Rabbi Dovid Bartfeld Director of Tahareinu Shovavim Lecture Fertility in Halacha

okay we are uh gonna learn a little bit about fertility in that is the topic of this year I'm pretty sure over the past couple years we've covered uh uh quite a bit on uh pills and uh uh procedures I think we did a couple years ago so before we restart the M it definitely behooves us to um speak a little bit about the fertility so let's go Al the first uh the first question when it comes to fertility in a couple gets married and uh you know that they don't have kids right away and the sh is at what point uh do they start uh getting nervous at what point should they start looking into different different doctors going to the doctor asking questions you know this is a very basic uh Shila that comes up whether you are recently married or you have kids that are recently married this is definitely something that is uh a what point do we start uh uh checking into the fertility topic um so it's very important to know that statistically this is something that people do not know and statistically On Any Given month what are the statistics of a young fresh fertile couple that everything is working 100% what are the statistics that uh that they should get pregnant on in that during that month the statistics are somewhere in the 20% um the way the cycle works the way the fallopian tube picks up the egg after ovulation and that the Zara has to fertilize that egg exactly at the right time it's only there for 24 bar a bar 24 hours 12 to 24 hours that it's available to be fertilized so there's a very short time span that has to everything work out perfectly and M On Any Given month there's a 20 25% chance of a couple getting a uh getting uh pregnant only over an entire year do we say that if everything you know everything really is working perfectly do the you know the percentages go up much higher to the 80 90% so less than a year there's not even a reason to be worried sometimes you have couples they're married for six months and they're panicking what's going on no reason to panic there's no reason to even worry before a year most Pim do say that before two years there's no reason to go to a doctor to start asking questions uh you know just let let the let deer do his thing so to speak um obviously obviously if the couple knows that they have an issue right if they know going into marriage that they have an issue then they should deal with that right away you know they shouldn't wait two years if they already know going in that there's an issue now um when a couple is dealing with infertility whether it is they just got married and it's two years and they ATT a you know nothing doing or sometimes what we call secondary infertility which is uh they're married they have one or two children or three children even and uh then suddenly it's been they just you know realize they they've been uh trying for two years three years four years we have a few you know that I'm dealing with now that yeah it's been already four years and uh it's it's it's it's it could be just as uh difficult and then painful um so what is the uh in the to percentage wise according to the numbers it's it's equal it's 30% that it could be an issue with the woman and 30% it could be an issue with a man 30% that it's both and 10% unexplained that is the official numbers that they give but that being said um so checking the woman for different fertility issues includes blood tests that would be like step one uh then there are more uh we'll call it invasive procedures which include um what's called an hsg hsg is when they insert dye into the uterus and take simultaneously they take a um x-ray of the uterus I usually would have a screen with a presentation showing what each procedure we did it when we did the actual procedures in what's and what's not but um so again this is a procedure that um again it's it's it's a little bit invasive it's not terribly invasive but the Shila is at what point do we check the Zer checking the Zer of the husband is what we would call a right because we have to get the Z how do you get the Z from the husband right is uh is an issue we know you're not allowed to right and uh there's a big is speaking about right is is one of the things that uh that we're we try very much to uh uh be during and at what point is it m how do we do it right this is something that uh that has to be discussed alic so first of all like this we start checking the woman with the basic uh blood test what's called hormonal levels so we'll check our hormonal levels just make sure that everything is is working properly on the hormonal side if she has an issue with the hormones then there's no reason to check the husband's zah if you already see that she has an issue that needs to be dealt with if you check the hormones and everything is Tak okay before we jump to do anything invasive by the woman we should check the Zara from the husband so how do you ATT a checkic how do you check the Z from the husand so um has a whole thing about what's called he's very mock that Zarah should never be taken out even if you're doing it for not like this right the first step that says that when Zar is being taken out the whole is is when you're doing it right for no for no reason if a person is taking out Zarah to be checked for fertility or later on as we'll speak about when when a person is doing fertility treatments and you need Zara for the fertility treatments right that for sure is not shouldn't be latala right so a that speaks that taking out Z for the purpose of having children even checking to see that the Z is okay is not called the thing is thata still has that it can't be done that's called that is not something that we do and therefore how so how do you get the Zar so what is accepted amongst uh the Pim the in general is to do what's to use what's called a halakic condom so what you use is really a sterile condom right not the ones that they sell in this so again a condom is basically a sleeve like