Fairy slipper reproduces by seed and vegetative means .
Breeding system: Fairy slipper is monoecious and cannot self-pollinate .
Pollination: Proctor and Harder  suggest that the natural unit of fairy slipper pollen deposition (the pollinium flake) contains sufficient pollen to fertilize most ovules. They also suggest that the pollen load affects the seed number. Pollination requires assistance of bumblebees .
Seed production: The seed production of fairy slipper is directly affected by the amount of pollen deposited on the stigma. Seed production is greater when there is more pollen deposited . An average seed count per capsule ranges between 10 and 20,000 .
Seed dispersal: No information is available on this topic.
Seed banking has not been documented in fairy slipper. Maryland field and greenhouse studies documented a seed bank in 7 other orchid genera, however. Soil-stored seed remained viable for 3 to 7 years of the 7-year study period at germination rates ranging from 30.5% to 74.9%. In greenhouse trials, orchids growing in soil inoculated with mycorrhizal fungi showed greatly increased germination rates compared to orchids in uninoculated soil . Although fairy slipper was not tested, these results suggest that fairy slipper may have a seed bank and require mycorrhizaal associates for best germination. Further research is needed on fairy slipper's life history.
Germination: Most fairy slippers require one of a number of different mycorrhizal fungi in the protocorm (1st stage of seed germination) tissue for germination to take place . Arditti and others  report that in the greenhouse, seeds from ripe capsules germinated very poorly or not at all, while 80% of immature seed in green capsules germinated. This suggests that fairy slipper seeds become less viable over time.
Seedling establishment/growth: Seedlings are rare in the Great Lakes region, but are "much more common" in mountainous regions of the West .
Asexual regeneration: Fairy slipper sprouts from underground corms. Following anthesis the nodal region of the corm gives rise to a new shoot bud, which will become the new corm. The previous year's corms remain in sequence, attached to the younger corms for 2 to 4 years .
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