A paradigm shift in fertility care? Discourses on AI for IVF in the Netherlands and the UK.

Artificial intelligence (AI) is increasingly promoted as a transformative innovation in in vitro fertilization (IVF), particularly for embryo selection. This article examines how discourses surrounding AI in IVF reflect broader shifts in medical paradigms and market logics. Drawing on a comparative critical discourse analysis of clinic websites, media texts and professional publications in the Netherlands and the United Kingdom, we explore how stakeholders frame the promise and potential of AI-enabled embryo selection. Our findings reveal three interconnected dynamics. First, UK discourses predominantly construct a paradigm shift from evidence-based medicine (EBM) toward data-driven care, positioning AI as a solution to the perceived limitations of randomised controlled trials. Dutch sources, by contrast, largely sustain EBM principles, framing caution as a safeguard against false hype and escalating costs. Second, UK clinics and technology developers predominantly employ promissory narratives that create self-fulfilling prophecies about an AI-driven future, while Dutch actors largely resist the inevitability of technological fixes. Third, the meaning of patient choice diverges: in the UK, choice is increasingly conflated with consumerism, enabling clinics to market unproven add-ons at additional cost; in the Netherlands, patient choice remains more insulated from market forces, though globalised imaginaries exert growing pressure. These findings illuminate how commercial interests and sociotechnical imaginaries shape reproductive care beyond clinical evidence, raising ethical concerns about equity, regulation and the commodification of hope. The IVF sector offers a critical lens on the wider implications of AI-driven medicine for healthcare governance in an era of marketisation.