Dr. ANIS FEKI: The Innovator Changing the Rules of Life
Interviewed by Ketia Belkania
There was a time when science intervened in reproduction only peripherally — quietly, cautiously, and almost apologetically. Today, it stands at the very epicenter of the creation process.
In his capacity as the President of the European Society of Human Reproduction and Embryology (ESHRE), Dr. Anis Feki holds a unique position: he doesn’t just observe the evolution of reproductive medicine; he actively shapes its direction.
In a world where embryos can be selected, frozen, tested, and studied more deeply through data, the question is no longer whether we can intervene, but rather — how far are we willing to go?
N Factor magazine welcomes Dr. Anis Feki, President of the European Society of Human Reproduction and Embryology (ESHRE).
In vitro fertilization (IVF) was once considered a true medical miracle. Today, it has become an almost routine, standard procedure used by millions. What have we lost from an ethical or emotional standpoint by turning reproduction into such a strictly regulated and standardized process?
Let’s start with what we have gained, because it is truly a colossal achievement. We have gained safety, predictability, and stability. Thanks to technological progress, access to these services has increased significantly, giving millions the joy of parenthood. However, your question hits exactly on the hidden danger that accompanies this routine: emotional detachment.
When the process becomes a clinical conveyor belt — endless tests, ultrasounds, hormonal injections — a patient can easily be reduced to just a “case” or a “protocol.” We must not forget that reproduction is never merely a technical act. Behind every cycle, test tube, and microscope lies immense hope, often recurring grief, identity crises, the pressure of time, and extreme vulnerability. Our primary responsibility as a medical community is to maintain the high efficiency of medicine without allowing it to devolve into an emotionally indifferent, cold system. A doctor must never lose empathy for a process that, for the patient, remains the profound mystery of creating life.
Fertility is increasingly determined by factors such as time, access to services, and, most importantly, financial means. Is reproduction becoming a privilege rather than a universal right?
This is one of the most acute and central ethical questions of our time. The desire to start a family is a fundamental human right, and it shouldn’t be dictated primarily by where someone lives or what their income is. Yet, the reality is harsh: access to fertility treatments today remains deeply unequal, both globally and within individual countries.
In some countries, IVF is fully funded by the healthcare system, while in others, it is entirely a commercial luxury. Consequently, yes, there is a very real risk that, in practice, reproduction has already become a privilege, even if we fundamentally believe it should be treated more equitably. When genetic screening and high-quality embryology are accessible only to the wealthy, we create a biological inequality that is ethically unjustifiable.
We are entering an era of AI-driven embryo selection and predictive genetics. Are prospective parents choosing probabilities, or are they already designing their desired outcomes? Where do we draw the line between medicine and “designer babies”?
At this stage, modern medicine primarily offers patients probabilities, not absolute guarantees or perfectly engineered outcomes. Artificial intelligence helps us identify the embryos with the highest chances of implantation and a healthy pregnancy, but the language and narrative we use to discuss these technologies are crucial here.
When probability is presented to the patient as control, society begins to harbor the illusion that medicine can design life. This is not the case. Biology is far too complex. The goal of reproductive medicine should be to help people navigate uncertainty and risk, not to create a false illusion of perfect predictability. Otherwise, we enter a dangerous zone where parental expectations become unrealistic, and future children become hostages to those expectations.
ESHRE plays a decisive role in setting standards across Europe and beyond. What is the one emerging technology that excites and encourages you the most, and the one that genuinely concerns you?
What truly gives me hope and excites me is the intelligent application of Big Data and AI to improve diagnostics. This allows us to personalize treatments, reduce unnecessary medical or surgical interventions, and create precise, tailored protocols for each patient.
As for my concerns — they relate to any technology whose pace of development outstrips its ethical governance and regulatory frameworks. This is particularly dangerous when commercial interests and marketing pressures become stronger than solid scientific evidence. Medical innovation without humility and strict ethical boundaries is not just risky; it’s dangerous. We frequently see so-called “add-ons” in IVF clinics that lack an evidence base but are sold at a high premium.
Reproductive medicine today stands at the crossroads of science, politics, and economics. Ultimately, who should define its boundaries: doctors, governments, or patients?
No single group should set these boundaries alone. It is a complex ecosystem. Doctors bring scientific evidence, clinical judgment, and safety standards. Patients bring their values, life experiences, desires, and bodily autonomy. Governments bring legitimacy, the law, regulatory frameworks, and public accountability.
