egg that was fertilized with a sperm. They remove its nucleus and exchange it with the nucleus of a donated egg. This is forbidden because they destroy the original fertilized egg in the process. The question of parenthood is more complicated here because the nucleus of the donated egg was derived from an egg fertilized with sperm.

The reason the mother who produced the egg is considered the mother of the child and not the birth mother, is, that the fertilized egg is considered an entity on its own that develops into a human to exit the body and live on its own. The body serves as a host to the egg during pregnancy. This is not the same case with implanting donor spermatogonial stem cells. The implant becomes part of the recipient's body, and it is the chemistry of his body that is producing the new sperm. Therefore, even if the new sperm produced are genetically identical to the donor's sperm, the father of the child is the one producing the sperm and not the donor.

The question who is the mother, arises when sperm is used for fertilization but some cytoplasm of a younger woman is inserted into the egg of an older woman in order to stimulate it into fertilization, resulting in, that the child will be born with important genetic traits implanted from the younger donor mother. This question is to be compared to sperm stem cell implantation in which the sperm stem cells of a donor are implanted into the infertile patient in order to stimulate his body to produce sperm. Although the child will have genetic traits of the donor nevertheless, the donor's sperm stem cells become part of the recipients body and it is his body that is producing the sperm, and therefore, he is the father. Consequently, even if the recipient's egg goes through a cloning type of nuclear transfer in which they replace the nucleus and DNA, the transferred materials become part of the egg in the dish, and the mother who produced the egg is the mother of the child.

Recently, a cloned mouse was produced through IVF by fusing two eggs into one egg, using the cloning method to start the pregnancy without a sperm, and implanting it into the womb of another mouse to produce a cloned mouse. The process of fusing was accomplished by taking the eggs of two female mice and placing them in an IVF dish with one egg touching the other and introducing a weak electric current to start the fusion. This fusion may be done with a chemical. The reason they were able to start a pregnancy in this situation is that one mouse was newborn whose eggs are immature and not capable of pregnancy, but because these eggs have strong paternal DNA markers that made the pregnancy possible.

The question is, who is the mother. In the above case in which one of the fused eggs was not capable of pregnancy, the mother of this egg cannot be considered the mother of the offspring. This egg has the same status as genetic material that is inserted into the egg to enable a cloning pregnancy, and it becomes part of the egg. Therefore, in this case, the mother of the mature egg is the mother of the offspring.

At this stage, we can ask a question. Who would be the mother if two mature eggs are fused and genetic material, such as a cell, is inserted to enable the cloning pregnancy. This question is similar to that of a hermaphrodite, who is both male and female. Since according to halacha, there cannot be someone who is both male and female, therefore, halachikly he is a questionable male questionable female. The same situation is with the fused eggs. According to halacha, there cannot be two mothers; therefore, the offspring's mother is questionable, is the mother of egg A the mother, or is the mother of egg B the mother.

Using this reasoning, we may question who is considered the father since his sperm becomes part of the egg, and the genetics inserted into the egg do not determine parenthood. We must conclude that the legal definition of fatherhood is the one who produced the sperm that impregnated the egg.

Therefore, when exchanging the nucleus of a fertilized egg with a donor's egg, the genetic material becomes part of the donor's egg, and the woman who produced the donor egg is now the mother. If the fertilization process is induced artificially, there is no father. If the fertilized nucleus that was exchanged is able to begin fertilization of the donor egg, we attribute it to the original sperm even if the second fertilization requires participation of the components of the original egg. All natural fertilization requires an egg and a sperm. Therefore, the father of the child is the donor of the sperm.

It is forbidden to bear children by fertilizing a donor egg with the husband's sperm, or by fertilizing the wife's egg with a donor sperm. However, if it was done and there is a legal agreement who has custody of the child, the agreement should also contain for future reference, the full identifications of the true parents, the woman who produced the egg, and the man who produced the sperm. This is important in order to avoid marrying close relatives.

