Could targeting the molecular causes of infertility finally transform IVF success rates?
pharmafile | January 29, 2026 | Feature | Medical Communications, Research and Development | Biotechnology, IVF, assisted reproductive technology, fertility therapeutics, infertility
By Dr Jordan Abdi
Over the past two decades, demand for IVF has risen sharply as parenthood is increasingly delayed across developed economies. Yet reproductive biology has not adapted to this socio-economic shift. Female fertility still declines steeply with age, and IVF success rates have remained stubbornly modest despite continuous optimisation of clinical workflows.
For many patients, this translates into repeated cycles, escalating cost and significant emotional distress. While recent IVF innovation has expanded access to treatment, it largely works around the biological problem rather than addressing it directly.
But this could all be about to change. A new frontier is now emerging, where biotechnology companies are developing therapeutics that target the molecular causes of infertility directly, rather than further refining the procedural mechanics of assisted reproduction. Across academia and a growing number of startups, attention is shifting upstream, from selecting outcomes to intervening in the biological processes that determine them.
How IVF success has traditionally been improved
Historically, innovation in IVF has focused on selection and optimisation. This includes identifying the ‘best’ embryo using PGT-A, AI-driven time-lapse imaging and improved culture systems, as well as refining stimulation protocols, lab conditions and transfer techniques.
These advances improve efficiency, but they do not change the underlying biology. No amount of embryo selection can compensate for a cohort of oocytes that is already chromosomally compromised by age.
Commercially, this has produced a striking imbalance, with an estimated 70% of fertility-care revenue coming from procedures rather than pharmaceuticals. Apart from gonadotropins and basic hormonal modulation, large pharmaceutical companies have historically had limited presence in fertility, leaving a major gap for first-in-class therapeutics that address the cellular mechanisms driving treatment failure.
A new frontier: addressing the molecular causes of infertility
The dominant biological cause of IVF failure in older patients is maternally inherited aneuploidy – errors in chromosome segregation during oocyte meiosis that lead to implantation failure, miscarriage or non-viable embryos.
So, rather than selecting among embryos after these errors have already occurred, a growing body of research is investigating whether the molecular architecture of the egg itself can be stabilised before – or during – maturation. The objective is not enhancement or genetic modification, but prevention, reducing the probability of the meiotic errors that drive downstream failure.
More broadly, reproductive biotechnology is beginning to diversify into multiple therapeutic pathways, from improving gamete quality to modulation of the implantation environment and longer-term regenerative approaches. Together, these efforts signal the emergence of a new category of fertility therapeutics aimed at biological intervention rather than procedural optimisation.
If borne out in preclinical and early clinical development, this approach would change the logic of treatment. Instead of patients cycling repeatedly to obtain a single transferable embryo, a therapeutic intervention could aim to increase the proportion of viable embryos per retrieval, improving both clinical outcomes and cost-effectiveness at the system level.
Future focus: the emerging biotech approach
This new class of reproductive biotechnology is beginning to take shape. One of the early-stage pioneers in this space is U-Ploid Biotechnologies, an Oxford-based company developing Lyvanta, a first-in-class intra-oocyte therapeutic designed to address age-related meiotic errors directly. Unlike selection-based technologies, Lyvanta acts within the egg itself, targeting the cellular machinery responsible for chromosomal segregation.
By stabilising the meiotic apparatus and promoting faithful separation of maternal chromatids, the approach aims to reduce age-associated aneuploidy prior to fertilisation, thereby increasing the number of healthy embryos generated per cycle.
U-Ploid is emblematic of a broader shift within the sector, moving fertility care upstream from post-hoc selection toward direct biological intervention. Similar approaches across academia and early-stage biotech suggest this is not an isolated strategy, but an emerging therapeutic category.
Challenges, opportunities and what comes next
Reproductive medicine is approaching a clear inflection point. The field is beginning to move beyond assisted reproduction toward what might be described as restorative reproductive medicine, a model focused on correcting the biological mechanisms that limit success, rather than optimising around them.
This transition will not be straightforward. Many of these technologies remain early-stage, and regulatory, ethical and translational hurdles will shape the pace of adoption. Classification of such interventions, their integration into existing assisted reproductive technology (ART) workflows and demonstration of safety and efficacy in controlled clinical settings will be critical.
That said, investment, academic collaboration and early engagement from pharmaceutical stakeholders are accelerating the movement from discovery into development. If successful, molecular-level fertility therapeutics would offer something IVF has never truly had – a scalable path to materially improving success rates, rather than redistributing probability through better selection.
For a field long constrained by biology, this represents the first credible move toward treating the root causes of infertility and a potentially significant new frontier for women’s health, reproductive medicine and the life sciences industry.
Jordan Abdi is a physician-scientist and co-founder and CEO of U-Ploid Biotechnologies, a reproductive health biotech developing first-in-class therapeutics to address age-related egg quality decline. He trained in medicine and translational science and has worked across clinical research, biotech formation and regulatory strategy, with a focus on bringing novel reproductive therapeutics from discovery into the clinic.
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