The Israeli military campaign in Gaza, launched on October 7, 2023, was triggered by a brutal incursion by Hamas militants that, according to Israeli sources, left over 1,200 civilians dead—including women and children—and more than 240 people taken hostage. In response, Israel declared its objective: dismantling Hamas’ infrastructure, restoring deterrence, and ensuring security for its southern regions.
Citing Article 51 of the UN Charter, which covers the right to self-defense, Israeli officials insist the military’s operations fall within the boundaries of international law. Yet, some of the strikes have drawn sharp criticism for what international observers call disproportionate harm to civilians.
Among the most heart-wrenching incidents was a December 2023 airstrike that leveled the El-Basma fertility clinic in Gaza. The attack didn’t just flatten a building—it obliterated the dreams of hundreds of families, raising profound ethical and legal questions.
The El-Basma Strike: When Science and Hope Collide with War
On December 3, 2023, Israeli airstrikes hit the El-Basma Reproductive Health Center. The destruction wiped out two industrial-grade liquid nitrogen tanks that preserved critical in vitro fertilization materials—more than 5,000 embryos, over 1,000 oocytes, and an equal number of sperm samples. Those embryos belonged to at least 150 couples who had either completed or were undergoing fertility treatment.
Dr. Samir Khalil, head of the clinic’s embryology lab, put it bluntly:
“We lost years of labor and hope. This wasn’t just biological material—it was the only chance at motherhood for many women. Some of them had been through chemotherapy and could only conceive with the embryos we had frozen.”
Among the would-be mothers were cancer patients, women over 45, and those with ovarian failure—patients whose physiological and financial circumstances made it unlikely they'd be able to undergo another round of treatment.
Leila Najjar, mother of two IVF-born children, had been preparing for the transfer of a third embryo. In an interview, she said:
“We had a dream—a son. Years of injections, hormones, savings—it was all lined up. Now, it's all gone.”
Another woman, 26-year-old Noura, recounted how she lost her newborn twins due to the lack of emergency care and the impossibility of reaching a hospital:
“One died during birth, the other hours later. We couldn’t even bury them. No children, no embryos, no future.”
Dr. Khalil called the damage “irreparable,” emphasizing that no humanitarian aid or international program could compensate for what was lost. This wasn’t just a healthcare disaster, he said—it was a violation of women’s fundamental reproductive rights.
Israel’s Position: Legal Defense, Strategic Rationale
Israel has pushed back hard against the framing of the El-Basma strike as a war crime or breach of international law. Israeli Defense Forces (IDF) spokespeople maintain that every strike undergoes rigorous vetting and that battlefield decisions are made in a fluid, high-risk environment “engineered by Hamas.”
In response to an inquiry, the IDF released a statement:
“We cannot confirm a strike on the specific facility without precise data—coordinates, time of attack, and photographic evidence. Every operation is guided by multi-source intelligence and subject to a three-tier target validation process, including legal review.”
This doctrine—referred to as “smart targeting”—defines a building as a legitimate military target if it meets any of several criteria: storage of weapons, use as a command post, coordination of attacks, or dual-use functionality (civilian-military overlap).
Col. Amir Cohen, an IDF spokesperson, elaborated:
“When Hamas systematically embeds military operations inside schools, hospitals, mosques, and clinics, no place is categorically off-limits. Our duty is to protect Israeli lives.”
Israeli officials also brushed off a March 2024 UN panel accusation, calling it “legally vague and politically motivated.” On April 5, Prime Minister David Mizrahi responded forcefully:
“The UN Human Rights Council has long ceased to be a neutral body. Since October 7, over 15,000 rockets have been fired into Israel. We didn’t start this—we’re answering.”
He pointed to Article 52 of the First Additional Protocol to the Geneva Conventions, which states that civilian structures lose protection if used for military purposes. According to Mizrahi, Israeli intelligence had “documented Hamas activity” near the IVF center.
