In Ecuador, reproductive assistance, whether from God, extended family, or medical technologies, is emphasized and desirable in a precarious and unequal world with a minimal social safety net and chronic economic insecurity. Assistance is the very grounds of being. In better-resourced realities like parts of the United States, assisted reproductive technologies can trouble the biological and social autonomy of individual heterosexual couples. Juxtaposing assisted reproduction in these divergent sites demonstrates that resources can make autonomy easier to establish and assistance between people and things difficult to perceive. Through an insistence on the material specificity of assisted reproduction itself, this ethnographic contrast contributes to anthropological approaches to ontological questions of being. In particular, ethnographic observation of the material realities of reproductive treatments in Ecuador demonstrates that medical care is one means to instantiate race. Private assisted reproduction makes whiter babies and patients in the face of a crumbling public health care infrastructure whose patients are by definition poor and Indian. The framework of assistance might serve then as a means to ethnographically trace the constitution of racial being in better-resourced nations, as well as allow for a more comprehensive recognition of the interdependence of existence.