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259: IN VITRO
F E RT I L I Z AT I O N
AND SURROGATE
MOTHERHOOD

ɳ Question

A married, childless woman underwent a kidney transplant several
years ago. Owing to chronic rejection, the transplanted kidney’s
function has deteriorated significantly. Currently, there is no treat-
ment available to suppress the chronic rejection of the transplanted
kidney and it is expected that its function will continue to deteriorate,
at either a slower or a quicker rate, leading to a situation in which the
patient will need either dialysis or another kidney transplant.

The woman would like to become pregnant and give birth but
pregnancy in her condition would be high-risk: she would be at risk
either of swift decline in her remaining kidney function and having
to start dialysis earlier, a situation that would give her a shortened
life expectancy and increased vulnerability to illness, or of needing a
repeat transplant sooner with the attendant uncertainty as to wheth-
er or not a kidney will be available. Complications of pregnancy are
also liable to arise, endangering the fetus’ development owing to her
present situation – the chances of this happening are fairly high.

Today, medical technology is able to offer another possibility, as
follows: a woman can be induced to ovulate, releasing a number
of ova from the ovaries at once, in a closely supervised, monitored

100 1 Medical-Halachic Responsa of Rav Zilberstein