"Survival of the fittest" is a useless tautology. An organism's evolutionary fitness, if there were such a thing, would be its ability to survive to reproductive age. So of course the fittest survive, we've defined fitness to mean survival.
In reality it's the species that has an evolutionary fitness; and the distinction is important. Take a bee colony for example, a huge number of the bees are infertile.
To address your example: infertility treatments may catalyze an evolutionary process of selecting against those who are disinterested in child rearing. Or, like the bee colony, infertility in some members of the species may be evolutionarily advantageous; hard to imagine, but not without precedent.