Yeshiva University News » Fertility

Study co-author Sylvia Wassertheil-Smoller, Ph.D., is a professor of epidemiology and population health at Einstein.

Feb 26, 2009 — Women who have more years of fertility (the time from first menstruation to menopause) have a lower risk of developing Parkinson’s disease than women with fewer years, according to a large new study by researchers at Albert Einstein College of Medicine of Yeshiva University.

“These findings, involving nearly 74,000 women, suggest that longer exposure to the body’s own, or endogenous, hormones, including estrogen, may help protect the brain cells that are affected by Parkinson’s disease,” says lead author Rachel Saunders-Pullman, M.D., M.P.H., M.S., assistant professor of neurology at Einstein and attending physician in neurology at Beth Israel Medical Center, an affiliate of Einstein’s in Manhattan.

An abstract of the study was released by the American Academy of Neurology (AAN). Further study details will be presented at AAN’s 61st annual meeting in Seattle, April 25 – May 2.

After Alzheimer’s disease, Parkinson’s disease is the most common neurodegenerative disease. About 1.5 million Americans currently have Parkinson’s, characterized by symptoms that can include tremor (shaking), slowness of movement, rigidity (stiffness) and difficulty with balance. The condition typically develops after the age of 60, although 15 percent of those diagnosed are under 50. There is no cure for Parkinson’s, although medications or surgery can ease symptoms of the disease.

Parkinson’s disease is almost twice as common in men as in women, and researchers have long hypothesized that sex hormones might play a role in the disease.

In the current study, researchers analyzed the records of the Women’s Health Initiative (WHI) Observational Study and focused on those women who developed Parkinson’s disease. The study involved about 73,973 women who underwent natural menopause.

The study found that women who had a fertile lifespan of more than 39 years had about a 25 percent lower risk of developing Parkinson’s compared with women who had a fertile lifespan shorter than 33 years.

In addition, the data showed that women who had four or more pregnancies were about 20 percent more likely to develop Parkinson’s disease than were women who had three or fewer pregnancies. “One explanation for this finding is that the post-partum period, which is typically one with lower levels of estrogen, subtracts from a woman’s total fertile lifespan,” says co-author Sylvia Wassertheil-Smoller, Ph.D., professor of epidemiology and population health and the principal investigator of the WHI study at Einstein.

“Overall, our findings might lead one to assume that hormone therapy would make sense as a neuroprotective agent,” says Dr. Saunders-Pullman. “However, we also found that women who were taking hormone therapy did not have a lower risk for Parkinson’s. Thus, our data does not support a role for treatment with exogenous hormones, that is, hormones that originate outside the body, to prevent Parkinson’s.”

In fact, hormone therapy can have harmful neurological effects. “Earlier studies in the Women’s Health Initiative demonstrated that hormone therapy increases one’s risk for both stroke and dementia,” says Dr. Wassertheil-Smoller. “Clearly, we need to conduct more research into estrogen’s effects on the brain.”

The study was supported by the Thomas Hartman Foundation for Parkinson’s Research and the National Institutes of Health.

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Article Photo Left to right: Aaron Kogut, Yonah Bardos, Chief Rabbi of Great Britain Jonathan Sacks, Lady Elaine Sacks and Rebecca Goldberg.

Oct 18, 2007 — Recent medical developments have given rise to revolutionary means of treatment for infertility, yet many of the methods are fraught with halakhic (Jewish legal) complexities. “Partners in Creation: Fertility, Modern Medicine, and Jewish Law,” the second annual conference organized by Yeshiva University’s Student Medical Ethics Society, examined these technological advances in treating fertility from both a medical and a halakhic perspective. For photos of the conference click here.

The conference attracted 500 people, including young couples, doctors, rabbinic scholars, students, and members of the Jewish community, and was also broadcast to audiences in Boca Raton, Montreal, and Jerusalem. Rabbi David and Anita Fuld, noted philanthropists who have a special interest in the accuracy of Halakhic and scientific information that reaches the community, sponsored the conference.

“We thought it was important to let couples know about opportunities available to them and to help them with their struggle, as well as create greater awareness of the issues,” said Aaron Kogut, co-president of the student-run Medical Ethics Society and a senior at Yeshiva College.