Still, no conclusive evidence has been made public that directly links the El-Basma clinic itself to any military use. Privately, Israeli military sources cite “command activity within 100 meters” of the facility—a claim that, even if accurate, stops short of proving the clinic was a legitimate target.
The erasure of Gaza’s only IVF clinic isn’t just a footnote in a larger war—it’s a grim symbol of the human costs rarely captured by statistics. It reflects a conflict where the destruction of buildings means the destruction of lives yet to be born, where strategy collides with biology, and where the battlefield reaches into the most intimate corners of human aspiration.
What was lost in El-Basma was not just medical material—it was potential, motherhood, and memory. And unlike roads or hospitals, these can’t be rebuilt.
The Fertility War: Israel’s Defense, UN Accusations, and the Fallout from a Strike That Shattered Generations
Israel has repeatedly insisted that its military operations in Gaza are grounded in international law, citing Article 51 of the UN Charter—the right to self-defense—as a legal bedrock. The IDF says it adheres strictly to the principle of proportionality under Article 57 of Additional Protocol I to the Geneva Conventions and employs “roof knocking” techniques—advance warnings issued to civilians before a strike. It also claims to conduct internal investigations into every suspected breach of rules of engagement.
Brigadier General Daniel Sherman, head of the IDF’s legal division, emphasized:
“We operate under a unique system of legal oversight. Every strike undergoes a review by a military attorney. In fact, around 15% of planned targets were aborted for legal reasons—primarily due to excessive risk to civilians.”
Israeli officials argue that much of the international criticism fails to account for Hamas’s alleged tactics: deliberately blending military assets into civilian areas to trigger global outrage against Israel. According to a December 2023 report by the Alma Research & Education Center, Israeli forces were engaged in targeted operations across southern Gaza, particularly in Tel al-Hawa—a neighborhood where, they claim, Hamas operated a weapons depot, a command node embedded in a residential block, and a signal relay system concealed within civilian infrastructure.
A preliminary report released by Israel’s military ombudsman in April 2024 stated that no fertility clinics were included on the list of pre-authorized targets. This suggests that the El-Basma strike may not have been intentional, but rather collateral damage from an attack on a nearby objective—or a consequence of a secondary explosion.
What truly infuriated Israeli officials, however, was a UN expert panel’s March 2024 statement suggesting that the IDF’s actions could constitute “an act intended to prevent births within a specific ethnic group”—a direct reference to one of the criteria in the 1948 Genocide Convention.
Israel’s Ministry of Foreign Affairs hit back:
“This interpretation is legal lunacy. Israel is not waging war against Palestinians as an ethnic group. We are confronting a terrorist organization that uses civilians as shields. Any comparison to genocide is not only baseless—it’s obscene.”
Tel Aviv has also emphasized its independent legal apparatus, pointing out that the International Criminal Court (ICC) declined to intervene in 2021 on cases already under internal review—an argument Israel continues to wield in its defense.
In January 2024, Israel’s chief military prosecutor stated:
“In the case of the El-Basma clinic, we have no conclusive evidence that the strike was deliberate or directly aimed at a medical facility. An internal inquiry is underway, but what we know so far suggests there was no intentional targeting of a healthcare institution.”
Israel’s overarching legal and political position is built on what it calls a framework of "layered defense"—a combination of necessity, legal constraint, and battlefield reality. It argues that its actions in Gaza were dictated by operational complexity and the deliberate use of civilian infrastructure by Hamas. Whether El-Basma was a targeted facility or the unintended victim of proximity remains unanswered, pending the results of the ongoing investigation.
UN’s Verdict and Legal Alarms
In a joint report released in March 2024, UN Special Rapporteurs on health, sexual violence, and women’s rights labeled the destruction of Gaza’s fertility centers as “systematic and deliberate.”
“The obliteration of IVF centers, the denial of access to frozen embryos, and the interruption of fertility procedures constitute a form of reproductive violence,” the report stated, “and may meet the threshold of actions aimed at preventing reproduction within a specific ethnic group.”
