Spiros Liatsikos, consultant in IVF and reproductive medicine at CREATE Fertility, argues that personalised fertility treatment should be viewed as an extension of established reproductive medicine.
No two fertility journeys are the same. While some patients conceive quickly with minimal intervention, others face a complex combination of hormonal, genetic and lifestyle factors that can make treatment more challenging.
Advances in diagnostic testing, genetic screening and treatment monitoring have created new opportunities to tailor care more precisely to individual patients than ever before, particularly within IVF and assisted reproduction. At the same time, growing awareness of fertility challenges has encouraged more patients to seek treatment plans that reflect their personal circumstances, reproductive history and future family-building goals.
While personalised fertility treatment is often seen as the future of reproductive medicine, it does not mean creating a completely bespoke pathway for every patient. Instead, it involves adapting established, evidence-based treatments to account for factors that may affect treatment response and outcomes, particularly in more complex cases of subfertility or after unsuccessful treatment attempts.
What personalised fertility treatment means in practice
Fertility treatment has never been entirely standardised. Our clinical decisions have always been informed by factors such as age, hormone levels, ovarian reserve, sperm quality and medical history. Advances in reproductive medicine, however, have expanded the amount of information available to us when developing treatment plans.
Today, treatment decisions may be influenced by a combination of demographic and clinical factors, including age, BMI, fitness level, ethnic background, baseline hormonal profile, ovarian reserve markers such as anti-Müllerian hormone (AMH) and antral follicle count (AFC), baseline ultrasound findings, semen parameters and previous treatment outcomes.
Rather than applying the same approach to every patient, we are increasingly able to fine-tune stimulation protocols, monitoring schedules and medication strategies based on an individual’s specific reproductive profile and their previous response to ovarian stimulation or embryo development in earlier cycles.
Importantly, the personalised fertility care we provide remains grounded in established clinical guidelines. Our aim is not to replace evidence-based medicine, but to use available information to determine which proven approaches may be most appropriate for a particular patient. In practice, this means following the physiology of human reproduction closely, while making carefully considered adjustments where clinically indicated.
Why personalisation is becoming more important
The growing interest in personalised fertility treatment reflects the increasingly diverse needs of the patients we see. Many individuals now begin fertility treatment at later reproductive ages than previous generations, often after prioritising education, careers, financial stability or other life goals. As a result, we are caring for a broader range of patients with more varied and increasingly complex reproductive circumstances than in the past.
Personalisation often becomes particularly relevant in the more complex fertility cases we treat. Patients who have experienced one or more failed conventional treatment cycles, diminished ovarian reserve, lower expected response to medication, or multiple contributing fertility factors may benefit more from a tailored approach than from a fixed protocol.
In my experience, patients of more advanced reproductive age, with lower egg reserve and lower expected response to medication, tend to benefit most from individualised fertility care compared with those following a standardised treatment pathway.
Previous treatment outcomes can also provide us with valuable clinical insight, particularly in relation to ovarian response, fertilisation rates and blastocyst development in the laboratory. While diagnostic tests offer important information, a patient’s response to earlier treatment cycles may reveal patterns that help inform our future decision-making. This allows us to refine treatment strategies and make informed adjustments where appropriate.
Beyond clinical outcomes, tailoring treatment in these cases can also improve patient experience by reducing the physical and emotional burden of repeated cycles and, in some cases, reducing overall treatment cost by avoiding ineffective approaches. It can also increase patient confidence, as individuals feel their care is more closely aligned to their specific needs.
The continuing importance of standardised protocols
Despite growing interest in personalised care, standardised fertility protocols continue to play an essential role in my practice. Many established treatment pathways are supported by decades of clinical research and have demonstrated strong outcomes across a wide range of patient groups.
For many younger, healthy patients with straightforward fertility challenges, standardised treatment approaches often remain highly effective. These protocols may still benefit from minor adjustments during treatment, but extensive individualisation is not always necessary and may not improve outcomes.
The challenge for us as fertility specialists is therefore not choosing between standardised and personalised care, but determining where individualisation is likely to add meaningful value. Effective fertility treatment often involves balancing proven protocols with carefully timed, iterative adjustments across treatment cycles, rather than assuming a single protocol will be optimal from the outset.
Managing expectations around fertility treatment
As conversations around personalised medicine become more common, there is also a growing need for us to manage expectations about what fertility treatment can realistically achieve.
One of the most persistent misconceptions I encounter within fertility care is the belief that treatments such as IVF can guarantee a pregnancy or a baby. This expectation is common, even among patients of advanced reproductive age. However, the reality is that no fertility treatment can guarantee success. Biological factors remain fundamental to treatment outcomes, and age continues to play a major role. For example, in women over 42, success rates using their own eggs are often below 10%, and after 45, treatment with autologous eggs becomes highly unlikely to succeed.
Although personalised treatment may help optimise a patient’s chances of success, it cannot overcome the biological limits of reproductive ageing, including increased rates of oocyte aneuploidy and declining embryo quality.
For this reason, personalised care is not simply about identifying the most appropriate medical interventions. It also involves providing clear, realistic information that helps patients make informed decisions about their treatment options and expectations.
The future of personalised fertility care
Emerging technologies are expected to accelerate the shift further towards more personalised fertility treatment over the coming decade. Advances in genetic testing, new reproductive technologies and the wider use of artificial intelligence are likely to significantly enhance how we assess and manage fertility care in the future.
These developments have the potential to improve clinical decision-making, refine embryo selection and better predict treatment response, particularly in more complex cases. However, they also raise important challenges. Increasingly sophisticated technologies are likely to drive up the cost of fertility care, which may make advanced treatments less accessible to a significant proportion of patients.
Ensuring that innovation improves outcomes without widening inequalities in access to care will remain a key challenge for fertility services in the years ahead.
Ultimately, personalised fertility treatment should be viewed not as a replacement for established reproductive medicine, but as an extension of it. By combining evidence-based clinical practice with a deeper understanding of individual patient circumstances, we can deliver care that is both scientifically grounded and appropriately tailored to individual needs.
