Background <p>In vitro fertilization (IVF) has become an integral component of reproductive medicine, providing a pathway to parenthood for infertile and sub-fertile couples. Currently, IVF accounts for approximately 2–5% of all births globally. Over the past decades, the field has witnessed substantial advancements, including changes in patient demographics, embryology techniques, pharmaceutical agents, and treatment protocols.</p> Methods <p>This review examines the evolution of IVF, focusing on technological innovations and shifting patient profiles, particularly the increasing number of older women undergoing treatment.</p> Results <p>While technological and clinical innovations have enhanced IVF success rates and safety, they have also contributed to a broader patient population, including women with pre-existing medical conditions. These divergent trends—improved treatment efficacy alongside growing medical complexity—have reshaped the clinical and public health risk profiles associated with IVF.</p> Conclusions <p>Ongoing surveillance, comprehensive patient counseling, and appropriate regulatory oversight are essential to sustaining high-quality reproductive care in the context of a continually evolving IVF landscape.</p>