The World Health Organisation has released its first-ever guideline for preventing, diagnosing, and treating infertility, urging countries to reform their approach to fertility care and financing. According to the WHO, infertility affects an estimated one in six people of reproductive age worldwide, yet access to care remains limited and often financially crippling.
The guideline, which includes 40 recommendations, aims to strengthen prevention, diagnosis, and treatment while promoting the integration of fertility care into national health strategies, services, and financing. It emphasizes cost-effective options and people-centered, evidence-based care. Infertility, defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sex, can lead to significant stigma, financial strain, and psychological distress.
The WHO guideline calls for greater investment in prevention, including education on fertility and infertility in schools and primary care, as well as action on leading risk factors such as untreated sexually transmitted infections and tobacco use. It recommends lifestyle interventions, including a healthy diet, physical activity, and smoking cessation, for individuals and couples attempting pregnancy.
The clinical pathways outlined in the guideline cover the diagnosis of common biological causes of male and female infertility and describe how treatment may progress from guidance on fertile periods to more complex interventions such as intrauterine insemination or in vitro fertilization (IVF). The guideline also highlights the need for ongoing psychosocial support due to the emotional burden infertility can impose.
WHO Director-General, Dr. Tedros Ghebreyesus, emphasized that infertility is a major equity issue globally, with millions of people facing significant financial and emotional challenges in their quest to have children. He encouraged countries to adapt the guideline, giving more people access to affordable, respectful, and science-based care.
The implementation of the guideline should align with rights-based sexual and reproductive health approaches that support informed decisions about whether and when to have children. According to 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 acknowledges gaps in current evidence and areas for further research, with upcoming editions expected to cover issues such as fertility preservation, third-party reproduction, and the impact of pre-existing medical conditions. As countries work to adapt and implement the guideline, the WHO’s efforts aim to address the significant public health challenge of infertility and promote greater equity and access to fertility care worldwide.