Infertility and Assisted Reproduction: The Future of Assisted Reproduction

The future of assisted reproduction lies in optimization of each treatment phase starting with ovarian stimulation through laboratory procedures, selecting the best embryo for transfer, embryo transfer, luteal phase support leading to pregnancy, and the birth of a healthy single ton baby. Gonadotropin-releasing hormone (GnRH) agonists have changed the course of ovarian stimulation for in vitro fertilization (IVF). GnRH antagonists have been introduced recently in ovarian stimulation for pituitary suppression. High implantation and pregnancy rates in oocyte donation cycles irrespective of acceptors' age imply that ovarian stimulation impairs endometrial receptivity in stimulated cycles. Embryo transfer procedure plays a pivotal role in the success of assisted reproduction. Improving embryo implantation continues to pose a major challenge to clinicians. The future developments in assisted reproduction should encompass individualized approach to ovarian stimulation, vitrification, single blastocyst transfer, and development of new tools for genetic testing.