The World Health Organization has issued its first global guideline for the prevention, diagnosis, and treatment of infertility. The guideline includes 40 recommendations to strengthen infertility care and promote cost-effective options.
Infertility is estimated to affect one in six people of reproductive age at some point in their lives. Access to care remains limited worldwide. In many countries, tests and treatments for infertility are largely funded out-of-pocket, often resulting in catastrophic financial expenditures. In some settings, a single round of in vitro fertilization can cost double the average annual household 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.”
Infertility is defined by the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. The condition can cause distress, stigma, and financial hardship, affecting mental and psychosocial wellbeing.
The guideline provides guidance on clinical management of infertility and calls for increased investment in prevention, including information on fertility and infertility in schools, primary health care, and reproductive health facilities. The guideline stresses the need to address risk factors for infertility, including untreated sexually transmitted infections and tobacco use.
Lifestyle interventions such as healthy diet, physical activity, and tobacco cessation are recommended for individuals and couples planning or attempting pregnancy. The guideline outlines clinical pathways to diagnose common biological causes of male and female infertility.
The guideline provides guidance on treatment options ranging from simpler management strategies, where clinicians provide advice on fertile periods and fertility promotion without active treatment, to more complex treatment courses such as intrauterine insemination or IVF.
Recognizing the emotional toll of infertility, which can lead to depression, anxiety, and social isolation, the guideline emphasizes the need to ensure ongoing access to psychosocial support for all those affected.
“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 promotes integration of fertility care into national health strategies, services, and financing. WHO is encouraging countries to adapt the recommendations to their local contexts and monitor progress. Implementation will require collaboration across Ministries of Health, health professional societies, civil society, and patient groups.
The guideline acknowledges current gaps in evidence and areas for future research. Upcoming editions are expected to cover issues such as fertility preservation, third-party reproduction, and the impact of pre-existing medical conditions.
