The possibilities of assisted reproduction have rapidly developed over the 35 years since the birth of the first child after in vitro fertilization (IvF) and embryo transfer in the year 1978. New possibilities have been implemented, such as intracytoplasmic sperm injection (ICSI), preimplantation diagnostics, ovarian stimulation with gonadotropin-releasing hormone (GnRH) antagonists and gonadotropins. This has led to the fact that in 2010 worldwide 5.2 million children were born after IvF and embryo transfer, to couples whose desire for children would have been very difficult or even impossible to fulfil without this option. In this article new possibilities for improving the pregnancy rates after assisted reproduction will be presented and critically assessed, such as ovarian stimulation, single embryo transfer, vitrification, blastocyst transfer, preimplantation diagnostics and genetic screening. Furthermore, developments in the preservation of fertility for cancer patients and in the field of time-lapse imaging of early embryonic development will be discussed.