Safety in reproductive medicine: breadth, depth and discovery

In this issue of Human Reproduction, a debate article presents a charge to balance effectiveness and safety in Reproductive Medicine. This debate contribution applauds the dialogue opened and constructive opinions that are presented. However, several additional issues are suggested for consideration. Safety must be more broadly considered beyond the achievement of a healthy singleton pregnancy, with reproductive medicine a unique field that has the potential to impact the health and wellbeing of multiple people at one time. Many fields have grappled with the need to balance effective treatment with unintended harms, and reproductive medicine should capitalize upon that body of literature. Finally, to maximize both efficacy and safety in reproductive medicine, there is no replacement for the conduct of well powered, rigorously designed, highly generalizable, multidisciplinary studies.