Success in Assisted Reproduction: What Does It Really Mean?

February 2, 2026
Author: Javier Migueltorena Puertas 
Versión en Español

Introduction

Recently, the paper La Jornada reported that in Mexico the probability of success of assisted reproductive technologies (ART) has doubled over the past 25 years, reaching figures of up to 65% on the first attempt and 96% after several cumulative cycles ¹. But what does it actually mean to say that effectiveness has increased?

What Does an Increase in Effectiveness of the ART Mean?

To correctly interpret these data, it is necessary to clarify what is meant by “success” in assisted reproduction, as there is no single universally used metric. In the specialized literature, at least three main indicators are distinguished: biochemical pregnancy, which refers to a positive hormonal test in blood or urine without ultrasound confirmation; clinical pregnancy, confirmed by ultrasound with fetal cardiac activity; and live birth, which is considered the most clinically relevant outcome ².

In addition, success rates may be reported per initiated cycle, per embryo transfer, or cumulatively after multiple attempts, resulting in substantial differences in reported percentages and limiting comparability across studies and centers ³. International organizations such as the Centers for Disease Control and Prevention (CDC) and the European Society of Human Reproduction and Embryology (ESHRE) have warned that the lack of standardization in outcome reporting hinders comparisons across clinics, countries, and time periods ⁴⁻⁵.

In the Mexican context, where most assisted reproduction treatments are concentrated in the private sector, these methodological differences become particularly relevant, as high figures may reflect cumulative rates or highly selected populations (for example, women under 35 years of age), rather than a true probability per individual attempt. Therefore, when it is stated that the effectiveness of ART has improved in Mexico, it is essential to specify which indicator is being used, in which population, and under what criteria, in order to avoid oversimplified interpretations or unrealistic expectations among those seeking these treatments¹⁻⁵.

Why Has the Effectiveness of Assisted Reproductive Technologies Improved?

Once the importance of correctly identifying what is considered “success” in assisted reproduction from a statistical perspective is understood, it is equally necessary to analyze why, from a clinical standpoint, improvements in outcomes have indeed been observed over recent decades. This improvement does not stem from a single factor, but rather from the convergence of technological advances, refinement of clinical protocols, and greater experience among specialized teams.

At the international level, significant improvements have been reported in embryology laboratories, particularly in embryo culture systems, cryopreservation through vitrification, and embryo selection, leading to increased rates of clinical pregnancy and live birth per transfer²⁻⁶. Likewise, optimization of ovarian stimulation protocols and better individualization of treatment according to age and diagnosis have contributed to reducing failed cycles and complications⁷.

In Mexico, although there are high-specialty public centers that offer assisted reproductive technologies, such as the National Institute of Perinatology, the Siglo XXI National Medical Center, and PEMEX Hospital, their capacity is limited. As a result, most treatments continue to be concentrated in the private sector, where there is typically greater access to cutting-edge technology and highly experienced clinical teams.

However, available evidence suggests that differences in outcomes between centers cannot be attributed solely to procedure volume, but depend largely on patient characteristics, the quality of clinical and laboratory processes, and the selection criteria employed⁸⁻⁹. In addition, the growth of medical tourism has favored investment in infrastructure and early adoption of innovations used in countries with a longer tradition in assisted reproduction¹. While these factors help explain the increase in reported success rates, they also reinforce the need to critically analyze who benefits from these improvements, under what conditions, and with what degree of access, issues that are central to a comprehensive bioethical evaluation of the phenomenon²⁻⁹.

Mexico and Medical Tourism in Assisted Reproduction

As mentioned above, Mexico has become an attractive destination for international patients seeking specialized medical care, and has experienced significant growth in reproductive medicine. This has favored the expansion of private clinics, with greater investment in infrastructure and early adoption of internationally used technological innovations, contributing to improved clinical outcomes while simultaneously offering a more accessible alternative for international patients¹⁻¹⁰. 

However, it has been reported that the effects of medical tourism on destination countries can be contradictory. While it may strengthen certain segments of the health system, there is also a risk of increasing inequalities in access when resources, incentives, and highly specialized personnel are directed primarily toward patients with greater purchasing power, potentially resulting in deterioration of care for the local population¹¹. In this sense, reproductive medical tourism in Mexico is not only a driver of innovation or economic growth, but also a phenomenon that raises central bioethical questions, particularly regarding equity in access and social responsibility in the development of assisted reproductive technologies¹⁻¹¹.

Bioethical Implications

Based on the above, it can be stated that, advances and improvements in assisted reproductive outcomes in Mexico can be understood as a significant achievement from a clinical and technological standpoint. Nevertheless, these advances also make it necessary to analyze the bioethical dilemmas that emerge from their development and from the conditions under which they are offered. 

One of the main challenges relates to the growth of medical tourism and the expansion of the private sector. While these phenomena have promoted investment and innovation in reproductive medicine, they may also create barriers to access for the local population. Infertility is a health condition that can affect anyone; however, when assisted reproductive technologies are concentrated primarily in the private sector and oriented toward patients with greater economic capacity, there is a risk of excluding segments of the population who lack the necessary resources to access these treatments. In the absence of substantial advances in public health provision, these inequalities tend to deepen. 