Carla Essad, a scholar of international humanitarian law, added that such acts could fall under Article II of the Genocide Convention—if intent to destroy part of an ethnic group can be proven.
El-Basma was more than a clinic—it was a lifeline. Founded in 2014 in the Tel al-Hawa neighborhood, the center had become Gaza’s premier institution for assisted reproductive technology. Offering everything from diagnostics to embryo storage and transfer, it treated up to 1,800 couples annually, with over 600 of them in the advanced stages of IVF.
Dr. Youssef Abdallah, a senior embryologist at El-Basma and a professor at Al-Azhar University, put the loss into stark terms:
“What we lost isn’t just a lab. It’s ten years of building an irreplaceable medical infrastructure under blockade. Hundreds of millions in humanitarian grants, international training, clinical partnerships—gone.”
At the time of the strike, El-Basma’s cryo-storage held:
- 4,071 embryos, more than 1,200 ready for implantation
- 1,320 sperm samples, many from cancer patients who preserved fertility ahead of chemotherapy
- 967 oocytes, harvested through invasive, anesthetized procedures
All of it was destroyed when the liquid nitrogen tanks were damaged, causing temperatures to rise above the critical -196°C threshold. Embryologists say that even a brief spike of 10–15°C leads to irreversible genetic damage.
According to estimates from the Gaza Ministry of Health and the clinic itself, between 140 and 170 women lost their chance to complete treatment. Among them:
- About 60 women over the age of 42, with near-zero natural fertility
- 15 cancer patients who had banked oocytes prior to chemotherapy—re-collection now medically impossible
- Around 30 women with rare reproductive syndromes, undergoing costly treatment under international humanitarian programs
A War That Kills Futures, Not Just Bodies
The destruction of El-Basma reverberates far beyond its walls. Experts and humanitarian observers see it not just as a tragic medical event, but as a trauma with demographic and psychological ripples that will be felt for years. In a region where childbirth is not only personal but cultural, the erasure of reproductive hope cuts deep.
The future of Gaza’s families now lies in limbo—frozen embryos lost forever, wombs left waiting, dreams destroyed. And in the fog of war, the question lingers: was it a tragic accident, or something far more damning?
Dr. Nadia Hashash, a reproductive endocrinologist who had worked with the El-Basma clinic, put it plainly:
“IVF isn’t a one-size-fits-all procedure. Every cycle is custom-tailored—hormonally intense, physically taxing, and deeply age-sensitive. Losing those embryos isn’t just losing one round of treatment. For many women, it was their last chance.”
According to the Palestinian Fertility Association, at least 22 women were undergoing donor-assisted treatments at the time of the strike—programs that are now impossible to resume. With the Gaza blockade restricting the import of critical medical supplies and no international oversight mechanisms in place, these treatments are gone for good.
The psychological toll is staggering. A 2018 study by the World Psychiatric Association found that, in conflict zones, infertility increases the incidence of PTSD symptoms by 38%. Among women who’ve undergone failed IVF, the likelihood of clinical depression multiplies by 3.5. In Gaza, those statistics are not just numbers—they're magnified by local realities:
- Motherhood is both a religious and cultural pillar of identity.
- There are no functioning alternative clinics offering comparable services.
- Gaza has just five licensed psychotherapists for its 2.3 million residents.
Leila Shawani, a psychologist working with women affected by the El-Basma destruction, said not a single patient has returned to a stable emotional state six months after the incident.
“This is a form of permanent grief. These women didn’t just lose the hope of becoming mothers—they lost a part of their identity.”
A December 2023 report from the World Health Organization paints a grim picture. Before the El-Basma strike, Gaza had only nine reproductive health facilities, including private clinics and fertility departments in public hospitals. After the destruction of El-Basma and the shutdown of two other centers in Deir al-Balah and Khan Younis, the territory’s entire reproductive care infrastructure effectively collapsed.
According to WHO:
- 97% of women in Gaza no longer have access to fertility testing and diagnostics.
- More than 1,200 women on IVF waiting lists have been excluded from treatment indefinitely.
