The cultural and emotional importance of having and raising healthy children is undisputed. Cross-cultural solutions to problems resulting from involuntary childlessness have included such strategies as adoption, finding new partners, and dissolving marriages that do not produce offspring. While both males and female infertility may result from heritable factors, environmental exposures, and disease, it is usually the result of functional incapacity in youth and in old age. The high value attached to reproduction is not puzzling. Human reproduction is protected by strong basic instincts. Childlessness is seldom met with stoicism by those who wish to have children. The happiness that follows the successful birth of a wanted child must not be discounted. Traditional definitions of “family” imply “offspring” before the acknowledgment of other memberships.