The technologies and apparatus of assisted reproduction take on special power in a milieu where it is thought possible to change one's “race.” Participating in Ecuador's nation-making through what the author of this remarkable ethnography calls a “national whitening project,” poorer people or clients of Indian background seek to transform themselves into objects of attention and care. In the care of whites, as doctors and clinical staff categorically are, the client becomes white. The means of such care is IVF, along with procedures such as egg donation or embryo freezing, delivered largely through private fertility clinics. The author brings out the fact that, crucially, the focus of assistance for many patients is less the modification of the materials of fertility (egg, sperm, embryo) than the patronage that is bestowed upon their person. Patronage is acted out in the clinic through the social activity entailed in attending to the patient's health and comfort, a relationship of dependence actively sought after by many women of the Ecuadorian Andes. They look for assistance, argues Roberts, because assistance is the very basis of existence—what is demonstrated at the clinic is that the patients are worthy of care.

For doctors, quite as much as patients, the epithet “assisted” takes on further resonances. In this Catholic country, God is everywhere, and an immediate, not distant presence. Yet rather than this presence stopping their activities, fertility clinics harness it. The scientific techniques that assist the procedures are also the means through which clinical personnel assist God: Roberts observes that in deliberately evoking common Euro-American notions, they do not perceive themselves to be “playing God” but rather as being “God's helpers.”

Rooted in anthropology, this book branches out in an informed and lively commentary on attitudes derived from the European Enlightenment to be found in mainstream (Euro-American) accounts of assisted conception. Among them is the kind of agency entailed in a nature/culture paradigm, whose starting point is that nature is a given; Andean approaches are more likely to have their roots in religious categories based on the pre-biological determinations of lineage that were precursors to the contemporary Ecuadorian concept of race. This is surely, really, a book of our times. It offers a skilful ethnography, a quite original cultural analysis, a contribution to science studies as well as medical anthropology, an engaging history of divergent religiosities, and a resource for anyone interested in diverse philosophies of personhood. It is also another chapter in the situatedness of knowledge and the specificity of race and gender relations. For all this, the narrative is not weighed down by the theoretical and conceptual forays—much of its life comes from the fine detail that gives it a human scale: from the aspirations of clinicians and clients, and from the stories patients tell of how they came to be where they are.