- As of January 2024, Gaza had zero operational cryogenic storage facilities.
This collapse doesn’t just halt future procedures—it annihilates the past. Thousands of previously stored samples are now lost, including embryos belonging to Palestinian women who live abroad and had planned to return for implantation. Their plans, like their embryos, are now suspended in time—and unlikely to be revived.
Under international humanitarian law, health facilities providing maternal and reproductive care enjoy special protection. Articles 16 and 18 of Additional Protocol I to the Geneva Conventions explicitly shield such institutions from attack, except in cases of direct military necessity. Absent that, any assault on them may constitute a violation of the principles of proportionality and distinction—the legal bedrock for determining the legitimacy of strikes in war zones.
In Gaza, those principles are now at the center of a growing global debate. Was El-Basma a casualty of legitimate warfare—or a red line crossed? Was the loss of those embryos unavoidable, or the consequence of a war logic that failed to account for what it means to destroy not just bodies, but the future itself?
As investigators dig for answers, the women of Gaza are left with none. Their wombs are empty. Their embryos are gone. And the world watches—largely in silence—as an entire generation disappears without ever being born.
Where Life Was Meant to Begin: The Legal and Human Cost of Gaza’s Reproductive Collapse
Beyond the grief and broken futures, the destruction of Gaza’s El-Basma fertility clinic opens a legal and moral fault line that cuts deep into international law, public health, and the rights of women under siege.
Reproductive rights are not abstract ideals—they are enshrined in binding global instruments:
- the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW);
- the Cairo Declaration on Population and Development;
- and the WHO’s Global Strategy for Women’s, Children’s, and Adolescents’ Health.
Professor Adel Hariri, an expert in international humanitarian law, explains:
“The deliberate or foreseeable destruction of facilities that provide access to reproductive care can constitute a violation of women’s rights to health, autonomy, and bodily integrity—especially when there’s no path to resume treatment or recover lost biological material.”
The devastation in Gaza, he notes, should not be measured in clinical terms alone. This is a profoundly personal loss—inflicted in a time of war—shaped not just by missiles, but by the total collapse of systems meant to sustain life. It is structural violence in its purest form: an attack not only on fertility but on dignity.
And without alternative clinics, foreign aid, or viable treatment pathways outside the besieged territory, the obliteration of El-Basma is not a temporary disruption. It is a complete erasure of Gaza’s reproductive medicine—a zeroing out of an entire field of care.
This is not a footnote in a casualty report. It is the extinguishing of futures that had already begun to form.
A War That Strikes the Womb
The El-Basma case is now seen by many legal experts as one of the most unusual and troubling precedents in modern warfare—an instance where the trauma of war extended not just to life lost, but to life that never got the chance to begin.
While Israel faces ongoing scrutiny for alleged excessive use of force, the strike on a fertility clinic creates a new and intimate dimension to the conflict—one where the effects of war enter bedrooms, wombs, and the psychological interiors of families. This isn’t merely a public health crisis. It is a crisis of memory, identity, and survival.
And it raises serious, unresolved questions:
– Did Israel possess intelligence that indicated the building was being used for military purposes?
– How many other health sectors have faced similar strikes—and what does a pattern of such incidents imply?
– What is the legal threshold for protecting reproductive infrastructure in conflict zones—and should this be codified in future international treaties?
So far, Israel has provided no publicly verifiable evidence that El-Basma was a legitimate military target. Meanwhile, the UN Human Rights Council and the UN Independent International Commission of Inquiry on the Occupied Palestinian Territory are both reviewing the case. Depending on their findings, this incident could move into the international legal spotlight.
The destruction of Gaza’s last functioning IVF center is more than an operational tragedy. It’s a moral one. It’s about the stolen possibility of birth in a place where birth was already a form of defiance against siege, poverty, and war.
And so, while the world debates legality, proportionality, and the rules of engagement, one truth remains chillingly clear:
Gaza’s war has reached the very moment before life begins—and extinguished it.