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What Fertility Clinics Don't Say: The Hidden Risks of Assisted Reproduction

Francisco Güell

July 10, 2026

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Perhaps the most alarming concern involves the serious health problems observed in the ART population, including congenital disorders, complications related to prematurity, and diseases that emerge later in childhood.<br>Post This

Psychologists are well aware of the considerable emotional exhaustion experienced by many couples after years of failed treatments—an exhaustion that remains largely invisible in public discussions.<br>Post This

The rapid expansion of Assisted Reproduction Technologies (ART) over recent decades has profoundly reshaped how society understands infertility, motherhood, and fatherhood. What was initially presented as an exceptional medical intervention has gradually become a widely normalized solution for those struggling to have children. More than 15 million children have now been born through ART worldwide;1 in countries such as Spain, births from these techniques account for nearly 14% of all newborns,2 while in the United States they represent approximately 2.6% of annual births.3

Yet this normalization has been accompanied by a serious information gap on two fundamental issues: the real success rates of these techniques and the health risks they pose to children. These omissions raise important questions not only for medicine, but also for family studies, public health, the ethics of reproductive decision-making, and even the prospect of future collective litigation.

Public Perception vs. Reality

As I explain in my book The Last In Vitro, public perceptions of assisted reproduction have been shaped by an incomplete and, in many cases, misleading narrative regarding both efficacy and safety. Fertility clinics commonly report their success rates in terms of positive pregnancy tests rather than live births, despite the fact that couples are seeking a child, not merely a favorable test result. This distinction is far from trivial. When official registries are analyzed using live births as the relevant outcome, success rates decline dramatically with age. Among women over 40, the probability of having a child using their own eggs falls to around 5% or 6%; by age 45, it barely reaches 2 percent. Yet public discourse routinely conveys the impression that reproductive technology can effectively overcome the biological limits of age.

Public discourse routinely conveys the impression that reproductive technology can effectively overcome the biological limits of age.

Psychologists are well aware of the considerable emotional exhaustion experienced by many couples after years of failed treatments4—an exhaustion that remains largely invisible in public discussions, where success stories and optimistic portrayals of reproductive technology tend to dominate. Yet this psychological burden is not limited to failed cases; troublingly, it is often present in successful ones as well. The low live-birth rates, combined with relatively high pregnancy rates, mean that many positive pregnancies end in gestational loss. When a child is ultimately born alive, the mother will commonly have suffered several miscarriages whose grief she never fully processed. After each loss, the focus shifts to moving forward and sustaining hope for the next attempt. As a result, perinatal psychologists and psychiatrists are increasingly recognizing that some women who become mothers after prolonged infertility and ART enter the postpartum period carrying unresolved reproductive trauma. This may manifest as persistent anxiety, hypervigilance, difficulties enjoying motherhood, and, in some cases, challenges in establishing a relaxed and confident early mother–infant relationship, highlighting the need for specialized psychological support.

Health Problems in the ART Population

Yet perhaps the most alarming concern involves the serious health problems observed in the ART population. The wide range of conditions identified falls into three major categories: congenital disorders detectable before birth, complications related to prematurity identified at birth, and diseases that emerge later in childhood.5

Among congenital conditions detectable before birth, elevated risks have been reported across multiple organ systems, including the cardiovascular, respiratory, neurological, digestive, and genitourinary systems. The scientific literature has also documented higher rates of syndromes associated with epigenetic alterations, such as Beckwith-Wiedemann syndrome, Russell-Silver syndrome, Angelman syndrome, and Prader-Willi syndrome. These conditions are especially...