Portfolio at NYU

Posted 03.30.03
What Makes an Egg Jewish?

By Caroline Binham

Lizz is a hot commodity: intelligent, blonde, attractive, and willing to donate her eggs to an infertile couple. Underneath her Internet photo, is the title of "exceptional," together with her price of $5,000. The website where you'll find her picture has pages of young women smiling out from their photos: women chosen for their thick brown hair, or because they are Asian American, or for their athletic ability, or their SAT scores. Lizz was chosen because she is Jewish.

An Asian American or African American egg results in babies with obvious genetic traits, but what exactly makes an egg Jewish? In these days of "designer babies," picking out a sperm or egg donor with specific hair color, height, weight and family medical history is commonplace. Lizz, however, has no "Jewish" genes, however that might be defined, so why should it matter what her religion is? The answer is as much an exploration of Jewish identity, culture, and religion as the age-old conundrum of "who is a Jew?" Judaism has always placed emphasis on the family line, and aside from formal conversion, having a Jewish mother has been a requirement for calling oneself Jewish. The advent of assisted reproductive technologies mixed the parental line, and with it, Jewish identity. Of course, for modern Jews, any discussion of genetics and "Jewishness" has the abhorrent element of eugenics that shadows the debate.

For a people that place so much emphasis on procreation, the contrariness in all this is that infertility affects the Jewish community like no other. The United Jewish Communities, a humanitarian federation of American Jewish organizations, sponsored a poll of the American Jewish population in 2001. The National Survey of Family Growth found that 52 percent of Jewish women aged between 30 and 34 had not given birth, compared to 27 percent of other women. The survey defined Jewishness as having a Jewish parent, upbringing, or being observant of Jewish law.

God's first commandment to Adam was "Be fruitful and multiply," and one reason for Judaism's special emphasis on procreation and the family. Competing with this is another Jewish philosophy: the importance of education. Rabbi Elliot Dorff, rector and chair of bioethics at the University of Judaism in Bel Air, CA., attributes the high rate of infertility to education: "We go to graduate school in greater numbers and therefore postpone pregnancy later." It is the postponement of children that has the greatest effect on fertility. Biologically, women are at their most fertile at age 22. By age 35, the egg quality has deteriorated greatly, according to the American Society for Reproductive Medicine.

The high rate of infertility and the onus on Jews to procreate has put Israel, not surprisingly, at the forefront of infertility treatment, with the most fertility clinics per capita in the world.

Judaism is one of the few religions to accept (and even condone) assisted reproductive technologies (A.R.T.s) because of the importance of procreation as a Jewish tenet. The Israeli Pua Institute, which specializes in Jewish medical bioethics, sends rabbis to I.V.F. facilities, ensuring a thorough knowledge of the newest procedures. They then comb through scripture and Jewish legal texts to see if they can reconcile these procedures to Judaism. There is, however, no defining opinion on the issue of motherhood in relation to babies born from egg donation.
"Over the last 1,800 years, the definition of Jewish identity is being born to a Jewish woman, or through formal conversion," said Rabbi Dorff. "Consequently, we need to know who the mother is to determine whether the child is Jewish or not. There was no problem before surrogates or egg donation."

So, find the mother, find the Jewish offspring. With babies born from egg donation, the mother could be potentially one of three people: the woman who donates the eggs, the "genetic" mother; the woman who carries the child to term, the "birth" mother; or the woman who will raise the child, the "social" mother. As A.R.T.s and egg donation are a relatively recent phenomena - the first donation took place in Australia in 1984- rabbis are still debating this topic that is obviously so crucial in determining Jewish identity.

Judi Fleishman runs the New York-based Ovum Donor Registry, which specializes in Israeli donors for American Jewish couples. Spurred by the dearth of American Jewish egg donors, Fleishman opened her registry in 1996, thereby creating a case of international gene migration. "It's been really interesting to see the whole issue evolve," said Fleishman, who defines herself as Orthodox and whose two children were born from a surrogate mother. "Like any law, Jewish law adapts. One rabbi will say one thing, then another says something really stupid: this is what happens when you don't have a pope!"

The predominant opinion among rabbis is that it is the gestational mother who determines the child's Jewish status. This is based on a ruling in the Talmud (the collection of writings forming Jewish law) that states that even if a woman was not Jewish when she conceived, if she converts to Judaism before the child is born, then the baby is Jewish: the emphasis is on birth not conception.