I will now proceed to relate the halacha to the categories discussed previously. These halachos (laws) were thoroughly reviewed in the Hebrew part of this text.

Artificial insemination is Rabbinically forbidden with the semen or sperm of any other individual except for the woman's husband. It is only permitted to be done with the sperm of the husband if there is reliable Rabbinical supervision to insure that they are using only the sperm of the husband. If they are treating a problem of a low sperm count by first gathering sperm from many ejaculations and then injecting it all together into the vagina, it is prohibited to cause the ejaculation by hand. The correct method is, during intercourse before ejaculation, to remove the male organ and ejaculate into the prepared laboratory bottle. The supervision of this method is more difficult because they must supervise stored sperm for many days.

The method using the sperm from a single low sperm count ejaculation and injecting them directly into the cervix has the advantage that it can be done within a short period of time, and the husband hands the bottle to the one doing the procedure. Therefore, the problem of supervision is much diminished.

The method of removing a sperm with a micro-needle and micro- injecting the sperm directly into the egg is even more preferable since the sperm was removed from his body without having him intentionally ejaculate. When applicable, the method of removing and implanting his own stem cells is most preferable since no sperm was removed.

The GIFT and IVF methods need strong supervision that they do not switch the husband's sperm or the wife's eggs.

The cloning method in which pregnancy is induced without a male sperm, is one of the methods to produce a "Golem" or human body without a human spiritual soul. A human being, having a soul can be created only by a human sperm impregnating a human egg, which is also natures way.

The question, who is the mother, arises when sperm is used for fertilization but some cytoplasm of a younger woman is inserted into the egg of an older woman in order to stimulate it into fertilization, resulting in, that the child will be born with important genetic traits implanted from the younger donor mother. This question is to be compared to sperm stem cell implantation in which the sperm stem cells of a donor are implanted into the infertile patient in order to stimulate his body to produce sperm. Although the child will have genetic traits of the donor nevertheless, the donor's sperm stem cells become part of the recipient's body, and it is his body that is producing the sperm and therefore, he is the father. Consequently, even if the recipient's egg goes through a cloning type of nuclear transfer in which they replace the nucleus and DNA, the transferred materials become part of the egg in the dish, and the mother of the recipient egg is the mother of the child.

In the IVF method, the father of the embryo is the genetic father of the sperm, and the mother of the embryo is the genetic mother of the egg.

The general halachik rules for using both the artificial insemination and IVF methods are. 1. They may be used only by a husband and wife team who must resort to these methods in order to have a child. If they have been divorced or one spouse died, one spouse may not use the frozen sperm or egg of the other spouse to produce children since the other spouse is now a stranger. Post mortem sperm retrieval is therefore prohibited. There are other prohibitions as well. First of all, it is disrespect to the dead to remove any part of it, and it is forbidden to benefit from the dead body. Then it is "marit- ayin" for a single woman to conceive and have a child. If a child was born from sperm that was removed from a warm body shortly after death, then the father of the child is the dead man, and he is forbidden to marry his father's close relatives. (It is forbidden to remove sperm from a "goses" because it is forbidden to move him.) 2. The husband and wife team may use only their own egg and sperm. One may not impregnate a Jewish egg with a non-Jewish sperm because of "marit-ayin", that they will raise a child in their home who has no halachik father. Where the woman's eggs are not fertile, but she could raise an IVF embryo in her womb, one may not impregnate a non-Jewish egg with a Jewish sperm because he is removing his sperm and mixing his Jewish sperm with eggs from a woman forbidden to him. Although he does not have intercourse with her yet he had no valid halachik reason to remove his sperm since he does not fulfill the mitzvah of having children because he is not the halachik father of the embryo.

