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Key content Increasing availability and expanding usage of infertility treatment is a concern with regard to a possible increase in the risk of future malignancy development for women and their offspring. Infertile women are at significantly increased risk of developing ovarian and uterine cancers, especially nulliparous women. Earlier studies pointed to a possible increase in the risk of ovarian cancer following large doses and multiple cycles of clomiphene citrate. Recent studies did not observe any increase in malignancy risk due to infertility medications. Other confounding factors, such as infertility itself, may well be the reason for the increased percentage of cancer cases noted in earlier studies. Uterine cancer risk is possibly increased following multiple cycles and high doses of clomiphene citrate. There is no strong evidence linking infertility treatment with non-gynaecological or childhood cancers, with the possible exception of melanoma. Learning objectives To highlight the available evidence linking infertility treatment with gynaecological, non-gynaecological and childhood cancers. How to counsel women about any possible risk of future neoplasia after infertility treatment. Ethical issues Is it ethical to persevere with multiple fertility treatment cycles if it might be associated with increased risk of neoplasia in the future?