First global guideline for infertility from WHO

The World Health Organisation (WHO) has published its first global guideline on infertility, aiming to make fertility treatment more affordable, safer and fairer for all.

The WHO estimates that infertility, defined as the inability to conceive after at least 12 months of regular unprotected sex, affects one in six people of reproductive age during their lifetime worldwide. The new guideline includes 40 recommendations on prevention, diagnosis and effective clinical management of infertility, which aim to improve fair access to safe, affordable fertility care. The WHO called on countries to adapt the recommendations to local contexts and to integrate fertility care into their national health strategies.

'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. We encourage more countries to adapt this guideline, giving more people the possibility to access affordable, respectful, and science-based care.'

The WHO noted that affordability is a common barrier to fertility care, noting that patients in many countries pay out of pocket for tests and treatments. It also highlighted the emotional and mental toll of infertility, particularly for women, and emphasised the need for ongoing support.

The guideline outlines clinical pathways for diagnosis and treatment of infertility, from simpler management strategies including advice about fertility and fertile periods, to more advanced treatment options including intrauterine insemination and IVF. The guideline include recommendations for diagnosis and treatment of male factor infertility, noting that this is often overlooked.

'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 and the United Nations' Special Programme on Human Reproduction. 'Empowering people to make informed choices about their reproductive lives is a health imperative and a matter of social justice.'

The guideline also includes low-cost strategies aimed at preventing infertility, including advising people of leading risk factors including untreated sexually transmitted infections and tobacco use. Other recommendations include provision of advice on lifestyle changes both for the general population and for those experiencing infertility, which may include information on diet, alcohol intake, physical activity and weight management.

The WHO plans to include additional recommendations in future versions of the guidance, on issues which may include fertility preservation, the impact of pre-existing medical conditions on fertility, and treatments including donor gametes, embryos or surrogacy.