Assisted reproductive technology (ART) legislation varies across the world, and although most countries providing in vitro fertilization (IVF) treatment have some form of regulation, its extent varies significantly. Although the birth of the first IVF baby was nearly 50 years ago, aspects of fertility treatment can still raise concerns and be influenced by society, such as by religious views. ART also moves forward rapidly with scientific advances, and as new treatments are introduced, these may require legislation. Clinics working within a regulated sector may be confronted with the challenge of legislation changes. This paper outlines examples of legislative change, the consequences, and challenges these may present to an ART clinic, and considers how such changes may be managed effectively.