The chapter traces the emergence of a specifically modern understanding of infertility. It argues that the invention and introduction of in vitro fertilization (IVF) needs to be interpreted as part of a long-term development which dates back to the late nineteenth and early twentieth centuries. At this time, reproduction was increasingly interpreted as a matter of choice. As birth control spread, those experiencing reproductive difficulties looked for medical help and sometimes also for expert-led adoption. By reconstructing changes in the medical diagnosis of infertility, including by routine semen testing, and treatment, including by surgery to reposition the uterus or widen the cervix, tubal microsurgery and ovarian transplantation, the chapter explores the options available to patients. Based on contemporary publications, health advice literature, case records and individual testimonies mainly but not exclusively from Germany, the chapter documents how a growing belief in medical possibilities, in expert advice and in the malleability of the body within a culture of choice shaped distinctively modern experiences of infertility.