a rubber glove that goes on top of the A and Tash is done with that with that uh sleeve and the Zera will go into that condom and then you take that to the lab and they could check it they could freeze it and use it for uh IVF we'll speak about the different uh fertility procedures that are done so when you when you gather uh you know again this is done D Tash so it's it's not you know it's not what would call technically it would still be if it weren't for the fact that we're being mighty the Zar for uh you know checking to see that that that uh you know there's no issue with the Zar or then using it for fertility purposes it would a be an issue right using a condom in general is user over here because we're using it only to get the Zar to to a lab that would be M so the reason why it's called a condom so first of all it's sterile meaning that the ones that they sell in the store usually have spermicides and all sorts of other things in them that would make it useless for our purposes it has to be one that you get from the lab it's a special one that you get from the lab that you know is meant for Gathering uh Zara um also Z writes what we call to do is if you do a little uh um hole in not at the end but you know somewhere in the middle of it a small little hole a pin hole in order that it shouldn't be considered a Raa that zaras you know can't go in uh into the you know into the Isha and like this it's there's there's definitely a mil to use that that he said that again that we have that you are using this um for uh you know it's not using it for having children um and said where wres to put the hole really doesn't do much um so he said it's not really necessary somebody wants to you know do that little extra whatever he can but just make sure that you don't end up messing up messing it up because you want to have the full specimen to be able to give to the uh uh to the lab so therefore you know I would recommend unless you know exactly what you're doing you're better off leaving the hole out um now that is uh leab getting the the you know when to check so we would first check the woman for regular blood test then the next step would be to check the Zara from the husband now um there is one thing that is very uh that is very common that is important to speak when we speak about infertility and that is what uh uh the the doctors in have called where that isic infertility it's kind of a little you know to the us that are but uh the name stuck and what does that mean So a family that's sh right if she has a cycle that is less than about you know 24 24 days or 20 really 25 days um again depending so so let me explain what's going on here a woman will usually ovulate two weeks before she gets her period before she gets her cycle two weeks before that that's when she is going to ovulate so let's make a if she's going to the Mikvah right five days right and then seven five and seven is is 12 so she's going to Mikvah early as she could go is usually day 12 right now if she is getting her cycle um on day 24 or day 25 right which is bar right 12 13 days later that means that it's less than two weeks right from the Mikvah till she's getting her cycos less than two weeks it is very very possible that she is ovulating before she goes to the Mikvah if a woman ovulates this is scientific fact if a woman ovulates before she goes to the Mikvah right again we said the egg could be good for about 12 to 24 hours so if she ovulates the day a full day before she goes to the Mikvah it is physically impossible for her to get pregnant this is a p scientific it's not physically possible for that she can't get pregnant right because by the time the Zarah from the husband comes in to her go the egg is not there anymore it's not physically possible so for G this is not a problem somebody that's not Shara whenever she ovulates that's when they're going to be together but for a woman that for a family that keeps tahara this could present the real issue now if you look in the earlier pisin they speak about all sorts of kulas and how do we get a woman to get to the mikah earlier right so there's a coola maybe not waiting five days maybe shortening it to four days right that would be one way and another sometimes it's all you need all you need is is 24 hours that that could do the whole trick right um sometimes it could be a coola uh M has a whole thing about um one one of the brings down if a woman doesn't go if she has very this is only going to work she has very short periods let's say she only bleeds for like 2 three days a woman that only bleeds for 2 three days she doesn't go to a m for the whole entire month right and then next time around when she gets her cycle as soon as she finishes three days she could already make a half sick and then it'll be 3 plus seven and then she could you know she gains two days like that perhaps gain two days so these are all patent to get around the right the that fact that she's ovulating before she goes to the Mikvah now a nowadays these doesn't exist these kulus andus are not necessary modern medicine has uh figured out uh how to push off a woman's ovulation very easily by giving a little bit of estrogen estrogen pill at the beginning of a cycle will push off a woman's ovulation it works very very nicely there's been studies about this you know we had the uh um uh Dr Holzer who was the who was in charge of the uh at least when I was in AR he was in charge of the um fertility unit in chartic hospital so he had done you know he before that he was in in Montreal for many many years he was the head of the fertility the women's uh clinic in in the hospital in Montreal and he said that you know the all the doctors that were dealing the gisha doctors that were dealing with the from Community there would come to him and ask what's the recipe the special recipe for pushing a again you know B doesn't exist but for when you need a you need to have a an AA had to push off ovulation so you know they would come to him with what's