Unless there is a valid reason, an embryo of non-Jewish parents should not be raised in the womb of a Jewish woman even if the motive is to convert and adopt a child with Jewish blood. The reason is that she is bringing a non-Jew into the world. If this method is the only alternative to adoption, it may be permitted. If the couple has a healthy child capable of reproducing, this procedure should not be done. If their reproduction experts have given up hope to impregnate the wife's eggs with her husband's sperm; and they are childless, and there are no children available for adoption that will be compatible with the husband and wife, or the children available may very well be Jewish but no one will tell them whether they are "momzairim" (bastards), nor will they disclose who the father and mother of the child is in order to know who are their forbidden relations, then this procedure may be permitted.

It is forbidden to donate eggs because of problems that may arise afterwards with marrying relatives or because the child will not be raised as an observant Jew. 3. Only two or three embryos should be produced at any one time, and all those produced must be placed into the womb leaving no embryos in the dish. This avoids the problem of having to destroy the extra embryos in the womb and in the dish. 4. If they went ahead and placed many embryos in the womb, and they attached themselves to the womb to the extent that the existence of the embryos are in jeopardy but the woman is not in danger, then it is prohibited to allow selective destruction of embryos in order to save some of them. 5. If they left embryos in the dish, it is forbidden to destroy them or donate them to others, but they must be used by the couple and may be frozen until they are prepared to use them. 6. The husband and wife team may hire a donor to carry their embryo (even if the donor is not Jewish), with a legal binding agreement that the child will be returned to the genetic Jewish parents immediately after birth. Many legislators will give the surrogate mother custody of the child because she suffered and carried the infant. 7. In the case of a frozen embryo whose genetic parents have been divorced or one has died, the parents are required to pay the embryo bank for upkeep until they settle on a donor to save the embryo. First choice is a non-Jewish donor with a legal binding agreement that the child will be returned to the adoptive Jewish parent or genetic Jewish parent immediately after birth. If there is a chance that the donor mother who carried the embryo may be able to keep the child, then, if the genetic mother is willing and able, she should carry the child, if not, then a suitable adoptive Jewish couple should be found. 8. The laws relating to a zygote in the dish are the same as with an embryo in the womb because life begins at inception. Therefore, it is forbidden to destroy this zygote in order to save it from genetic maladies, and one must violate the Sabbatical works to save this zygote when necessary. 9. Before fertilization, it is permitted to test the eggs of the wife for potential genetic defects or maladies and if they test positive, not to fertilize the eggs.

If a couple had frozen their sperm and eggs and died before fertilization, the relationship of the genetic father to his sperm and the genetic mother to her eggs remain after death. Therefore, if the law was violated and IVF was used, and the embryo was rooted to a donor womb, the halachik parents of the child are the deceased parents. When a sperm of Jewish lineage impregnates an egg of non- Jewish lineage, the sperm loses its halachik relationship to its genetic father, and the embryo is not Jewish. When an egg of Jewish lineage is impregnated with a sperm of non-Jewish lineage, the embryo is Jewish with no halachik relationship to the genetic father.

If a non-Jewish mother is pregnant with her own and she converted to Judaism during her pregnancy, the embryo is then considered part of the body of the genetic mother and therefore, the embryo also becomes Jewish, and in this case only it becomes related to its mother a birth. If however, she was pregnant with an IVF embryo belonging to a different non-Jewish genetic mother, then the embryo is not considered part of the woman to become Jewish with her conversion.

A Jewish embryo formed from an egg and sperm of a Jewish couple that developed in the womb of a non-Jewish donor, when born, the child should be ritually immersed in a mikveh. This is to be compared to a Jewish child who grew up amongst gentiles and then found his way back to Judaism. He immerses himself in a mikveh and does penitence.

There is no prohibition against destroying eggs of a woman when necessary. Therefore, a birth control pill that works on the woman's eggs but that does not directly or indirectly kill the zygote, is permitted when necessary. Consequently, a morning-after pill that indirectly kills the zygote by not permitting it to attach to the walls of the womb, is forbidden even if there is only a small chance that a zygote or embryo has formed.

