Your Medical Frontline
Taharat Hamishpacha and
Reproductive Health
Shvat 5781 January 2021
BS"D

It's Been A Full Year

Dear Friends,

A year ago, we went from Purim masks to daily masks, and now Purim is upon us again.

As you may know, Tahareinu pivoted immediately to continue all of our services remotely, and our leadership attended medical conferences via Zooms and webinars. Our advisors continue their dedication throughout - answering your calls from their homes.

Our hotline calls continue to rise - this past month they rose another 20%, and we are pleased to announce we are b"H soon recruiting more advisors based anywhere in the world. The advisors will be recruited from Tahareinu Certification Course graduates - our third course is planned for after Pesach this year. Stay tuned!

Below you will find many promising medical updates on fertility and reproductive health, and more on the question of the day. Read below.

We wish you a freilichen, tumid Purim.

Yours,
Rabbi Yitzchok and Chaya Melber
Tahareinu Founders
News on Fertility, RPL, and Pain

From $3000 to $20: Good News for Avoiding Recurrent Miscarriages

Couples experiencing unexplained recurrent pregnancy loss (RPL) may be recommended to undergo IVIG, or Intravenous immunoglobulin, a procedure that combats autoimmunity. The problem is its cost - around $3000.

Recently, research has come to light that the drug HCQ (hydroxychloroquine) can be just as effective. HCQ - a longstanding medication used for treating malaria, lupus, rheumatoid arthritis and other diseases - has gotten a lot of press in the last year due to alleviating Covid-19 symptoms. The main advantage? It’s $20. Talk to your OBGYN or call Tahareinu for more info.

….And in other good news for RPL: Hadassah Hospital in Har HaTzofim, Jerusalem has opened a public, interdepartmental clinic for RPL - recurrent pregnancy loss. Women experiencing 3 or more recurrent miscarriages can receive a complete workup - all covered by Israel’s national healthcare. The clinic is run by Dr. Paul (Pesach) Claman, who made aliyah two years ago from Canada. We were honored to have Dr. Claman as our keynote speaker for Tahareinu's annual Advisor Spring Conference last week, held this year via Zoom.

More Hope for Endo Pain

The endometriosis pain relief drug Orilissa is now available in Israel. Note that because it is a hormonal treatment with contraceptive tendencies, it might affect fertility. Therefore, the idea is to take the drug for alleviating endo pain before trying to conceive. We hope this drug provides the pain relief so many endo sufferers longingly seek.

Male Factor Infertility: Israeli Surgery-Free Procedure Comes to NY

For men with zero or very low seed count, the Israeli groundbreaking lab test called ESSM can now be performed at the Maze Men’s Clinic in New York. 
ESSM divides the entire sample into 5 micro-liter droplets and carefully scans them under a high-powered microscope. Any seed found is placed on a specialized device and then cryopreserved (frozen efficiently) for use in an IVF procedure.

ESSM is non-invasive and may be performed as many times as needed. Its main advantage is finding and preserving seed which otherwise might not have been found or been usable after freezing.

Plant-Based Pain Relief For Intimacy During Menopause
 
A new, plant-based drug is now available for women suffering from intimacy pain at the menopause stage. Called Intrarosa, this prescription medication is made with a plant-derived form of the hormone DHEA combined with coconut and palm oils. After menopause, DHEA becomes the body's primary source of hormones associated with intimacy, namely androgens and estrogens. 

IVF: Can Artificial Intelligence Better Ensure Success?

Israeli startup Embryonics uses AI based on past IVF embryo data to determine which IVF embryos are the most promising. Read this Jerusalem Post article for more info.
Question of the Day: Do Covid-19 Immunizations Affect Pregnancy or Fertility?

If you are pregnant or trying to conceive, should you get the Covid-19 shots?

Rabbi Melber has dedicated extensive research to this topic, speaking with medical experts worldwide, reading medical journal research, and attending live discussions with the Israeli Ministry of Health as an official member of its Commission on the Advancement of Women’s Health.

To this end, Rabbi Melber’s stance on the Covid-19 Prizer and Moderna inoculations is as follows:

Fertility
Couples trying to conceive will not increase their risk of female nor male factor infertility by getting these immunizations. Several women’s reproductive medical organizations have come out attesting to this publicly, namely ACOG - the American College of Gynecologists, ASRM - the Advancement of the Science and Practice of Reproductive Medicine, and SMFM, the Society for Maternal-Fetal Medicine. Note that ESHRE, the European Society of Human Reproduction and Embryology, takes a more cautious approach specifically as there is no data for long-term effects. Nonetheless, Rabbi Melber’s research concluded there are no known effects specifically on fertility.
 
Pregnancy
These immunizations are not associated with problems for the baby in utero nor the pregnant mother. Of concern are recent cases of some pregnant women suffering from serious Covid-19 who also miscarried. As with anyone, Covid-19 more so affects those who have other risk factors, and pregnancy can increase the likelihood of health complications especially in women with pre-existing conditions. Based on the research and data available, Tahareinu recommends the inoculations for any trimester, and every pregnant woman should weigh her personal risk factor for Covid-19 along with her OBGYN.

Long Term Effects
It is acknowledged that long term effects of these inoculations remain unknown as they have only been available for a couple of months. At the same time, those with whom Rabbi Melber consulted are of the opinion that it is unlikely these inoculations will result in ill-effects long term. The main question for pregnant women and couples trying to conceive therefore is whether the risk of unknown long-term effects outweighs their personal risk from Covid-19 symptoms. Statistically, couples of childbearing age are not at high risk of Covid-19, and those with higher-risk factors can discuss their situation with their doctor.

Pfizer/Moderna Inoculations In Summary

Short term: No effect on fertility, and no recorded dangers for pregnancy. 

Long term: Each couple should assess their own risk/benefit along with her doctor(s).

All in all, Rabbi Melber recommends that couples trying to conceive, as well as pregnant women, receive the Pfizer/Moderna inoculation against Covid-19.

Note: Tahareinu at present is only addressing the Pfizer or Moderna brands of Covid-19 inoculations. The information above applies only to those two brands.
Tahareinu Hotline and Consultations

Solve your tahara problems, initial infertility, reproductive-area pain or other gynecological issues.

Call the Tahareinu


For ongoing infertility,
recurrent pregnancy loss,
or reproductive genetic issues,
you and your spouse are warmly invited to schedule a personal phone or Zoom consultation with our founder and president, Rabbi Yitzchok Melber. Please send an email to rabbimelber@tahareinu.com with your first name and location, and briefly describe your issue. We will be plan to be in touch with you to schedule. Important: These personal consultations are reserved for more involved reproductive issues.
All other Tahareinu issues are addressed via our hotline,