If the gestational mother determines a baby's Jewish status, then why does it matter what religion the egg donor is?

Rabbi Dorff wrote in the Conservative Movement's 1991 to 2000 "Responsa" on ethical considerations that he believed the woman who bears the baby to be the mother. But he admitted: "There is a logic to argue it either way." Especially if you draw parallels with sperm donation: under halachic (Jewish) law, a sperm donor, rather than the intended father, would be considered the father of any offspring.

Over the last year, Montefiore Hospital's center for reproductive technology in Westchester County started to cater to observant Jewish couples (the issue of matrilineage cuts across most of Judaism and is not limited to the Ultra-Orthodox community). Supervisors arrive from the Pua Institute in Israel to ensure the center's kosher status. Dr. Harry Lieman, the center director who implemented the program, advises couples to seek counsel from their own rabbi and then advertise privately for Jewish donors, if that is what they want. "The real issue is what makes the baby; is it genetics or is it the mother?" said Lieman, who is Orthodox. "In New York State Law, it's the mother, there are no issues. Jewish Halacha doesn't necessarily say that. To avoid controversy, we offer Jewish donors."

Montefiore followed the example of Maimonides Hospital in providing I.V.F. treatment for observant Jewish couples. In Brooklyn's Dyker Heights, in a row of suburban houses and neat yards, is Maimonides' Genesis Fertility Center. The name is revealing: it was Maimonides, the medieval philosopher who said: "Whoever adds one Jewish soul is considered as having created an entire world," and it is the book of Genesis that contains the commandment to procreate. The center has helped thousands of couples conceive since 1996. Although not specifically for Orthodox Jewish couples, the center started with the aim of helping all couples while respecting religious dictates. It was the first outside Israel to comply with halachic requirements in I.V.F. treatment, such as complete supervision of the parents' sperm or eggs to avoid the mixing-up of those from other couples. On an average afternoon, the reception area holds a variety of couples, including one already with a baby girl, one gay couple and one Orthodox. Down a corridor, its wall filled with thank-you cards that bear testament to the thousands of babies born through Genesis, is Dr. Susan Lobel's office. Dr. Lobel, a soft-spoken Orthodox woman, became interested in reproductive medicine because "a lot in medicine is chronic and I was attracted by the fact that I would be able to actually help people." The center does not advise couples on Jewish law - that is up to the rabbi - but it does provide couples with Jewish donors from Judi Fleishman's donor registry. "We use Jewish donors to cover all bases, all opinions," said Dr. Lobel. Fleishman's average donor is about 22, has completed her military service and is participating in the Israeli practice of traveling for a year before college. The young women wouldn't be able to do this at home: unlike the U.S.A., Israeli law permits egg donation only from women already undergoing fertility treatment. "They're Israeli, so there is little debate about their Jewishness. They are the right age for donation, and they go back to Israel afterward, so there is little chance for intermarriage later between her genetic offspring," said Lobel, raising another important debate in the Jewish community over gamete donation. Sperm donors, typically, are not Jewish to avoid an adulterous union between a married Jewish woman and a Jewish man other than her husband.

The program is not without its detractors. Rabbi J. David Bleich, professor of Talmud at Yeshiva University, never recommends egg donation. "It is not in accordance with the spirit of Judaism, it is reproduction outside the family unit," he said. "The gestational mother might determine Jewish status, but there is a distinct possibility that the egg donor might. In theory, matrilineal issues might be surmountable, in the real world, they are not." Rabbi Bleich only condones A.R.T.s that use a wife's eggs and husband's sperm. He believes if donated ova are used at all, they should come from frozen supplies of eggs from women who produced too many for their own use during I.V.F. treatment. "Those women have accepted a risk to themselves," he said. "Paying women for their eggs is unwise in itself, but these young ladies are putting themselves at risk, and I wonder if they have pondered this." As A.R.T.s are so new, there is little concrete knowledge on the long-term effects of donating eggs. The known risks include: ovarian hyperstimulation, abdominal bloating, headaches, nausea, multiple pregnancy, torsion (when the distended ovaries cause the ovarian tubes to twist and cut off their own blood supply), a small association between fertility medications and ovarian cancer, and all the dangers involved in a medical procedure requiring general anesthesia, according to a report by the Society for Assisted Reproductive Technologies.

