One of the most fascinating things about practicing Reproductive Medicine in an ethnically and religiously diverse area is learning to understand the value systems that our patients bring to the table when they come to seek out fertility treatment. Some faiths such as Roman Catholicism reject Assisted Reproduction as a separation between reproduction and intimacy and others such as Judaism encourage it emphasizing the importance of the biblical commandment “to be fruitful and multiply.” Sunni Islam permits assisted reproduction but forbids the use of donors or gestational carriers. The most fascinating and perhaps most paradoxical is that of Shia Islam, the predominant religion in Iran. Most of the world views the Islamic Republic of Iran as one of the most brutal and intolerant in the world, yet when it comes to Assisted Reproduction, it is actually one of the most open minded. As pointed out in an Op-Ed in the Pittsburgh Post Gazette, Iran’s Shiite theocracy allows relatively unrestricted access to ART and IVF, including the use of egg and sperm donation, a practice forbidden in most of the Middle East. Iran, in fact, now has over 70 clinics, luring patients from Sunni countries that forbid the use of donation.