The contribution of private and public centres to innovation in fertility care: acknowledging the past and preserving the future

The remarkable advances in the efficacy and safety of IVF treatment that have been achieved since the first IVF baby was born in 1978 stand comparison with any other branch of medicine. These advances have continued despite the withdrawal of public investment in clinical reproductive medicine and research, raising a number of questions. How is this global shift from public to largely private sector care provision affecting the quality and direction of research, innovation and clinical training? This Commentary reviews the implications, both positive and less so, for academic reproductive medicine and training, and outline the opportunities that exist to secure the future of the subspeciality and ongoing progress in fertility care in this changing environment.