Another relevant ethical dilemma concerns transparency in the communication of success rates. The lack of standardization in outcome reporting can make it difficult for individuals to clearly understand their real chances of success and the risks associated with treatment. In this context, access to clear, verifiable, and complete information is fundamental to respecting the principle of autonomy, as only with adequate understanding can individuals make truly informed decisions about their reproductive health.

Conclusion

The advancement of assisted reproductive technologies in Mexico undoubtedly represents a relevant achievement from a medical and technological perspective. Increased success rates reflect years of innovation, clinical specialization, and continuous improvement in procedures, enabling more individuals to achieve their family-building goals and fulfill their reproductive plans. However, as demonstrated throughout this analysis, these advances cannot be evaluated solely on the basis of aggregate figures or isolated clinical outcomes. 

Understanding what “success” truly means in assisted reproduction, as well as recognizing the multiple ways it can be measured, is essential for properly interpreting information circulating in the media and in clinical practice. The lack of standardization in outcome communication and the way success rates are presented can generate unrealistic expectations, particularly among individuals in contexts of high emotional vulnerability. In this sense, transparency and clarity of information are not merely technical issues, but essential ethical elements for respecting autonomy in reproductive health decision-making. 

At the same time, Mexico’s positioning as a destination for reproductive medical tourism has contributed to the growth of the private sector and early adoption of technological innovations. Nevertheless, this phenomenon also highlights important tensions regarding equity and access. Infertility can affect anyone, but when available solutions are concentrated primarily in the private sector, there is a risk that large segments of the population will be excluded from these benefits. 

From a bioethical perspective, the central challenge lies not only in continuing to improve success rates in assisted reproductive technologies, but in ensuring that their development occurs in a fair, responsible, and socially sensitive manner. This involves promoting honest communication, reflecting on the limits of the commodification of reproduction, and strengthening the role of public policies to reduce inequalities. Only then can advances in reproductive medicine represent not a benefit for a few, but a real and dignified opportunity for all individuals facing infertility in Mexico.

References

1. La Jornada. México duplicó en 25 años la tasa de éxito del embarazo asistido. La Jornada. 8 de diciembre de 2025. https://www.jornada.com.mx/noticia/2025/12/08/sociedad/mexico-duplico-en-25-anos-la-tasa-de-exito-del-embarazo-asistido
2. Schieve LA, Reynolds MA. What is the most relevant standard of success in assisted reproductive technology? Hum Reprod. 2004;19(4):778–782. https://academic.oup.com/humrep/article/19/4/778/2913625
3. Maheshwari A, McLernon D, Bhattacharya S. Cumulative live birth rate: time for a consensus? Hum Reprod. 2015;30(12):2703–2707. https://academic.oup.com/humrep/article/30/12/2703/2380228
4. Centers for Disease Control and Prevention (CDC). Assisted Reproductive Technology (ART) Success Rates. Atlanta: CDC; 2023.https://www.cdc.gov/art/artdata/index.html
5. ESHRE Capri Workshop Group. Multiple gestation pregnancy. Hum Reprod. 2000;15(8):1856–1864. https://academic.oup.com/humrep/article/15/8/1856/2915935
6. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11(3):307–311. https://pubmed.ncbi.nlm.nih.gov/10369209/
7. Fauser BCJM, Devroey P, Macklon NS. Multiple birth resulting from ovarian stimulation for subfertility treatment. Lancet. 2005;365(9473):1807–1816. https://pubmed.ncbi.nlm.nih.gov/15910954/
8. The relationship between IVF clinic volume and live birth outcomes. Fertil Steril. 2021. https://www.fertstert.org/action/showPdf?pii=S0015-0282%2821%2900928-6
9. Pregnancy rates cannot be used reliably for comparison of IVF clinic performance. Hum Reprod. 2010;25(1):110–117. https://academic.oup.com/humrep/article-abstract/25/1/110/696273?utm_source=chatgpt.com&login=true
10. Connell J. Medical tourism. Wallingford (UK): CABI; 2011. https://www.cabidigitallibrary.org/doi/book/10.1079/9781845936600.0000
11. Johnston R, Crooks VA, Snyder J, Kingsbury P. What is known about the effects of medical tourism in destination and departure countries? A scoping review. Int J Equity Health. 2010;9:24. https://pubmed.ncbi.nlm.nih.gov/21047433/ 

Javier Migueltorena Puertas is a graduate of the Medical Doctor program at Universidad Anáhuac México, Campus Norte, with a strong interest in Gynecology and Obstetrics, and particularly in reproductive medicine. He is currently completing his social service at CADEBI, where he participates in projects that integrate bioethics with legal and regulatory frameworks across Ibero-America. His long-term goal is to specialize in reproductive medicine. This article was assisted in its writing by the use of ChatGPT, an artificial intelligence tool developed by OpenAI. 

The opinions expressed in this blog are the sole responsibility of their authors and do not necessarily represent the official position of CADEBI. As an institution committed to inclusion and open dialogue, CADEBI promotes and shares a diversity of voices and perspectives, convinced that respectful and critical exchange enriches our academic and educational work. We value and encourage any comments, responses, or constructive criticism you may wish to share.