IUI is quite tolerable for most women. The process is like a pap smear; maybe some minor cramps during the therapy, but nothing major. Afterwards, some have mild cramps; usually, this passes quickly. Most women go right back to their regular activities.

IVF carries more possible pain than IUI. At the sites of the daily hormone injections, bruising and soreness can result. Since the egg retrieval is done under sedation, you won't feel anything during the operation. Thereafter, you might have cramps and discomfort for one or two days. Like an IUI surgery, the embryo transfer itself is usually comfortable.

How many IUI cycles should be tried before IVF?

Before discussing a move to IVF, most doctors advise 3–4 IUI cycles. Of course, if there are no other circumstances suggesting IVF should be tried first. Age, diagnosis, and individual situation all affect this advice. While women over 40 might consider IVF after fewer failed IUI attempts, younger women with unexplained infertility might try more IUI cycles.

Does age affect IUI and IVF success rates?

After 35, especially, IUI and IVF success rates drop with age; after 40, the drop is more pronounced. Older patients might be advised to move to IVF sooner since IVF success rates often vary less than IUI success rates based on age.

Can I choose between IUI and IVF myself?

Although patient preferences are important, fertility treatment choices are best when they are made in concert with a doctor. Based on a particular diagnosis, age, and other considerations, the doctor will make recommendations. Some disorders just won't respond to IUI, thus IVF is the only realistic path for success.

What are the success rates? Comparing IUI vs IVF outcomes

Usually, between a 5-20% success rate per cycle, IUI varies greatly depending on age and diagnosis. For women under 35, IVF provides far better success rates—between 40 and 50% per cycle—but this drops with age. These figures help to explain why many doctors advise IVF for women with limited time to reach pregnancy or with a specific diagnosis.

Are there risks with IUI or IVF?

Both procedures carry some possible complications. IUI may result in mild spotting or cramps later. Though rare, infection is theoretically possible. Fertility drugs raise the risk of multiple pregnancy. IVF is more complicated, thus it carries more possible risks. These include possible OHSS, infection, bleeding, multiple pregnancies, should more than one embryo be transferred, and risks related to the egg retrieval process.

ESHRE 2O25 Recap: How Fertility Innovation Is Shaping the Future of Surrogacy

Olga Pysana
7 days ago
6 min read

Updated: 6 days ago

Sitting at the airport in Paris after attending the 41st Annual Meeting of ESHRE (European Society of Human Reproduction and Embryology), I’m reflecting on how much is changing in our world. From groundbreaking tech to shifting ethical conversations, the event spotlighted developments that directly impact surrogacy journeys, intended parents, and fertility clinics alike.

Here’s a breakdown of the major takeaways - and what they mean for the future of third-party reproduction and global surrogacy.

Artificial Intelligence Is Revolutionizing Fertility Care

Walking through ESHRE 2025, the transformation was undeniable - AI in IVF has moved from experimental curiosity to clinical cornerstone. This year proved that AI in fertility treatment isn't just a buzzword anymore; it's the reality reshaping how we approach reproductive medicine.

Clinics worldwide are now actively adopting machine learning tools to optimize ovarian stimulation protocols with unprecedented precision, embryo prediction in terms of viability and oocyte quality beyond human capability, and improve clinical decision-making using large-scale data analysis that was impossible just years ago.

The conversations weren't about potential anymore - they were about documented results. Embryologists shared stories of AI systems achieving 30% better pregnancy rates while reducing the emotional toll of multiple failed cycles that have historically defined the IVF experience.

For surrogacy specifically, these advances represent a complete paradigm shift in how we approach third-party reproduction.

What this means for surrogacy is nothing short of revolutionary: higher chances of success with fewer embryos needed for transfer, and potentially shorter journeys for intended parents who've often endured years of uncertainty.

The AI-powered oocyte and embryo selection systems are creating surrogacy experiences that are more efficient and emotionally sustainable. Instead of the traditional trial-and-error approach that could stretch surrogacy journeys across multiple years, we're seeing intended parents reach their goals faster with greater confidence in outcomes. The IVF technology isn't replacing the human touch that makes surrogacy so meaningful - it's amplifying our ability to optimize every aspect of the medical process.

PGT-A Controversy and NGS Under Ethical and Technical Scrutiny

The PGT-A controversy dominated every genetics session at ESHRE 2025, and the debates were intense. Preimplantation Genetic Testing for Aneuploidies and Next-Generation Sequencing (NGS) in IVF were the hot topics everyone was talking about between sessions. While these embryo testing technologies offer deep insights into embryo genetics, there's growing concern about the ethical implications of embryo selection, over-reliance on mosaicism data, and potential loss of viable embryos due to rigid testing standards. The IVF ethics discussions were particularly heated, with some clinics admitting they might be discarding perfectly good embryos because the genetic data looks questionable on paper.

For surrogacy programs, this controversy hits differently because every embryo transfer carries enormous weight. As genetic testing in IVF becomes more advanced, surrogacy professionals and intended parents alike must stay informed about what's medically necessary - and what's still debated among experts. The reality is that we're still figuring out what all this genetic data actually means for successful pregnancies, and the gap between what we can test for and what we should test for keeps getting wider.

