It is important to rule out infertility caused by compulsive behavior that undermines a woman’s health. A woman who cannot conceive because she has an eating disorder should not be helped to conceive by artificial means. The risk of turning a mild chronic psychiatric problem into an acute problem is substantial. If the woman continues to try to maintain a physiologically unreasonably low weight, the fetus may suffer substantial damage. Given the psychiatric basis of the problem, an informed consent to accept the risk of pregnancy is problematic. If the woman had control of her behavior, she would have been able to conceive by gaining weight. The patient should be referred for psychological evaluation before any risky therapies are instituted.