The premise of this argument is that there is an appropriate age limit for conventional IVF/ICSI treatment. Why should there be a limit at all? It may be argued that as long as we can squeeze an egg out of an ovary and a woman wishes to proceed that should be enough for us to proceed. Good medical practice dictates that doctors advise patients with honesty and integrity and that might include advising no treatment – there is no compulsion to provide a patient with treatment on request or payment. For fertility specialists to fulfil every patient request whatever the ‘cost’ would class us alongside commercial surgery. If we are to argue that infertility is a medical diagnosis then we must not accept the definition of ‘industry’. There are a number of reasons why we might not accede to a request for IVF/ICSI in women past their 43rd birthday.