the special recipe to push off the ovulation so again this there medication that could do it if that doesn't work there's a little bit stronger medication but there is pills that you could take nowadays to push off ulation this should never be an issue but this is something that a couple that just got married or at any point during their you know life cycle if they see that they are that she's getting a period a cycle less than 26 days 25 days or less then she should you know they should at least be tracking of the very least be tracking ovulation how do you track ovulation so a little bit before she goes to the Mikvah a couple days before there's these little sticks the same as pregnancy sticks they're called ovulation sticks and you basically it's a it's a urine test and she she'll know when she's ovulating and this is the m to know and she'll see if she gets a positive two three days before she's going to the Mikvah then she's obviously missing ovulation and she has to go to the doctor and get the get the get the medicine you know she's dealing with a gu's a doctor then there's the the taru hotline here's the plug for a wonderful organization called taru that has a hotline uh currently answering uh I don't know four four plus four four and a half thousand chist a month or more uh worldwide um this just practical medical advice not really it's not hotline this is a hotline for women that have staining issues these types of uh issues where you know just uh you know what's going on with my body how how could we uh explain to the doctor uh the you know that we're that this is what's what's happening and it's affecting tahara it's AFF fertility um you could get a lot a lot of practical good information it's women advisers they're not passing they are just giving practical medical advice what pills to take what you know what to speak to about the what the doctor just to explain to a woman what's going on and it's a very good uh uh resource to have um I believe the number is a 18554 tahara easy enough to remember and uh uh so moving on so that is regarding regarding a woman that ovulates before um before she goes to the mikah okay so now let us talk a little bit about um fertility treatments when we speak about the fertility ala there's fertility treatments that are done the very first thing that usually doctors will do when a couple can't get pregnant you know and they're they're going into uh you know pass medication into different procedures that can be done the first one is called IUI IUI stands for intrauterine insemination intrauterine insemination is basically um when they take the zerah from the husband how do they get the Z from the husband the same way they're going to use a condom they're going to get Zer from the husband then they take that Zar they take it to a lab and they wash it and they clean it and then they put it into a syringe with a catheter long catheter like a long tube and that tube is inserted inside is of the woman all the way into her uterus so like this it bypasses a lot of times what what can happen is that the environment in Isa Mak of a woman could be very detrimental to Zara and it could be that just that's the issue that the Zar just not making it all the way in to be able to fertilize the egg so the first step that they're going to do they'll usually do a couple cycles of this is called IUI where they're going to squirt the the the Zara that was cleaned and and prepared in the lab and they're going to put that in directly into the uterus of a woman and like this they're hoping that that's going to uh you know bypass and and get she'll be able to get pregnant like that so let's discuss a little bit about the H shist that could come up over here so number one uh um number one let's talk about we we inserting squirting this Zar in so we already spoke about getting the Z right that's being done with um will this uh will this Insurgent make a woman T right because they're going they're going actually into the uterus you're going into the mar so is that whenever you open the marar from the outside it makes a woman T that's why there are certain procedures that are done that make a woman tmy just even if there's no damn whatsoever just the fact that something went into the mar makes a woman Tomy so question is how how big of an opening do you need in order or big of an instrument do you need in order to make a woman T so this is a big and they're actually all the way down to four millimeters anything over 4 mm some say 7 mm anything uh you know in that range would be woman is actually pretty M he says that you have up to 19 mm now the catheter that they uses under 4 mm it's very very thin and the reason for that is because anything thick that you stick inside could be very very uncomfortable very painful right that that's why is is a very uncomfortable thing so therefore um there will not be a dam first of usually there shouldn't be any Dam and and it's not a p this catheter is is is under 4 mm so putting it inside is not going to make a woman tummy oh another Shila is so this is uh Mar usually closed open so the the the the marar is usually open around couple millimeters uh uh uh you know every woman is different also depending on the time of the month uh during when a woman ovulates it slightly expands a little bit but it's not Mish always close close so the mar the way uh kind of uh you know to describe it would be like a like a donut um like a donut with a very small dut hole with a very small dut hole cuz that that is the cervix right which is the entrance to the actual pearshaped uterus so it is called opening it it is opening at to 4 mm but so la dka Co open right so lav dka will it actually be opening anything could be I mean it could be opening a little bit but but it's not called exactly wouldn't be called again according to you have up to 19 millimeters you know even those that are M for anything over four this would be under four and therefore Hally not a problem at all even if you're