In this paper, I examine the sense of loss that some adoptive parents experience in being unable to conceive and how this interfaces with the “ambiguous loss” of the birth mother for the adoptee. I outline an interpersonal-relational perspective on adoption using current thinking on the concept of projective identification. I propose that the adoptive parents and their own attachment histories, including their representations of the adoptive child, partially determine the meaning (s) of the adoption transmitted to the adoptee. The multiple losses associated with infertility interact with the young child's understanding of his origins, his self-representation, his fantasies of where babies come from, and the conscious and unconscious meanings of adoption within the family constellation.