While assisted reproductive technology gives hope to couples who otherwise could not conceive a child, there are many factors to consider such as ethical decisions you may have to make, financial investment, the time it may take to conceive and the stress on a relationship.   

Embarking on the path of assisted reproductive technology is not for the faint of heart.  People must navigate a whole myriad of difficult issues, not the least of which is its emotional toll.  It can be a roller coaster of hope and disappointment.  The resulting stress can negatively impact everything – a couple's general health, their job performance, and even their marriage.  Most couples can benefit greatly from ongoing counseling and participation in support groups.

The costs can be high financially as well as emotionally.  Costs for vitro fertilization (IVF) can range from $5,000 to $15,000 – and up. And it's difficult to make financial decisions in the midst of emotional turmoil.  However, while costs can be substantial, they can be managed when couples do their homework and create a plan.  The steps they can take include:

• Learning all they can about treatment
• Analyzing their finances
• Learning the ins and outs of insurance
• Investigating sources of funding
• Making decisions early on about how far they are willing to go
• Investigating the alternative of adoption

Finally, couples need to be aware of the physical and ethical issues that come up during and after treatment. 

There are physical risks to many of the procedures.  If surgery is required, there are all the normal risks associated with it.  Ectopic pregnancy (a pregnancy in the fallopian tube or outside the uterus lining) is possible.  Some preliminary studies have suggested that fertility drugs may lead to an increased risk of ovarian cancer.  Women carrying multiple pregnancies are more likely to need to spend weeks or months in bed and are more likely to miscarry or give birth prematurely.

Ethical issues, in particular, can be devastating for couples to face.  For instance, when multiple babies are conceived, it may become necessary to remove one or more fetuses to improve the survival odds for the others.  Sometimes "extra" embryos are cryopreserved for later use but are not needed.  What are the ethics and emotional repercussions of disposing of something that has the potential to become human life?  Couples who are considering infertility treatment need to discuss these possibilities and others before starting treatment. 

Complex moral and societal questions are being asked and debated by lawmakers, scientists and religious leaders alike.  

• Is infertility a disease?  And if so, should treatment be covered by medical plans?
• What counts as fair and equitable access to infertility treatment?  Should it be available only to those who can afford it?
• What is the moral status of a human embryo?  

As is often the case with advances in technology, the scientific strides made in infertility treatment will continue to raise dilemmas of policy, law, regulation and philosophy that have never before faced humankind.