The conquest of infertility is an incredible achievement, it is a victory of human will, endurance and technology. However as we have entered the new millennium, new challenges are arising in relation to scientific, ethical and humanitarian aspects in infertility management. However, in spite of our increasing knowledge and skills many questions remain unanswered and new concerns and problems constantly arise. In the early nineties, ICSI was still an experimental therapeutic approach yet in the meantime it has revolutionized the treatment of male infertility worldwide. Testicular sperm extraction for ICSI and cryopreservation techniques are important milestones in assisted reproductive technology while in vitro maturation of germinal cells the intracytoplasmic injection of round and elongated spermatids are still in the experimental stage. In the last few years new compounds such as recombinant gonadotropins (FSH LH and hCG) and GnRH antagonists came into use for ovulation induction and controlled ovarian stimulation which improved safety, allows for individualized adjusted therapies and make treatment more patient friendly.