Kogut, along with Stern College for Women senior Chani Schonbrun, the society’s co-president, and Yonah Bardos, its executive director and a YC senior and rabbinical student, organized the event.

Founded in 2005 by Bardos and a group of YU students as a special project of the Center for the Jewish Future, the society runs lectures and large-scale events at the university, as well as organizes genetic testing to combat the high incidence of genetic diseases in the Jewish community.

“This really shows the power of the student,” declared Kogut. “YU’s Center for the Jewish Future under the auspices of Rabbi Kenneth Brander, and President Richard Joel have all taught us that we can go out and make a difference, and I think the conference clearly demonstrated that.”

Chief Rabbi of England Sir Jonathan Sacks delivered the keynote address, focusing on the intersection of science and Torah and the delicacy required in handling the powers of new technology in medicine. “The test of civilization,” Rabbi Sacks said, “is not just what it can do but what it chooses, for ethical reasons, no to do. God created the world in six days and rested on the seventh. There are limits to creation and we must remember those limits.”

Rabbi Dr. Edward Reichman, associate professor of clinical emergency medicine at YU’s Albert Einstein College of Medicine, presented a brief history of infertility in Jewish law and laid the groundwork for the issues that would be addressed throughout the course of the day.

Dr. Richard Grazi, director of the Division of Reproductive Technology at Maimonides Medical Center, and Rabbi Kenneth Brander, dean of the Center for the Jewish Future, gave the second plenary, taking turns discussing the basics of treating infertility. Dr. Grazi dispelled some common myths about infertility and described possible complications and procedures regarding infertility. Rabbi Brander explained the halakhic concerns associated with those procedures and also stressed that the “the gift of science and helping to treat infertility speaks to our ability to be junior partners with God. Halakhah (Jewish law) celebrates scientific opportunities to realize the couple’s interest of having a family.”

Nine breakout sessions covered topics such as egg donation, pre-implantation genetic diagnosis, halakhic infertility, and the psychological effects of infertility. The participants reconvened for the final session on new frontiers within fertility technology, featuring experts such as Dr. Susan Lobel, founder of Metropolitan Reproductive Medicine; Rabbi Menachem Burshtein, founder and director of Machon Puah in Jerusalem (whose talk in Hebrew was translated for the audience by two UN translators); Rabbi Herschel Schachter, rosh kollel at RIETS’ Marcos and Adina Katz Kollel (institute for advanced rabbinic study); and Rabbi Gideon Weitzman, head of the English Speaking Section of the Puah Institute and visiting associate professor at Einstein.

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Dr. Edward Reichman, associate professor of clinical emergency medicine at Albert Einstein College of Medicine, will speak at the conference.

Sep 7, 2007 — Young couples facing the challenge of infertility have many more options today due to extraordinary advances in medical research. However, Orthodox families must reconcile not only the medical and ethical issues inherent in addressing fertility problems, but also the parameters of Halakhah (Jewish law).

A groundbreaking conference, “Partners in Creation: Fertility, Modern Medicine, and Jewish Law,” co-sponsored by the Center for the Jewish Future (CJF) at Yeshiva University, will examine technological advances in treating fertility from both a medical and a halakhic (Jewish legal) perspective. The conference will be held on Sunday, October 14, 9:30 am-5:30 pm at Yeshiva University’s Wilf Campus in the Washington Heights section of Manhattan. The conference is organized by the Yeshiva University Student Medical Ethics Society (MES) and funded by the Fuld Family.

In addition to plenary sessions dealing with general aspects of infertility treatment, participants will be able to choose from a series of specialized tracks, each geared toward comprehensive analysis of the most pressing issues in the field. Topics include egg donation, artificial insemination, pre-implantation genetic diagnosis, and halakhic infertility.

The keynote address will be delivered by the Chief Rabbi of Great Britain, Rabbi Jonathan Sacks. Individual sessions will be guided by preeminent rabbis and physicians who are leading experts in the fields of reproductive medicine and Halakhah.

“Reproductive technology, one of the most rapidly advancing fields in modern medicine, continues to generate profound ethical quandaries as it explores new and uncharted frontiers,” said Dr. Edward Reichman, associate professor of clinical emergency medicine at YU’s Albert Einstein College of Medicine. “By bringing together some of the greatest minds in both reproductive medicine and Jewish law, this conference will illustrate how the Jewish tradition continues to address cutting-edge science in a practical and relevant way.”