Cloning human zygotes or embryos for body parts destroys their life potentiality and is forbidden. When the embryo is needed to clone an organ in order to save a life it can theoretically be permitted when there is no other equal alternative to save that life. However, recent research has been using ordinary cells with success.

Frozen eggs may be destroyed with Rabbinical approval when the genetic mother decides against more pregnancies.

It is forbidden to destroy sperm. With regards to frozen sperm that will no longer be used due to a halachikly approved reason, if he is paying for its upkeep, then he should send them a lawyer's letter prohibiting them to use his sperm for anything else, and also stating that he cannot continue paying for the upkeep of this sperm.

It is forbidden to destroy an embryo as long as it is alive even if only in a frozen state and not yet placed into a womb, and even if it cannot be attached to a womb and therefore cannot mature to be born. Moreover, one is required to save such an embryo from destruction as opposed to sperm where there is only a prohibition to destroy but no obligation to save. Therefore, he is required to pay for the upkeep of a frozen embryo regardless, until he can find a donor womb. Therefore, if the husband or wife must undergo certain medical procedures that may damage their reproductive organs, the proper way to do it is to store the sperm separately and the eggs separately and not the embryo.

This rule is a very delicate point in deciding to permit the IVF procedure since many embryos are produced for each procedure as backups, both in the womb and in the dish. If too many embryos attach to the womb they will all destroy each other, therefore, the procedure is to selectively destroy embryos. Selective destruction of embryos is forbidden even if they will all be destroyed because the woman's womb cannot function properly with too many embryos. The reason is, because we cannot play G-D and we are forbidden to destroy one life in order to save another life. If, however, the woman's life is in danger due to the many embryos attached to the womb, it is permitted to selectively destroy as many embryos as needed to put her out of danger.

Then there is the problem with the unwanted embryos left in the dish, the unused embryos must be used again for another attempted pregnancy at a later date. Therefore, only two or three embryos should be produced with backup eggs and sperm to produce another embryo if needed. All these embryos must be placed into the womb leaving no embryos in the dish.

In the event that a married woman was impregnated through artificial insemination or GIFT or IVF using her egg and womb but not the sperm of the husband, she does not become forbidden to her husband because she had no physical sexual contact with the donor of the sperm. If done without her husband's permission, the husband may sue for divorce since it is not his child, and she caused him much embarrassment by having a child belonging to someone else while being married to him. If the sperm was from a non-Jew, then there is no halachik relationship between the donor and the child. Nevertheless, this is not an adoption but a pregnancy that is a source of discomfort and embarrassment to the husband. This is also grounds for him to sue for divorce since he did not agree.

We may now pose a practical question. May a male who never fathered any children marry a reproductively defective female who can have children only through IVF or its related procedures? The answer is, if they love each other to the extent that they feel that they cannot live without each other and they would not contemplate looking for another shiduch, then they may marry with the condition that they proceed with the IVF as directed in this article to the best of their abilities. With the exception that if, according to the laws of the government, the surrogate contract can be broken and the surrogate mother may keep custody of the child, then it is forbidden to contract in that jurisdiction. After the birth, it is advisable to perform a genetic identification test to be sure that there were no errors made during the procedure.

The cloning method in which pregnancy is induced without a male sperm, is an unnatural way to produce a human body. This can be compared to the unnatural way the Maharal of Prague created the Golem. Therefore, any human body created by means other than by a sperm impregnating an egg is a Golem or human without a spiritual soul.

The new method of boy or girl selection using a technique that separates the male producing sperm from the female producing sperm can be used with either the artificial insemination method or with the IVF method.