Lizz in the flesh is a petite Brooklyn-based freelance writer (and open in all details apart from her last name). Her one past donation in July 2001 resulted in seven eggs, four embryos and one (failed) pregnancy. She said: "I knew there were risks, but I went on my instincts. I didn't consult a rabbi, but I felt that I'd been brought up to be generous. It was a gift, a mitzvah: God was compelling me to do this good deed." In a small reversal of the migration of Jewish genes to the United States, she donated to an Israeli couple, whom she met prior to the ovum transfer in San Diego. She got $5,000 for a process that took three years to make. She is now in the early stages of being matched with a non-Jewish couple (her agency was started by a Jewish former surrogate mother).

On top of the Jewish matrilineal complications of egg donation, a strong desire to find a Jewish donor can exist among non-observant Jewish couples. Judi Fleishman, who wanted a Jewish surrogate for her own children but could not find one, said: "I've never been given a reason why couples want a Jewish donor. I guess Jews want Jewish eggs."

Like most infertile couples, prospective Jewish parents want their children to be as close to them as possible, as a way of creating a legacy. Rabbi Dorff said: "They want a donor within their own ethnic group's gene pool. That's not prejudice as much as it is a sense of wanting a child as much like them as possible." Although Jewish donors can be separated into different ethnicities such as Ashkenazi, Sephardi or Mizrachi, stating that Jewish donors somehow have special genes suggests eugenic issues that are particularly repugnant for the Jewish community. Dr. Susan Kahn, author of "Reproducing Jews: a Cultural Account of Assisted Conception in Israel" said: "In the context of the Jewish historical experience, there is an inevitable shadow that casts itself over the issue of genetics and Jewish identity."

More than genetics, then, it could be a mere cultural preference. As an egg donor, Lizz is "exceptional" in more ways than one: she was born Catholic, the result of a liaison between a law student and her married professor, but her adoptive Orthodox Jewish parents had her converted at birth. Under Jewish law, she is fully Jewish, even if her genetic parents were not. Her decision to donate was motivated, in part, by her belief that parenting was not dependent on genetics. "Jewish people, since the day we were created, have been focused on the Jewish community. And if you're not Jewish, you don't really understand," she said. Even as a non-"genetic" Jew, Lizz admits: "Jewish parents feel much more comfortable with the metaphysical concept that if the genes are Jewish, then maybe culturally Jewish things might be passed on." Would this be furthering a stereotype of Jewishness, however positive? Helane Rosenberg is a New Jersey mother from egg donation, and also a professor of education who counsels both Jewish and non-Jewish infertile couples. She said: "People who want Jewish donors believe that Jewish people are intellectual, artistic and motivated. It is their belief that they can up the odds for their child to possess those characteristics." Scientifically, there are no specific genes that determine intellect, creativity, or any other talent.

For Dr. Kahn, these motives and indeed, the whole issue of seeking a Jewish egg donor is based on a misconception. "Most Jews outside of the Orthodox community have a whole way of defining Jewishness. They know that Judaism is determined matrilineally. But they participate in secular American society where genes are the ultimate determinants of identity. There is an ambiguous sense of Jewishness," she said. "There is a sense of genetic basis for Jewishness rather than it being based on behavior and adherence to the law. It's a funny paradox. They seek a Jewish donor because they want their child to be more Jewish somehow."

Lizz defines herself as both culturally and religiously Jewish (saying that God meant her to be Jewish) and plans on raising her children as observant. If anything, she is proof that being Jewish is far more than genetics. By extension, Judaism is far more than a religion. Rabbi Dorff, who had similar experiences with an adopted sister, said: "Judaism is an organic community. Every Jew is connected to every other Jew. They're not really able to leave the Jewish body of people at will."

Nothing might make an egg Jewish, nor are genes alone determinative of identity. Kahn said: "From a Jewish legal point of view, there is nothing genetic or biological about being Jewish." But Kahn also maintains that the issue of Jewish identity through motherhood will not be resolved definitively because it is not only about motherhood. "Judaism has always been defined by diversity and disagreement between different segments of the community," she said. "What these technologies have illuminated is diverse opinions of where Jewishness comes from. Everyone is struggling to come to terms with these technologies, harness them to Jewish reproduction and make coherent sense of how to reproduce Jews."