The World Health Organization (WHO) has issued its first-ever global guideline aimed at improving fertility care, calling for countries to enhance the safety, fairness, and affordability of services for infertility. This landmark document addresses a critical issue, noting that infertility affects approximately 1 in 6 individuals of reproductive age at some point in their lives.
Despite the rising demand for fertility services, access remains severely constrained in many regions. In numerous countries, the burden of financing tests and treatments falls on individuals, often leading to devastating financial consequences. For instance, the cost of a single round of in vitro fertilization (IVF) can exceed double the average annual household income in some areas.
Addressing a Global Health Challenge
“Infertility is one of the most overlooked public health challenges of our time and a major equity issue globally,” stated Dr. Tedros Adhanom Ghebreyesus, the Director-General of WHO. He emphasized the isolation many individuals face due to prohibitively high costs, which force them into seeking cheaper, less reliable treatment options or making difficult choices between starting a family and maintaining financial stability.
The new guideline comprises 40 recommendations designed to bolster the prevention, diagnosis, and treatment of infertility. It promotes cost-effective solutions at every stage, advocating for the integration of fertility care into national health systems, services, and financing models.
Infertility is defined as the inability to conceive after 12 months of regular, unprotected sexual intercourse, a condition that can lead to significant emotional distress, stigma, and financial strain. The guideline outlines effective clinical management strategies for infertility and highlights the need for increased investment in preventive measures, including education about fertility and infertility in schools and healthcare settings.
Comprehensive Recommendations for Care
The recommendations also identify key risk factors contributing to infertility, such as untreated sexually transmitted infections and tobacco use. To mitigate these risks, the WHO suggests lifestyle interventions, including a balanced diet, regular physical activity, and smoking cessation, for individuals and couples who are planning or trying to conceive.
The guideline emphasizes early education about fertility and infertility to assist individuals in making informed reproductive choices. It details clinical pathways for diagnosing common biological causes of infertility in both men and women. The guidance ranges from simple management strategies—such as advising on fertile periods—to more complex interventions, including intrauterine insemination and IVF.
Recognizing the profound emotional impact of infertility, which can result in mental health issues such as depression and anxiety, the guideline stresses the importance of providing ongoing psychosocial support for those affected.
The WHO urges nations to adapt these recommendations to their specific contexts and to monitor their implementation. Success will depend on collaboration among health ministries, professional societies, civil organizations, and patient advocacy groups. Furthermore, the implementation of these guidelines should align with comprehensive, rights-based approaches to sexual and reproductive health, empowering individuals to make informed decisions regarding family planning.
Dr. Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, highlighted the importance of grounding infertility treatment in gender equality and reproductive rights. “Empowering people to make informed choices about their reproductive lives is a health imperative and a matter of social justice,” she remarked.
While the guideline is comprehensive, it also acknowledges gaps in current evidence and areas that require further research. Future editions are expected to address topics such as fertility preservation, third-party reproduction, and the implications of pre-existing medical conditions on fertility.
Through these guidelines, the WHO aims to ensure that fertility care becomes more accessible, respectful, and rooted in scientific evidence, ultimately enabling millions to navigate the challenges of infertility with greater support and understanding.
