Innovations in assisted reproductive technologies: evaluating efficacy, safety, and long-term outcomes in female infertility

This narrative review evaluates innovations in assisted reproductive technology (ART) for female infertility, focusing on efficacy, safety, and long-term outcomes. The key objectives include synthesizing advancements such as artificial intelligence (AI)-driven embryo selection, preimplantation genetic testing (PGT), vitrification, and time-lapse imaging, along with their clinical applications. Evidence indicates that PGT can improve implantation and live birth rates per transfer in selected patient groups, that is, those with recurrent pregnancy loss or advanced maternal age. Evidence of AI-assisted selection is promising, but predominantly retrospective, with the potential to improve the efficiency of embryo selection, but has not yet been proven across a variety of clinical settings. However, safety concerns, including ovarian hyperstimulation syndrome, multiple pregnancies, and potential long-term maternal and offspring health risks, persist. Critical reflections highlight ethical dilemmas (e.g., "designer babies", embryo disposition), psychological stressors for patients, and disparities in ART access due to socioeconomic factors. This review underscores the need for personalized protocols, robust longitudinal studies on child development, and equitable policy frameworks. These conclusions advocate for interdisciplinary collaboration to balance technological innovation with ethical integrity, psychological support, and global accessibility.