There is a significant increase in the use of assisted reproductive technology to treat infertility, yet access to services is not equal for all women in the United States. Some marginalized groups face significant barriers accessing assisted reproductive technology. The authors review obstacles preventing marginalized populations from procreating, based on class, race and ethnicity, age, marital status, sexual orientation, and disability. The sociopolitical climate in the United States that maintains these obstacles is evaluated by the authors in this article. Finally, suggestions are provided for structural changes to decrease disparities in access to assisted reproductive technology and recommendations for family therapists working with clients who are unable to access assisted reproductive technology.