Interest in fetal intervention has become widespread in recent years. Laser therapy for the treatment of severe twin-twin transfusion alone has been the subject of more than 100 peer-reviewed articles in the past 3 years. Significant issues have arisen that affect the availability of these new therapies in the United States. Formal training fellowships have yet to be established. Questions as to the ultimate number of treatment centers that are required to provide reasonable access should be addressed. The establishment of research networks to evaluate new fetal therapies through randomized clinical trials would appear paramount to the advancement of the field.