The Student Medical Ethics Society is a student-run organization with the goal of promoting education and awareness of medical ethics at YU. Dedicated students work alongside committed professors and teachers to translate complicated topics into language that the lay person can understand. The society is especially focused on issues of medical ethics relating to Torah values. It was founded in 2005 by a small group of undergraduate students with the support of the CJF and now runs large-scale events with university-wide participation. This is the second annual conference it has hosted. The society also organizes genetic testing to help combat the high incidence of various genetic diseases in the Jewish community.

Preregistration is required. To register and for more information, please click here.

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Sep 6, 2007

YESHIVA UNIVERSITY CENTER FOR THE JEWISH FUTURE CO-SPONSORS CONFERENCE ON MEDICAL ETHICS OF FERTILITY, MODERN MEDICINE, AND JEWISH LAW

Leading Experts to Explore Cutting-Edge Technology

New York, NY, September 6, 2007 – Young couples facing the challenge of infertility have many more options today due to extraordinary advances in medical research. However, Orthodox families must reconcile not only the medical and ethical issues inherent in addressing fertility problems, but also the parameters of Halakhah (Jewish law).

A groundbreaking conference, “Partners in Creation: Fertility, Modern Medicine and Jewish Law,” co-sponsored by Yeshiva University Center for the Jewish Center which will examine fertility issues, will be held on Sunday, October 14, 9:30 am-5:30 pm at Yeshiva University’s Wilf Campus in the Washington Heights section of Manhattan. The conference, organized by the Yeshiva University (YU) Student Medical Ethics Society (MES) and funded by the Fuld Family, will provide participants with both an overview and in-depth information on technologically advanced medical practices in use today that help families struggling with infertility. For the first time, the final session will focus on newly developed technologies and medical procedures from a halakhic (Jewish legal perspective.

In addition to plenary sessions dealing with general aspects of infertility treatment, participants will be able to choose from a series of specialized tracks, each geared toward comprehensive analysis of the most pressing issues in the field. A sampling of topics includes egg donation, artificial insemination, pre-implantation genetic diagnosis, and halakhic infertility, among others. The keynote address will be delivered by the Chief Rabbi of Great Britain, Rabbi Jonathan Sacks. Individual sessions will be guided by preeminent rabbis and physicians who are leading experts in the fields of reproductive medicine and Halakhah.

“Reproductive technology, one of the most rapidly advancing fields in modern medicine, continues to generate profound ethical quandaries as it explores new and uncharted frontiers,” said Dr. Edward Reichman, associate professor of clinical emergency medicine at YU’s Albert Einstein College of Medicine (AECOM). “This conference, by bringing together some of the greatest minds in both reproductive medicine and Jewish law, will beautifully illustrate how the Jewish tradition continues to address cutting-edge science in a practical and relevant way.”

The Student Medical Ethics Society is a student-run organization with the goal of promoting education and awareness of medical ethics at YU. Dedicated students work alongside committed professors and teachers to translate complicated topics into
language the lay person can understand. MES is especially focused on issues of medical ethics relating to Torah values. MES was founded in 2005 by a group of undergraduate students with the support of YU’s Center for the Jewish Future (CJF) and has grown from a small group of students with shared interests to running large-scale events with university-wide participation. This is the second annual conference it has hosted. The Society also hosts genetic testing events to help combat the high incidence of various genetic diseases in the Jewish community.

Preregistration is required and will be open to all those who have an interest in learning more about the ethics of infertility. Admission is $20, $15 for YU alumni, $10 for RIETS rabbinic alumni, $10 for students, and $5 for YU students. For Early Bird Discount please register before September 27. The conference is accredited by AECOM to offer 6 AM PRA category 1 credits. To register please go to www.yu.edu/medicalethics

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Mar 13, 2006
From The New York Times
Metro Section

By ANDY NEWMAN

It sounds like the setup of a joke: 20 rabbis walk into a fertility clinic.

But it really happened. One recent Tuesday afternoon in Brooklyn, a group of young men in yarmulkes packed the waiting room of the Genesis Fertility Center, eyes glued to a roundish smudge on a video screen, absorbing a lecture in basic reproductive technology.

