Medical Ethics is increasingly recognised to be central to Good Medical Practice and the field of reproductive medicine presents some of the most challenging and complex issues of any branch of medecine. Scientific progress in ART has advanced so rapidly that Ethicists struggle to keep pace, but fertility clinicians can help to bridge the gap between clinical care and the sometimes ‘sci-fi’ world of the embryology laboratory. They can help patients benefit from developments that offer would-be parents the chance of a family without the risk of genetic disease and thereby advance one of humanity’s major goals. Society too is entitled to be engaged in the debate: the transition in just 42 years from in vitro fertilisation being a way of by-passing blocked Fallopian tubes to egg donation, egg freezing, womb transplantation, posthumous reproduction and CRISPR gene editing has raised issues that legislators struggle to explain and some faith groups strive to contain. As clinicians, we are confronted with the patient in the consulting room whom we long to help. We face a difficult balancing act between what is technically feasible, what is practically possible and what is ethically acceptable given resource and other restraints.This chapter is intended to help fertility clinicians achieve that balance.