Fertility is markedly compromised several years before the menopause, suggesting that factors other than complete depletion of the follicular store play a role in the loss of oocyte competency in ageing women. The reduced reproductive potential of older women is related to the functional and structural qualities of the oocytes. Older women are more likely to be affected by a number of pathologies that can reduce their fertility potential. Increasing maternal age is also associated with an increase in ovulatory dysfunction. Reduction in uterine receptivity as a possible contributing factor to the decline in fertility with age has been difficult to ascertain. Fibroids that distort the uterine cavity can reduce the chances of successful implantation. This chapter discusses various assisted reproductive technologies, namely, in vitro fertilization (IVF)/gamete intrafallopian transfer (GIFT), ovarian stimulation for IVF/GIFT, donor insemination, oocyte donation, assisted embryo hatching, blastocyst transfer and preimplantation genetic diagnosis (PGD) of aneuploidies.