Assisted reproductive technology (ART) is no longer experimental science and is now considered standard medical treatment. During the evolution of ART our understanding of embryo physiology and stress response has led to significant improvements in the laboratory in regards to the technology (culture media design, gas phase, fertilisaton techniques, cryperservation methods) and QC/QA such that pregnancy rates have significantly improved. These improvements, coupled with the well documented issues surrounding multiple births, have led to a significant increase in the use of single embryo transfer (SET). In addition the industry has redefined the definition of a successful outcome from a positive pregnancy test to the birth of a live, term, healthy single baby. This redefinition has led to a renewed focus in the laboratory to optimize the culture environment to grow the healthiest embryo possible and also to develop new technologies to select which embryo from a cohort has the highest chance of implantation and development into a healthy baby. These new technologies include high magnification sperm selection, new culture media design, morphokinetic assessment of embryo development, metabolomic assessment of spent culture media and preimplantation genetic diagnosis/screening. In addition there is a renewed focus on the health outcomes of offspring generated from in vitro fertilisation (IVF). With emerging evidence demonstrating that culture media composition can influence birth weight and thus may have long term consequences for the offspring, new research is required to understand the methods of programming offspring health such that further optimization of technologies can occur. This will help to ensure that the children born from IVF technology are not only healthy at birth but also are not at any higher risk of disease onset later in life compared to children born from natural conception.