OBJECTIVES: Assisted Reproduction is among the fastest growing areas of medicine, rising debates about financing in vitro fertilisation (IVF) or other assisted reproductive techniques by national third party payer. This study describes policies of infertility treatment as well as willingness to pay for treatment in affected couples in Germany (contribution-financed health care system) and the U.K. (tax-financed health care system). METHODS: Literature review with the key words: infertility, willingness to pay, epidemiology. For assessment of national reimbursement policies, websites of the respective health care institutions were reviewed. RESULTS: In 2001, over 25,000 IVF treatment cycles were carried out in Great Britain, 25% being funded by the National Health Service. New clinical guidelines accepted by the Department of Health, assure that from 2005, more assisted reproduction services are covered by the NHS, such as one full cycle of IVF. Over 2/3 of the patients currently paying privately are expected to demand for NHS services resulting in an enormous increase in IVF treatment. In Germany, about 75,000 treatments were performed in 2001. Since January 2004, German statutory sick funds restricted reimbursement to 50% of the costs for the first three IVF treatment cycles. Due to these regulations, changes in treatment patterns for IVF can be expected for the future. An ongoing online-questioning revealed that for only 60%, the decision for IVF treatment remained unchanged, whereas the rest either postponed the decision or cancelled IVF. Two studies (USA, Sweden) revealed the willingness to pay of infertile couples to be 14,500€ or more. CONCLUSIONS: Contradictory dynamics between willingness to pay and change of mind due to restrictive reimbursement policies show need for more research in the field of infertility treatment. Economic and social consequences of changing frame conditions for IVF should be closely assessed, to ensure high quality of life for affected couples.