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Since the first successful in vitro fertilization (IVF) pregnancy 24 years ago, the progress of assisted reproduction has been astounding. IVF remains the cornerstone of fertility treatment, and there have been many significant clinical and embryological advances. The success rates of treatment continue to improve steadily, and with developments such as intracytoplasmic sperm injection there are many more couples who can benefit from assisted reproductive technologies. Cryopreservation techniques are being improved continually, and with its application to oocyte and ovarian tissue freezing, female fertility preservation is fast becoming a reality. Newer developments involving in vitro maturation of immature oocytes, preimplantation diagnosis and aneuploidy screening are discussed, as well as the risks and complications associated with assisted reproductive technologies. The rapid growth of this technology has also been paralleled by a number of ethical and social dilemmas that society has, in many circumstances, struggled to reach a consensus on.