The MS (MicroSort) method of gender selection is done by first removing the husband's sperm and placing it into a dish. The sperms are then stained with a DNA staining chemical that has the ability to glow when a laser beam shines on them individually. The X chromosome in the female producing sperm has slightly more DNA material than the Y chromosome in the male producing sperm, therefore, the X chromosome absorbs more dye and consequently it glows more brightly than the male-producing sperm. The dyed sperms pass by an electrode that senses the difference between the X and Y chromosomes, intensity of glow, and gives the X chromosomes a positive charge and the Y chromosomes a negative charge. A charged plate separates the positive and negative charged chromosomes, channelling them into different receptacles. When it detects the positively charged sperm, it sends a micro-electric signal to open the gate designated for the female producing sperm. When it detects the negatively charged sperm, it sends a micro-electric signal to open the gate designated for the male producing sperm. We now have two containers to choose from, one with seventy-four percent male producing sperm and another with ninety-one percent female producing sperm.

The PGD (Pre-implantation Genetic Diagnosis) method is an IVF method using the husband's sperm and the wife's eggs. After three days, the embryos are tested one by one by removing a cell from the embryo and examining its chromosome. If they spot a Y chromosome its a boy, and if not, its a girl. When they have three embryos of the desired gender, they will then implant them into the mother's womb. This method is foolproof. It is, however, forbidden to let the remaining embryos perish, and it goes without saying that it is forbidden to destroy them. The halachik guidelines with this method are the same as with the IVF method of pregnancy as discussed before.

The primary halachik concerns are first, that it is prohibited to remove sperm from the body unless it is done so during intercourse. Second, a couple may not select to have only boys or girls. The commandment to be fruitful and multiply is fulfilled by having at least a boy and a girl. Furthermore, we have found no evidence to suggest that the reason that a couple may have all males or females is because the husband may be a producer of predominantly male or female producing sperm. We attribute this to the will of G-D and, as we understand it, it is according with the rules of probability.

We have stated before that for the purpose of begetting children the IVF method is permitted. In our case the couple can have children. If, however, the couple have all boys or all girls and they are willing to try once again to fulfill the commandment by using the sperm selection method, it would then be permitted in order to fulfill the commandment.

With the MS method it is forbidden to destroy the remaining sperms. This method can be used only, if the couple agree to freeze the sperm and use it again in a way that the woman can become pregnant from this sperm, as through artificial insemination during the fertile period of her cycle, even though it may not be during her most fertile period. Furthermore, as stated previously, there must be stringent supervision that the husband's sperm is not accidentally switched with another.

There is also a Rabbinical problem that could result from permitting specific limited cases of boy or girl selection. It could result in a free for all, claiming that they heard it was permitted without asking a Halachik expert.

Furthermore, as of today, there are no statistics to prove that the stain used for male-female sperm selection is safe, since it is new to human sperm, and what may be true for animal sperm may not be true for human sperm.

This discussion leads to another halachik question. Is it permitted to undergo sperm selection in order to avoid genetically transmitted maladies? This question should be divided into two different questions. The first question relating to genetic testing of the sperm. The second question relating to male-female selection where the malady can be transmitted to one sex but not the other.

As far as genetic testing of the sperm is concerned, at present the test will cause the sperm irreversible damage and the sperm will not function. If, however, it becomes practical to separate genetically defective sperm from healthy sperm then the guidelines pertaining to question two for male-female selection will also apply to question one.

In these cases, there is no embryo and consequently, presently nothing exists whose existence is in danger. Therefore, the rule that even if the chance of danger to one's life is small we regard it halachikly as if he is in great danger, does not apply to a life that has not started even in the embryonic stage. Consequently, the remaining halachik arguments in favor of sperm selection deal with whether the odds are for it to happen or not to happen. The fact is, however, that the odds are against transmitting a serious genetic defect to a male or female. The odds range from twenty-five percent to about forty percent, and then with the exception of Cerebral Palsy these defects can be treated many times successfully. If, in the future, they will be able to test for genetic defects without damaging the sperm, and the accuracy of the test would determine if the odds are in favor of transmitting a serious genetic defect, then the halachik arguments in favor of sperm selection will be as follows.

One argument in favor is that the resulting malady will cause the offspring to die within the life span of the father and he will lose his mitzvah of begetting children. The second argument is that even if the child's life is not in danger but a defective child causes both psychological and financial damage to the parents.

