Abstract: This chapter focuses on the right (or rights) to procreate in the United States, with a focus on reproductive technology use. The United States has been too often described as the “wild west” of reproductive technology use. When measured against many of its comparators — Canada, Australia, the UK, Germany, etc. — it is undoubtedly true that more forms of reproductive technology use are permitted in the United States than elsewhere. It is for this reason that the United States has been a frequent destination for “circumvention tourism” or “fertility tourism.” At the same time, it would be wrong to think that reproductive medicine is unregulated in the United States. The chapter argues that it is just that the regulation is more fragmented, both in terms of the locus of control (federal vs. state authority, governmental vs. professional self-regulation, etc.) and also of the legal sources involved (more of a focus on tort law and family law than direct regulation at the statutory or constitutional level).