“This is the egg,” said the center’s lab director, sounding like a filmstrip narrator. “Here are zygotes. These are fertilized eggs.”

From there things got complicated, touching on everything from the shelf life of sperm samples to the mechanics of intracytoplasmic fertilization to the ethics of pre-implantation genetic diagnosis.

Arcane as this stuff may sound, the rabbis, all graduate students at Yeshiva University, need to know it, and not just for the course they are taking in infertility and Jewish law.

“This is going to be important,” said the center’s founder, Dr. Richard V. Grazi, as the screen showed a pipette piercing an egg to deliver sperm. “People are going to be asking you a lot of questions about this.”

As the science of babymaking hurtles into the future, it bumps up more and more against not just the laws of nature but also the laws of God (at least as interpreted by people). Doctrinal riddles on weighty subjects — birth, death, identity and family — that would have seemed like seminary parlor games not long ago are now posed by baffled congregants.

“Let’s say a woman has a fully functional womb but her eggs are not viable,” said Rabbi Kenneth Brander of Yeshiva, the course instructor. “Her sister says, ‘Take some of my eggs.’ Who’s the aunt and who’s the mother?” He went on. “What is the relationship between son and father where conception happened posthumously? Does the son say Kaddish for the father?” he asked, referring to the Jewish prayer for the dead.

If a couple has six girls and seeks fertility treatment to try for a boy, may they destroy a fertilized egg of the wrong gender? Can a husband in a divorce unilaterally destroy the couple’s stockpile of frozen fertilized eggs?

“This is not like ‘Star Trek’ science,” said Rabbi Brander, a dean at Yeshiva, which has the largest Orthodox rabbinical seminary in the country. “This is stuff that comes up every day. And if the rabbi doesn’t understand reproductive technology he can’t answer the questions effectively. If he doesn’t know the Jewish law he can’t answer them, either.”

Genesis, on 84th Street in Dyker Heights, retains an Orthodox rabbi — the chaplain at Maimonides Medical Center — to keep things in accordance with Jewish law.

Dr. Grazi said that about two-thirds of his patients were Jewish and half of those were Orthodox.

Rabbis, of course, are not the only clergy members called upon to square reproductive medicine with religious doctrine.

Abdulaziz Sachedina, an expert on Islamic bioethics at the University of Virginia, said he often gets requests from imams and from Muslim doctors to parse some of the trickier issues.

Under Islamic law, for example, a couple may use a surrogate mother, but the husband must take the surrogate as a temporary wife. In the United States, Professor Sachedina said, “This is done very quietly.”

A course in medical ethics is required at many Roman Catholic seminaries. The church disapproves of any pregnancy that does not result directly from sexual intercourse.

“It’s the difference between something that supplements a marital act and something that substitutes for it,” said Msgr. William Smith, who teaches bioethics at St. Joseph’s Seminary in Yonkers.

After their video lesson, the Yeshiva students descended to the lab and donned scrubs.

They toured the incubator room and visited the andrology lab, where sperm is stored in tanks of liquid nitrogen and may be fetched for a kosher couple only under the supervision of a rabbi.

“If you want access to the tank,” said Rabbi Avraham Friedlander, the Maimonides chaplain, “you need our presence.”

Offering the students an example of a tension between Jewish law and medical procedure, Rabbi Friedlander explained the circumstances under which a man may produce a sperm sample in the doctor’s office.

“Usually we ask them to produce at home,” Rabbi Friedlander said, “because of modesty concerns. But it has to be brought in within an hour.”

Afterward the young rabbis pronounced themselves impressed.

“Remarkable,” said Rabbi Reuven Brand, a fellow in an honors program at the seminary. “The ability of technology to help people is staggering.”

There will always be some questions that elude easy answers. What if a single woman in her 20′s wants to put off motherhood to pursue a career and seeks to freeze some of her eggs for later use? Jews are instructed to multiply fruitfully. Would a rabbi send the wrong message by condoning the postponement of starting a family? And what about the possibility of complications?

Now comes the joke.

“There are four volumes in the code of Jewish law,” Rabbi Brander said. “This is in the fifth volume.”

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