right technically it would be fully closed and you're opening Hally that wouldn't be considered a correct very good um a very interesting Shila and that is um what if a woman is ather right what if she's a nether so and and that's when she's ovulating so they got the Zera from the husband they let's say they froze it they have they have Zera from the husband from different time it's frozen whatever it is it's ready to go right and they check okay whenever she ovulates that right that's when we're going to put in the zah into the woman right when she's ovulating so we we track our ovulation they usually do ultra sound towards the beginning of the month okay come back in a couple days we'll check again with the ultrasound and they see that uh you're about to ovulate what's going on what day is it it's uh day 10 she's ovulating early she's still in ether for another two days right she didn't get to the Mah yet could you put in the Z while she's a that's a solid question what's a big deal there's no there's no iser there's noer over here I don't know if what if she gets pregnant with the we know K tell us that a benid is a right one of the the the the T right there there's 10 there's nine different uh uh uh uh children that are born from different uh uh situations one of them is a which officially has terrible mid and things like that it goes into the wants to have a kid with a like you know that's a Ben you don't want that so what's going on over here is it m or not that is a pretty solid so like everything else of course it's they say that he was better not to um and they say that it's completely okay and the reason for that is because even the whole Ben is only the that's what creates a Ben Ben is is is because it came through a uh through a over here there's no the the Zar was taken out beforehand in a m way and now it's being put in with a with a syringe so the fact that she happens to be is really not a problem again you could ask everyone should ask their own local P but but the pasas uh you know shouldn't be an iser it shouldn't be a a problem because again the the the Ben issue is dka through a is just give dr's recipe yeah you technically can uh you know usually uh usually when when they're doing uh uh these types of things um they they are giving her stuff you know different medications sometimes to help boost her ovulation so could be just a maive where she didn't get to make a he till you know it's it could be it's day 12 or day 13 Even but for whatever reason she was staining she didn't get a clean BEDA like a whole host of things could happen and that's why it's such a big L at stka because let's say you know was day 12 or 13 but because they you know sometimes they'll give her they'll give her like a extra shot of uh you know gon like different medications just to boost the to make sure that it's you know you want it's very expensive such a thing even such a a could could be many thousands of dollar so we try the doctors will try to do what whatever they can to make it really uh to make it stick so um you know what are you going to do she already took all this medication she's pumped up with medication she's ready to go everything is lined up perfectly the only thing is she happens to you know not going to be going to the M for another day so you push it off or not is it's t a very serious otherwise you say just wait till next month it's not so P to wait till next one she took the medication they prepared the Zera it's ready to go it's unfrozen you can't freeze it any like there's a lot going on over here that you there's definitely a big Mak um one other very very interesting thing that a lot of people I don't think think about and that is let's say you are you know going to be Mel and squirt that Zara in while she's a now um right there's a this needs a little bit of two second why do we wait five days before starting shim huh I'm saying saying the full five days is I'm saying in general why do you wait anything before right what's the right right in other words there the while a woman it has Z inside her right while Zar Zar is only good for three days right Zar is good for three days so how do you get the five right that's the whole that's the whole sh was before there a lot that was tacked on to the to get the five days for three days is an issue right now that means that K man that Zarah is coming out she cannot make bikas bikas are not are not worth anything while she is a so what happens if we insert Zarah right there was no BS is over here right the P can speak about what happens by mistake they were together right so you have to restart sh like you know stop shim how does it work but over here right so she's a middle shim you put in Zar in way now does she get that's a very fascinating question so one should be should be to now wait an extra three days and and only continue sh she can continue then but she should continue shim only after 3 days these three days do not count for her shim because if again if possible that that is the right thing to do least that that that was that is to wait the three days and give her a of um oh now let's move on to IVF you have what 10 minutes yeah um so the next question is like this what is IVF so this is IUI you know sometimes that works and and then you know a couple will have a child that way and they don't need to move on to the next step if unfortunately that doesn't work the next step is going to be what's called IVF what does IVF stand for invitro fertilization invital fertilization is when they take over here all they took was the Zara from the husband and they squirted it directly into the uterus hoping that that will be enough if that wasn't enough now the next step is going to be they take the Z from the again the same way with the condom and then they take an egg from the wife right what does that mean again so how how does this work every month right uh when a woman goes through her cycle so her ovaries produce usually one egg CL right that means that a