WHO urges fair, affordable fertility care as high out‑of‑pocket costs hit families hard
One in six people of reproductive age worldwide experience infertility, and in some countries a single round of in vitro fertilisation can cost about twice the average annual household income, according to the World Health Organization (WHO).
WHO defines infertility as the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
The agency describes infertility as “one of the most overlooked public health challenges of our time and a major equity issue globally,” said Tedros Adhanom Ghebreyesus.
According to WHO, infertility can cause “significant distress, stigma, and financial hardship,” affecting people’s mental and psychosocial well-being.
WHO reports that in many countries, people largely fund infertility tests and treatments out of pocket, often facing catastrophic financial expenditures.
WHO has released its first global guideline for the prevention, diagnosis and treatment of infertility.
The organization calls on countries to make fertility care safer, fairer and more affordable for all and to integrate fertility services into national health strategies, services and financing.
According to WHO, the guideline includes 40 recommendations that promote cost-effective options at every stage of care. It outlines clinical pathways to diagnose common biological causes of male and female infertility, as well as unexplained infertility.
Clinicians can move from simpler management strategies, such as advice on fertile periods and fertility promotion without active treatment, to more complex treatment such as intrauterine insemination or IVF.
WHO said infertility care “is not just about IVF,” but also about steps primary health care providers can take, including guidance on lifestyle interventions like stopping smoking.
The guideline stresses prevention and calls for more information on fertility and infertility, including the role of age, in schools, primary health care and reproductive health facilities.
It highlights leading risk factors such as untreated sexually transmitted infections and tobacco use, and recommends healthy diet, physical activity and tobacco cessation for individuals and couples planning or attempting pregnancy.
Recognizing that infertility can lead to depression, anxiety and social isolation, WHO stresses the need for ongoing psychosocial support.
According to WHO, countries should adapt the recommendations to local contexts and align implementation with rights-based approaches to sexual and reproductive health.
“The prevention and treatment of infertility must be grounded in gender equality and reproductive rights,” said Pascale Allotey of WHO and the United Nations’ Special Programme on Human Reproduction.
WHO also notes evidence gaps and says future guideline updates will cover fertility preservation, third-party reproduction and the impact of pre-existing medical conditions.
