Although controversial at the time of its introduction, assisted reproductive technology (ART) is now seen as a standard instrument in the toolbox at a doctor's disposal to assist infertile patients. However, ART has not been without its challenges, difficulties, and failings. An honest and open discussion of these hurdles, as well as the implications of new research and advances in assisted reproduction, was the motivation for a conference that took place in September 2013 in Florence, Italy, and ultimately this publication. Ten previously published journal articles, five on basic research and five on clinical work, were chosen by a panel of experts to be presented and challenged by peers in the field at this unique two-day meeting. This booklet brings together updates on those papers from the original authors as well as additional perspectives from leaders in the field. A summary of the conference itself is also included.