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                                                                                               when it comes to kiddushin, if the young man made a condition that                                                                                                  4
                                                                                               she be unblemished.  Therefore, the Torah defines this sort of feature
                                                                                               as a blemish.  However, if he did not make that condition, we rule that
                                                                                               the kiddushin are only doubtfully valid, and in the above case there
                              TELLING A HUSBAND
               79             ABOUT THE RISKS OF                                               people would not consider this a true blemish.
                                                                                               is no doubt at all, because we follow the way of the world, and most
                              PROCREATION DUE TO
                                                                                                  According to the words of Chavas Ya’ir, there are instances where
                              HIS WIFE’S MEDICAL
                              CONDITION PRIOR TO                                               something that would disqualify Kohanim does not disqualify wom-
                                                                                               en, and some blemishes that would disqualify woman do not disqual-
                              THEIR MARRIAGE                                                   ify Kohanim. But, in general, that which does not disqualify Kohanim
                                                                                               does not disqualify women, as my father-in-law ruled regarding
                                                                                               artificial teeth, except for blemishes mentioned in the Shulchan Aruch
                                                                                               (Even Ha’ezer #39:4).


                   1    Question Risks of PRocReation due to his Wife’s Medical Condition          1    SuMMaRy and Conclusion

               A thirty-eight-year-old woman without children was referred to me               According to  my father-in-law,  Rav Y. S. Elyashiv  zt”l,  false teeth
               by the women’s clinic for my professional opinion before undergoing             are not considered a blemish, as for Kohanim, and the physician is
               in-vitro fertilization (IVF). Several years ago, she underwent surgery          permitted to ignore the matter and not to tell the husband about her
               to replace a diseased mitral valve with an artificial, metal one. As a          false teeth. According to the Chavas Ya’ir, the blemishes of woman
               result, she now takes a medication on a permanent basis to prevent              are not comparable to blemishes in Kohanim.
               the formation of blood clots on the mitral valve, which can upset its
               functioning or cause an embolism on the brain. The accepted course
               of treatment is Coumadin, which is known to cause defects in fe-
               tuses and a tendency to miscarry. The recommendation today is to
               use heptorin instead through shots or intravenously, with a lengthy
               hospitalization during the first and last weeks of pregnancy.
                  Even with all these precautionary measures, we estimate the dan-
               ger of a blood clot forming on the mitral valve at about 15%, 40% of
               which (6%) land up affecting the mother’s brain. Moreover, problems
               with the fetus (defects or miscarriage) are known to occur in 30% of
               the cases.
                  Since the case involves a 38-year-old woman and IVF treatment,
               the chances of complications during the pregnancy to both mother
               and fetus are amplified even without heart disease in the background.




        94               1  Medical-HalacHic Responsa of Rav ZilbeRstein                       Wife has False Teeth  2                                         103
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