One Embryo Transfer (SET) Becoming the New Global Standard

Single embryo transfer is quietly becoming the default at clinics worldwide, and ESHRE 2025 made it clear this isn't just a trend - it's the new standard. More clinics around the world are switching to SET as their go-to protocol, representing a major shift from the "transfer two and hope for the best" mentality that dominated IVF for decades. This reflects a fundamental push for safer pregnancies, dramatically lower risk of twins or higher-order multiples, and better long-term health outcomes for both surrogate and baby. The data presented was compelling: countries that have embraced SET in surrogacy are seeing fewer NICU admissions, reduced maternal complications, and healthier babies overall.

For surrogacy professionals, this shift demands more strategic planning and completely different conversations with clients. The embryo transfer trends are forcing us to have clearer communication with clinics and intended parents about success rates and realistic expectations when you're only transferring one embryo at a time.

Rise of Frozen Egg Banks

The rise of frozen egg donor banks was impossible to ignore at ESHRE 2025 - this trend is fundamentally reshaping how intended parents access donor gametes. The growth of frozen egg banks is changing the entire donor egg landscape, with more patients now buying pre-frozen donor oocytes instead of waiting for fresh cycles, skipping the traditional fresh donor cycle coordination completely, and using international egg banks to match more quickly than ever before. What used to take a few months of donor matching and cycle coordination can now happen in days. The convenience factor is undeniable, and the quality of frozen oocyte IVF has improved dramatically with better vitrification techniques.

For surrogacy programs, this shift is speeding up timelines for many journeys but creating new challenges we're still figuring out. While buying donor eggs from established banks eliminates the uncertainty of donor availability, it's also raising important questions around egg quality consistency, optimal batch size for each intended parent, and whether fertilization outcomes truly match fresh donor cycles. The conversations I had with embryologists revealed mixed feelings - some love the predictability, while others highlight that the final success rates as per the number of blastocysts received with a fresh cycle is still much higher.

Male Infertility Research Gains Momentum

Male infertility research finally got the spotlight it deserved at ESHRE 2025, and it was long overdue. For too long, male factor infertility was the overlooked piece of the fertility puzzle, but that's changing fast. The conference dedicated entire sessions to sperm quality, DNA fragmentation, and how paternal age affects outcomes in ways we're just beginning to understand. There was a major focus on the impact of lifestyle factors, environmental toxins, and BMI on male fertility - topics that used to get maybe one poster session but now had packed auditoriums. The advanced testing methods for male fertility being presented were genuinely impressive, from AI-powered sperm selection to genetic analysis that can pinpoint exactly why conception isn't happening.

This shift is crucial for IVF and male factor cases, especially since nearly 50% of infertility involves some male component. Better diagnosis of male infertility issues means more effective treatment paths for intended parents, and frankly, it means we stop putting women through endless procedures when the problem might be easily addressed on the male side. The conversations with andrologists revealed how much we've been missing - simple lifestyle changes, targeted supplements, or specific sperm preparation techniques can dramatically improve outcomes. For surrogacy programs, this means having more thorough preparation for sperm donation, which could save everyone time, money, and emotional energy down the road.

Embryos Created in One Country, Shipped for Surrogacy to Another

Cross-border surrogacy dominated private conversations with agencies and shipping companies at ESHRE 2025, and the numbers were staggering. A growing number of embryos are being created in one country and shipped internationally for transfer into a surrogate, creating an entirely new industry around international gamete transport. Countries like Argentina, Canada, and Albania were frequently discussed as origin points, while Mexico, Colombia and surprisingly Ghana in recent months were on the receiving side with one global transport provider reporting that 90% of their business is now surrogacy-related. The scale of this movement is unprecedented—we're talking about thousands of embryos crossing borders monthly, each representing someone's hope for a family and requiring precise temperature control, legal documentation, and timing coordination.

This trend has huge implications that extend far beyond the embryo transport logistics themselves. The legal frameworks across borders are struggling to keep up with the reality of families being created through international collaboration, and the regulatory gaps are creating both opportunities and headaches for intended parents. What struck me most was hearing from logistics companies who now spend more time on customs documentation than medical protocols. The technology for safe embryo shipping has advanced remarkably, but the human systems—legal, regulatory, and logistical—are still catching up to what's become a routine part of modern surrogacy destinations.

Final Thoughts: What This Means for the Surrogacy Community

The overarching message from ESHRE 2025 was crystal clear: fertility care is becoming smarter, more personalized, and undeniably more global. As these technologies evolve and our industry adapts at breakneck speed, the future of surrogacy is taking shape before our eyes. Surrogacy journeys are becoming more efficient through AI-powered matching and optimized protocols, more collaborative with international embryo transport and cross-border partnerships, and genuinely more patient-centered as we move away from one-size-fits-all approaches. The surrogacy trends 2025 revealed at the conference painted a picture of an industry that's finally catching up to what intended parents have been asking for: faster timelines, better outcomes, and more control over their journey.

But here's the reality check from every ESHRE update session: with innovation comes complexity that can be overwhelming. It's never been more important for intended parents, surrogates, and professionals to stay informed about these rapid changes, ask the right questions about new technologies and protocols, and lean on trusted experts throughout the process. The tools are incredible, the possibilities are expanding, but navigating this new landscape requires more knowledge and guidance than ever before. The future of surrogacy isn't just about better technology—it's about how we help people use that technology to build their families without getting lost in the complexity of all these amazing new options.

Have questions about how these trends could impact your surrogacy journey? Reach out— I'm here to help you navigate this evolving landscape with clarity and confidence.

Contact independent surrogacy consultant here