Oocyte and embryo donation have evolved significantly since they were first introduced to treat human infertility nearly four decades ago. Social, ethical, and regulatory challenges to oocyte and embryo donation have generated controversy and invited public scrutiny. However, oocyte and embryo donation continued to provide physicians the opportunity to treat the ''untreatable.'' Undoubtedly, clinical practices related to oocyte and embryo donation have greatly changed over the years. Yet, they have endured as viable choices of treatment for many patients and their physicians, remained popular owing to their versatility, and, perhaps most importantly, provided consistently high pregnancy success rates. (Fertil Steril Ò 2018;110:981-7. Ó2018 by American Society for Reproductive Medicine.