Cytogenetic abnormalities of the human oocyte, as described by Pellestor, are remarkably common and there appears to be a multifactorial effect of maternal ageing. Aneuploid embryos are common following in vitro fertilization (IVF), even in unstimulated cycles. Egg freezing has proved to be technically much more difficult than embryo freezing. Ovarian failure is an untreatable condition but the opportunity for pregnancy can be restored by egg donation. Success rates are high and are maintained with increasing age. If the uterus cannot support a pregnancy, for example because of fibroids, or if the potential mother is too unfit for pregnancy, surrogacy will be required. In reviewing the uses of assisted reproduction, some 'abuses' have been revealed. The infertile couples seeking help can be desperate for treatment and therefore be vulnerable to suggestion. Reproductive tourism is burgeoning, driven by women's needs for treatment but also by commercial interests.