whole bunch are simula and they start growing at the end of the day one egg is gonna mature and that inside that egg uh inside that really it's really a follicle it's called a follicle and inside the follicle is an egg that when the follicle opens up it will release the egg and that's what's called ovulation and that egg again we said as 12 to 24 hours where the Zera from the husband could could uh could be could fertilize it now what they're going to do by IVF is they going to insert a needle through uh you know they're going to insert a needle uh into the woman and go where are the eggs the eggs are in the ovaries so they're going to go and they're going to with the needle they're going to like a like a vacuum they're going to vacuum with that needle eggs mature eggs and they're going to take those eggs and they're going to fertilize them in vitro in vitro means like in the lab right in a little dish right they fertilize the eggs and they take those eggs once they see that the egg is what's it turns into an embryo so a fertilized egg will grow into an embryo once you have an embryo which is basically so it takes uh bar 10 days two weeks something like that where they they it's there's a machine called the embryoscope where they have like a whole bunch of uh uh you know uh uh uh little fertilized eggs and they can watch them grow because you don't want to chap it with the air or anything so keep it closed and there's a camera on each one it's you know say m FL to see it and you see how the how this cell splits and splits again and it turns into an embryo and uh that is uh when once they have uh uh you know an embryo of the size that they that they could put it back in they'll take that embryo and then they use the same catheter that we spoke about before that's not going to be AAR and they're going to insert the embryo into the uterus right and hope that the embryo is going to attach itself to the uterus and that is you know that is how a regular pregnancy works is that the embryo when it's when it's um fertilized usually an embryo egg is fertilized in the fallopian tube and it travels for about 10 days and then it it implants itself it's called implantation it implants itself into the wall of the uterus so this in this situation um instead of it being fertilized in the fallopian Tu we fertilized it in in the in the lab and they're going to take the one that they feel looks the best and they're going to put that back into the woman so um first first Justa um the egg retrieval the way it works is they stick a needle into is Mak they do not go into the uterus the the the the if you can imagine like a pair right which is the uterus and then the fallopian tube right it's like two you know like two horns type of things right and and at the end of those are the ovaries so the ovaries are kind of on the side of the uterus um so if they're going through and they're not going to the uterus they're going they make a hole with a needle it's a tiny little incision and they go directly to the um to the over fre and they're aspirating the eggs now usually before they do this they'll give a woman medication to make her ulate many eggs right they want to get as many as possible so even though a woman usually will only ovulate one egg when they when they do this they give her you know strong ovulation medication to really try to get her as because they want to retrieve as you know it's not a comfortable uh procedure they want to try to get as many as so they could take as many of those eggs and fertilize them with the Zer from the husband so this this procedure is not matam there will be a little bit of blood because they're going you know they are going into is so mam it's not mam they're not going into the years and there's no P of mar they're not touching the marar they're not going into the mar not going anywhere near the marar they're going on the outside of the mar they're going through the wall of isak and getting to the uh ovary and aspirating a um aspirating a uh um uh eggs from there and they're GNA use those to fertilize the you know the Zera from the husband to fertilize those eggs how many eggs do they get um it could vary anywhere between 3 to 10 like depending on it could be more again depending on how she took you know how she takes to the medication maybe put two or three back in what maybe they should put two or three back in sometimes they do it you know it depends on depends on the situation you know multiples is all whole parti itself so it depends on the doctor depends on the procedure every place has their own guidelines what they're allowed to do what they're not allowed to do also depends how many they have they only have three four embryos you know they're going to try to do each one separately and see get the best chances if they have a whole bunch maybe for another cycle meaning the another cycle for that also yeah to put one in it has to be at the right at the exact time right that when they take it out they're not putting it back in right away they're usually going to wait till she this hormones calm down give her other hormones make sure everything is perfect and put it at the exact time that it has to go in yes they're frozen the embryos are frozen and uh and they're used you know when when when uh when when needed when you know when is when is when is a sh we call it now um okay so the EG right so how does it work with so this this uh technically it didn't come Al regular B will call it so all speak out you know if they're using the regular Zer from the husband and the and the egg from the wife then we consider this 100% if the father's a Cen the kids a Cen everything is 100% uh that's how we treat it as regular now it's important to speak a little bit about um there are crazy crazy stories if you just you know look it up Google it whatever um from malikan this is going back already many many years when they were building the whole IVF mus and each doctor was trying to prove how it works and it's so so there's