By Ayomide Otitoju
The World Health Organization (WHO) has issued its first-ever global guideline on infertility, urging countries to make fertility care safer, more equitable, and affordable for all. Infertility is estimated to affect one in six people of reproductive age worldwide, yet access to diagnosis and treatment remains limited, often requiring high out-of-pocket expenses that can surpass a household’s annual income.
“Infertility is one of the most overlooked public health challenges of our time and a major equity issue globally,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Millions face this journey alone — priced out of care, pushed toward cheaper but unproven treatments, or forced to choose between their hopes of having children and their financial security.”
The guideline features 40 recommendations aimed at improving the prevention, diagnosis, and treatment of infertility. It emphasizes cost-effective interventions, integration of fertility care into national health strategies, and financing mechanisms to make services more accessible.
Infertility, defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse, can cause substantial psychological distress, stigma, and financial hardship. WHO’s recommendations include steps for effective clinical management, preventive measures, and education on fertility and reproductive health through schools, primary healthcare, and reproductive health services.
The guideline also highlights major risk factors for infertility, such as untreated sexually transmitted infections and tobacco use, and recommends lifestyle interventions like healthy diet, physical activity, and tobacco cessation for those planning or attempting pregnancy.
For treatment, the guideline outlines clinical pathways that progress from basic fertility advice to advanced procedures such as intrauterine insemination and in vitro fertilization (IVF), based on patient preferences and clinical findings. It also stresses the importance of psychosocial support, recognizing the emotional impact of infertility, which can include depression, anxiety, and social isolation.
WHO encourages countries to adapt the recommendations to local contexts and monitor implementation, involving Ministries of Health, professional societies, civil society, and patient groups. The approach aligns with rights-based, gender-equal sexual and reproductive health policies, empowering individuals to make informed reproductive choices.
“The prevention and treatment of infertility must be grounded in gender equality and reproductive rights,” said Dr. Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing. “Empowering people to make informed choices about their reproductive lives is a health imperative and a matter of social justice.”
The guideline also identifies gaps in evidence and signals future updates on topics including fertility preservation, third-party reproduction, and impacts of pre-existing medical conditions.
