Difficulty in conceiving is a trying situation for any couple . Because of the centrality of children in Judaism, infertility is often especially painful for Jewish couples [2,3]. Societal norms in the observant community - such as the tendency to have children soon after marriage, and to have larger families with births more closely spaced than is usual in the general society - can add to the pressure .
General medical practice is to initiate a medical evaluation only if a couple has not conceived after one year of trying, or, if the woman is over 35, after six months. This norm is based on the general population, which is largely sexually experienced (either due to delaying pregnancy after marriage or due to premarital relations). In the case of a young and sexually inexperienced couple, there is reason to allow a few additional months before beginning a medical evaluation. Remember, hymenal bleeding at the time of marriage renders a woman niddah. Therefore, a month or two can elapse before a couple begins having sufficiently frequent intercourse around the time of ovulation.
Two situations, which are often not addressed in the medical literature, need to be taken into consideration when evaluating couples who observe Jewish law. These are effective marital relations and halachic infertility. Standard diagnosis and treatment regimens also raise unique concerns in Jewish law.
 Greil A. Infertility and psychological distress: a critical review of the literature. Soc Sci Med 1997;45:1679-704.
 Semenic SE, Callister LC, Feldman P. Giving Birth: The Voices of Orthodox Jewish Women Living in Canada. J Obstet Gynecol Neonatal Nurs. 2004 Jan-Feb;33(1):80-7.
 Gold, M. And Hannah wept: Infertility, adoption, and the Jewish couple. Philadelphia: Jewish Publication Society 1988.
 Friedlander D, Feldmann C. The Modern Shift to Below-Replacement Fertility: Has Israel's Population Joined the Process? Popul Stud (Camb). 1993 Jul;47(2):295-306.
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