Norbert Gleicher, MD, the Medical Director and Chief Scientist of the Center for Human Reproduction (CHR) in NYC offers here a quite challenging analysis of current IVF practice. Building on the fact that live birth rates in fresh autologous IVF cycle in the U.S. (and in most other parts of the world) have been declining from an all-time peak around approximately the years 2010 – 2011 while IVF cycle costs have been dramatically increasing, he is pointing out the main reasons for these developments. And they are likely not what you expect!