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In March 2004 the Italian Parliament enacted a Law (Law 40/2004) establishing a long list of restrictions for ART procedures. The law articles were constructed around the assumption of considering the embryo as a human being, with the same or even more rights of the woman or the couple seeking treatment for their infertility-related childless. In detail, the Law obliged to use only 3 oocytes to be fertilised and all the resulting embryos had to be transferred. Embryo freezing as well as pre implantation screening (PGS) or diagnosis (PGD) and sperm or oocytes donation were forbidden. In May 2009 the Italian Constitutional Court was called to judge parts of the Law 40 and cancelled some of the restrictions since they violated women’s rights to have access to the best possible treatment with the lower health risks for both her and the future children. The Constitutional Court stated that the decision on the number of oocytes to be used for insemination, the embryos to be transferred and the embryos to be frozen were a matter of good clinical practice and under the full responsibility of the reproductive specialist. PGD and PGS remains a matter of debate because the Court was not called specifically to address this subject, although a clear opinion in favour has been expressed in previous decisions. The Constitutional Court will be called only in the future to express a judgement on gametes donation that is still forbidden. The present work reviews the clinical and social effects produced by 5 years of a restrictive ART Law (2004-2009); the preliminary results after the Italian Constitutional Court decision (May – December 2009 and comments on cross border infertility treatment for procedures that are still barred.