The concepts of infertility and childlessness are culturally moderated, and meanings and consequences differ in different social contexts. In the West, infertility, in the strict sense, is considered to be a medical term with a medical meaning (van den Akker, 2002). However, a number of other explanations and understandings of infertility exist cross-culturally. Not being able to have a child when one wishes has strong repercussions in many cultural contexts. However, at the same time, there is an increasing number of people who decide not to have children. Today, within Western societies, voluntary childlessness is increasingly respected and accepted as a ‘lifestyle choice’ (van Balen and Inhorn, 2002). Childlessness can therefore assume a number of guises: both voluntary and involuntary, medical and social. In this chapter, however, I will focus on involuntary childlessness. Involuntary childlessness can be caused by infertility, but is not strictly a medical concern. A person or couple can be defined as involuntarily childless for a number of social reasons including, in some contexts, the absence of children of a particular sex (Pashigian, 2002).