Research is presently being done with stem-cells that have been removed from the Blastocyst, a ball of cells that emerges from the egg's protective shell a few days after fertilization. The goal of this research is to create specialized cells compatible to parts of the body so that they will replace body cells damaged by disease or accident. This method can potentially save lives. At present the research is very far from its goals.

The latest research with stem cells is with stem cells created by the cloning method without sperm. These cells may be left to die rather than attach them to a woman's womb, and a woman is permitted to abort this type of pregnancy rather than suffer a miscarriage or give birth to something with serious health problems, providing that the abortion does not endanger her life. Therefore, it is halachikly permitted to do serious medical research with cloned stem cells. It is permitted to abort a cloned embryo if the embryo is needed to heal a seriously ill person even if his life is not in danger, providing that there are no alternative methods. During the first forty days of the existence of the cloned embryo, abortion is permitted for any reason. After the first forty days, when the embryo assumes a human form, abortions are permitted only for a good reason as explained before. If the government prohibits cloning or cloned stem cell research the law must be upheld.

It is, however, permitted to do research with fetal tissue taken from abortions who aborted for personal reasons and not in order to supply the researchers with stem-cells. However, the latest research has had success with ordinary cells.

If someone is infertile and in need of medical treatment in order to solve the problem, he is in the same category as someone suffering from headaches or depression that can be healed through physical treatment. The analogy is that someone infertile who is seeking help, has psychological problems that can be healed through physical treatment. Therefore, when there are no other alternatives, one is permitted to ask a non-Jew to do work for him on the Sabbath when needed for the continuation of his or hers fertility treatment.

Married males who have problems with erection have problems with their obligations of marriage and with reproduction. As far as reproduction is concerned, the artificial insemination method is an alternative solution, because his sperm can be removed with an instrument without erection. This is an alternative if his wife is willing to undergo such treatments. This still does not solve his marriage obligations.

Today, there are basically four methods of dealing with this problem. The implant procedure is accomplished through minor surgery, placing implants within the male organ. The halacha rules out surgery if there is an alternative non invasive method. Furthermore, if the only option to treat his erection problem is a painful procedure, the husband may refuse and agree to artificial insemination. If his wife does not accept his decision and demands from her husband that he fulfill his marriage obligations, she may sue for a "get" (halachik divorce) in a Rabbinical court.

Another option is taking a pill called Viagra. Some people experience bad side reactions after taking Viagra or pills similar to Viagra. These pills are not prescribed for people taking nitroglycerine for their heart condition. As long as the pill does not damage his body to the extent that he would need medical treatment to correct it, he may use Viagra.

A third method is an injection for people who cannot take the pill and the Vacuum Erection System (VES) will not work for them. If the VES is not an option, and Viagra damages his body, then the injection procedure should be used. If the injection procedure does not work for him, or it is not accessible to him, and the last option is the implant procedure, then he is permitted to receive the implant.

The VES (Vacuum Erection System) is safe to use and generally does not cause side reactions. However, there may be a halachik problem that will not allow its use. The procedure with this system is, the organ is placed into a vacuum tube and a pump creates a vacuum which causes an erection. In order to keep the erection stabilized after removing the organ, a narrow stretchable ring is placed on the organ close to the body. The user is given an option to try different size rings. The halachik problem is caused when the diameter of the ring needed is so narrow that it will trap the semen and not allow it to flow into the vagina. When he removes the organ and thereafter the ring, the semen will flow out. This is prohibited because it is masturbation, unless the semen is saved in a tube for the purpose of artificial insemination and his wife agrees to undergo the procedure. However, in a situation like this he should be using Viagra unless it causes his body damage. There is a way to correct the problem by cutting the ring after ejaculation and allowing the semen to flow into the vagina before removing the organ. A safe way of cutting the ring is to use a small arts and crafts scissor with a round end that will not cause damage.

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