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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