The correct model is not the domination of any one actor, but a responsible and dynamic balance among all three. Politicians should not ban scientific progress based purely on ideological motives; doctors should not act without societal consensus; and patients’ desires should not become subjects of commercial exploitation.
IVF is also a massive global industry. Is there a risk that “hope” itself has become commercialized?
Yes, that risk is absolutely real, and we are already seeing its manifestations. Hope is an incredibly powerful emotion. When people are vulnerable, and battling infertility is one of the deepest emotional traumas, turning that hope into a marketing tool becomes very easy.
That is exactly why transparency, evidence-based communication, and strict ethical regulations are critically important. Under no circumstances should patients be treated primarily as consumers. They are, first and foremost, human beings seeking medical help. The financial interests of clinics must never supersede the well-being of the patient.
What is the most uncomfortable, difficult question about IVF that society is not yet ready to ask?
It is probably this: The issue isn’t whether we can do even more, but whether, sometimes, we should do less.
We are accustomed to medicine constantly pushing the boundaries of what is possible. But medicine must also preserve proportionality, realism, and human dignity. There are moments when the most ethical medical decision is to stop — when treatment becomes futile and only inflicts psychological and physical harm on the patient. Acknowledging this and conveying it to the patient appropriately and empathetically is one of our most difficult tasks.
Fifty years from now, when people look back and evaluate this current moment in reproductive medicine, what do you hope we got right? And what do you fear we will regret?
I sincerely hope that future generations will remember us for putting science at the service of people, not markets. I hope we will be able to safeguard universal access, safety, and most importantly, the well-being of the future children born with our help.
What I fear, and what we might regret, is that in some areas we are moving too fast; our technical and scientific capabilities are growing much faster than our ethical wisdom and capacity for understanding. Technological progress must not distance us from our humanity.
Looking ahead, what is the one specific area where ESHRE intends to take on a more confident and active leadership role?
Setting the standards for responsible innovation. This includes generating rigorous evidence, clinical quality control, absolute transparency, continuous training for medical personnel, and ethical oversight. New technologies require not just enthusiasm and hype, but strict governance. As a leading organization, ESHRE has a direct duty to help shape this global regulatory framework.
If ESHRE had a human identity, who would it be more like: a scientist, a philosopher, or a diplomat?
Ideally, all three combined. It would be a scientist with its academic rigor and precision, a philosopher with its ethical depth and understanding of values, and a diplomat, because dialogue and balancing different interests are essential. But if I had to choose just one, I would say it is a scientist with a conscience.
If tomorrow you could redefine and implement a single global standard through ESHRE, what would it be, and why hasn’t it happened yet?
I would enforce one absolutely fundamental, universal standard: every patient, anywhere in the world, deserves clear, understandable information, evidence-based treatment, and completely transparent reporting of clinical outcomes.
Why hasn’t it happened yet? Because healthcare systems, legal frameworks, financial resources, and commercial interests are extremely diverse worldwide. Such fragmentation makes it difficult to implement a unified standard. However, this difficulty is not a reason to give up; rather, it’s just another reason why we must take the lead.
Has working in reproductive medicine made you more optimistic about the future, or more cautious?
Both. I am extremely optimistic because every day I witness the incredible, unyielding resilience of our patients and the truly fantastic progress of science. At the same time, I have become much more cautious, because the more power and capabilities medicine acquires, the more discipline, responsibility, and humility it demands of us.
If you had to explain ESHRE’s role and mission to a child in just one sentence, what would you say?
I would say: We help doctors and scientists care for people who really want to have a baby, and we make sure it’s all done safely, fairly, and kindly.
What is something in your field that is genuinely beautiful, yet rarely described with that word?
Its quiet, invisible courage. Reproductive medicine is full of complex science — microscopes, incubators, genetic sequencing — but it is also full of boundless patience, trust, and human dignity. This field is beautiful not only because it deals with the beginning of life, but because it deals with people who refuse to give up and continue to search for meaning in life. That is the incredible fortitude of the human spirit.
If you could freeze one moment in your career forever, which would you choose?
I wouldn’t choose a scientific title, an award, or a moment standing at a podium. I would freeze the exact second when a patient in my office feels seen, feels their emotions are respected, and realizes they are no longer alone with their pain. Ultimately, that is the true measure of this field, and of medicine in general.
