In vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), and other technologies of assisted conception have been heralded by the medical community and the media as "the answer" for infertile couples. "Tough Choices" presents a forum of international voices posing critical questions: What are the medical and social options for couples facing infertility? What is known about the safety, costs, and benefits of reproductive technologies? What is to be done about the diversion of resources away from pressing community health needs? "Tough Choices" argues for a public health approach to infertility, maintaining that too little attention has been given to the social, ethical, and legal issues involved. It includes an author note: Patricia Stephenson is Senior Researcher at the Centrum for folkhalsoforskning in Sweden. Marsden G. Wagner is Regional Officer (retired) for Maternal and Child Health for the World Health Organization's European regional office.