About 8-10 % of all people of reproductive age are unable to conceive children. In recent years, an increased number of consultations for fertility treatments has been observed with a continuing positive trend. It is known that infertility itself and assisted reproductive technologies (ARTs) are frequently associated with recurrent miscarriages, pregnancy complications or psychosocial problems. In parallel, metabolic and vascular diseases and obesity are becoming a growing issue, even among the younger population, and are affecting fertility and pregnancy outcomes of mother and child. Possible interactions between these conditions and the underlying mechanisms are not well understood hitherto. Furthermore, reproductive outcomes are increasingly challenged by the potential effects of environmental pollution on key reproductive processes, including oocyte maturation and atresia, sperm quality, implantation as well as their role in recurrent miscarriages. The Leipzig reproductive health (LE-REP) project is aimed at investigating the interplay between ARTs and the aforementioned reproductive challenges, including different aspects of fertility problems, early and late pregnancy as well as long-term effects on mothers and their children born via fertility treatment. This multidisciplinary initiative is expected to provide a deep understanding of underlying mechanisms, providing a framework for future preventive strategies improving reproductive health. Finally, LE-REP aims to establish a high-level university fertility center of excellence, combining advanced clinical care, cutting-edge research and education to train future reproductive medicine specialists.