Infertility, defined as the inability to conceive after 12 months of unprotected intercourse, impacts one in eight American couples. Evidence suggests ethnic differences in causes of infertility and adverse obstetric outcomes that warrant a unique investigation and understanding. Differences in etiology and response to fertility treatment have been deemed in part genetic, geographic, and because of historic injustices that have dictated societal norms. Additionally, disparities in income and access to medical care have further contributed to ethnic differences in infertility prevalence and pursuit of effective fertility treatment. This chapter highlights these differences both nationally and more broadly internationally. Finally, this chapter concludes with future directions—understanding ethnic differences in the prevalence of common conditions that impact one’s fertility will undoubtedly inform opportunities to ameliorate these causes. Future provisions of fertility treatment should aim for an individualized approach.