ESHRE 2026: How reproductive ageing, personalisation and AI are reshaping fertility care
Despite affecting around one in six people globally (WHO 2025), infertility has long been framed as a private struggle rather than a serious medical condition warranting dedicated clinical care and sustained investment. However, discussions emerging from the 2026 Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) reflect a broader transformation underway across the field. As people choose to have children later in life and the population seeking to conceive grows increasingly diverse, fertility care is shifting from standardised protocols toward personalised, goal-oriented treatment, supported by rapid advances in Artificial Intelligence (AI)-enabled care.
Treatment approaches are evolving alongside advanced reproductive age
Advanced reproductive age (ARA) emerged as a key theme across multiple ESHRE 2026 symposia, reflecting the growing challenge of treating women aged >35 years with declining ovarian reserve. Research (Jun 2025) of single euploid blastocyst transfers challenged the assumption that maternal age directly limits implantation once a competent embryo is available, finding no significant effect of oocyte provider age on pregnancy or live birth outcomes after euploid embryo transfer. Instead, the primary age-related constraint appears earlier in the pathway: fewer oocytes are retrieved, and fewer embryos reach euploid status, shifting the focus from per-transfer success rates towards cumulative embryo yield. This has shifted treatment goals towards accumulating sufficient euploid embryos to maximise the likelihood of achieving desired family size, supporting approaches such as embryo banking, dual stimulation and personalised stimulation strategies.
The “fertility gap”, defined as the difference between the number of children people intend to have and the number they ultimately achieve, was also a topic discussed throughout the congress. While IVF success rates are often communicated on a per-cycle or per-transfer basis, they may not fully capture the probability of achieving broader family-building goals, particularly for women seeking more than one child. Furthermore, real-world IVF outcomes may be influenced by treatment discontinuation. Increasing discontinuation rates across successive IVF cycles represents a key unmet need, highlighting the need for strategies that support treatment persistence.
Increasingly diverse populations seeking fertility treatment are driving personalised care
The fertility and reproductive health sectors are also experiencing dynamic growth, driven by shifting demographics and evolving societal attitudes, which was a theme that featured strongly throughout ESHRE 2026. The population seeking to conceive has grown more diverse, encompassing transgender and gender-diverse individuals and same-sex couples, reflecting a broadening concept of family. Wider use of GLP-1 receptor agonists has also sparked discussions around obesity and pregnancy. Beyond this, patients with specific conditions, including women with Polyendocrine Metabolic Ovarian Syndrome (PMOS), endometriosis or malignancy, are being managed in a more personalised way, partially supported by increased diagnosis rates. This was seen through tailored GnRH stimulation protocols, with ESHRE’s 2025 guidelines recommending dose adjustments according to predicted ovarian response. The guidance supports lower doses in patients at greater risk of ovarian hyperstimulation syndrome (OHSS) and notes that increasing doses beyond a certain threshold does not improve outcomes. Discussions also included male infertility, specifically the role of genomic approaches in non-obstructive azoospermia. An article (Feb 2025) indicated that sequencing can inform both molecular diagnosis and the likelihood of successful sperm retrieval, which is also addressed in Merck’s acadeMe programme.
This theme of personalisation is also reflected across the broader WH landscape, with expanding hormonal and non-hormonal options and different dosing modalities across contraception and menopause care.
AI applications in embryo and oocyte assessment is gaining momentum
One of the clearest technology themes emerging from ESHRE 2026 was the expanding role of AI across the IVF pathway. Discussions this year highlighted growing interest in applying AI in the treatment journey to assess oocyte quality, an area that has traditionally relied on subjective morphological assessment and remains one of the greatest challenges in predicting IVF success.
Advances in machine learning are enabling algorithms to integrate oocyte morphology with imaging and other biological data to generate standardized assessments of developmental potential. Previous research (Jul 2025) suggested that these approaches could improve the prediction of oocyte competence beyond conventional visual grading, helping HCPs make more informed decisions while reducing variability between embryologists. As these tools continue to develop, they may support more individualized treatment planning, improve counselling around expected IVF outcomes, and optimize the use of retrieved oocytes.
Companies such as Future Fertility are already bringing AI-powered oocyte assessment into clinical practice, with recent investment (Apr 2026) aimed at expanding global access to automated egg quality assessment technologies. Meanwhile, Merck highlighted AI as a strategic focus during its ESHRE 2026 symposium, underscoring growing industry recognition that digital technologies will become an increasingly important component of next-generation fertility care.
The future of reproductive medicine
Fertility care is gaining momentum and assisted Reproductive Technology (ART) is fast becoming central to how the next generation builds families. Innovation is coming from every direction: novel treatments (Gameto), mental health support built into fertility care, at-home testing (Hertility), insurance and financing (Future Family, Gaia Family), and end-to-end packages covering IVF, egg freezing, and adoption assistance (Progyny).
ESHRE 2026 made one thing clear: fertility is not a one-off clinical episode. It sits at the intersection of reproductive ageing, metabolic and endocrine health, mental health, and changing definitions of family. That conversation is expected to carry into the rest of 2026 with the ASRM Scientific Congress & Expo (Oct 24–28) and ASRM Innovate (Oct 28-29) expected to push reproductive science and technology forward, followed by the 8th International Conference on Women’s Health, Reproduction and Fertility in Barcelona (Nov 19–20).