there's crazy stories of doctors that were using their own Zara to uh fertilize everybody's eggs like there a doctor that you know has like 80 kids I don't know crazy crazy my um so you know obviously uh that caused a huge w and when you see the pisum speak about IVF this was always a very big uh issue to deal with how do you know right how do you know that everything is okay how do you know that they're using the right Zar how do you know they're using the right the right B the right egg like it's it's a scary thing so a lot of the pisin that speak out uh you know I want to say against IVF but cautious with IVF this this was a big deal by them um nowadays there's two things that really changed a lot first of all nobody's trying to prove really that IVF works anymore that is uh it's been established it works and most doctors uh you know again everybody I guess wants to have good numbers but at the end of the day uh another huge thing that happened was DNA testing he that nowadays you could test the DNA of anybody and this is how they found out right at the end of the day how do they find out they were testing these kids DNA and they saw that it wasn't the Father the father was the was all the same person so nowadays there's DNA testing so M there's a what's called a Myas there's a big Myas that uh which means in English that there the doctors are afraid to really play around with the system right almost like thing right that the you know the that the government is very mckin and controls what goes into uh what goes into the milk so the you know that no one's interested in playing around with the government and the assumption is that the milk is so not the milk is is of cow and and not some other tr that being said um and there's wonderful organizations that uh that and pu and the you know again different cities have their own uh branches that uh do a haer and basically what they do is they'll have you know from yed that goes to the lab and everything whenever they touch anything that has to do with this couple there's going to be a yid there that's going to double check to make sure that that it's uh you know otherwise it's on the Locking key and when it's not on the Locking key they're checking to see that the samples that they're using are the ones that are marked with his name and her name and uh and like this you know everything is done you know what to do when when is not available again that everyone should ask their own CH but I think across the board it's it's in most big hospitals big areas where for sure in the in the the yisha areas where there's a concentration of yiden uh the the the these wonderful organizations have really ensured that that you can get a proper and that is definitely uh important to do um and I would say would even add that sometimes you know the hospitals have protocols they they also don't want mistakes to happen but mistakes happen you know and having that extra layer of is always just to make sure that even if it wasn't maliciously you know we spoke about a doctor maliciously using his own or whatever even if not mistakes Could Happen people are tired and whatever it is so when you're using you know when you have available that should be used uh to ensure that that no no mistakes happen either um I would end with two interesting sh number one is what to do with the leftover Zarah let's say a couple you know they did IVF and they had a whole bunch of children beautiful mishak and that's it they're done you know whatever it is she's too old they can't have anymore maybe we see sections they can't afford it each one is30 plus th000 I don't know whatever it may be you know this is where they're holding they had three four five kids you know this way and this is where they're this is where they all but Lisa first of all let's say there's Zara that's still frozen what do you do with the Zera is it is it vatala now that they should throw out the Zara what about the embryos if they have you know embryos what do you do with those so again I was MAV from my r britz two things things first of all when it comes to the Z the whole is again the whole is is being mighty the zal once the Zara came out in a Kosher Way right what happens to afterwards is really inconsequential and the M if they want to dispose of it they can dispose of it usually it costs money every year you want to keep it frozen it costs money so if you stop paying for it and they want to dispose of it they could dispose of it I think you just tell them to be mocker that you don't want them to use it for other projects cuz otherwise they they can't do that and um you know nobody wants to have uh extra children or whatever running around so uh no it could be a real it could be a mess and and a real Mass with and things like that you know who knows think about it uh Zara truth is actually Zara could be again get a p if it's a y really again goes for for yish goes after the woman but what if she was je it could be it could be it could get messy you could figure out figure out a way could get messy so rather you just want to have have them dispose of that and similarly the Pim say that the embryos don't have a and therefore you know when a person is done the same thing he should should not they should not be using them for other things but uh he's not to you know pay that it should be frozen once they are finished uh you know with whatever they can't afford or whatever for whatever reason this is what they're doing uh familywise and they can't do anymore um it would be M to tell them you know to stop paying for it as long as it's being disposed of in a way that would not cause any any it would that that would be uh okay again that's what I was M from my re Bitz um okay I guess that concludes this uh fertility in um again there are other shist you know about uh um uh sperm donation and egg donation which uh are big sh in of course everyone should ask sh if it'sa but maybe at a different time we could discuss to everybody thank you for coming