WHO issues first global guideline to make fertility care safer and more affordable

The World Health Organization on Friday released its first global guideline on infertility, calling on countries to make fertility care safer, fairer and more affordable as rising demand continues to outpace access to services.

WHO estimates that infertility affects one in six people of reproductive age worldwide, yet many still rely on out-of-pocket payments for diagnosis and treatment. 

In some countries, a single round of in vitro fertilisation costs twice the average annual household income.

“Infertility is one of the most overlooked public health challenges of our time and a major equity issue globally,” WHO Director General Dr Tedros Adhanom Ghebreyesus said.

“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."

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

The new guideline contains 40 recommendations covering prevention, diagnosis and treatment of infertility, and promotes cost-effective options at each stage. 

It also advises countries to integrate fertility services into national health strategies and financing systems.

WHO defines infertility as the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. 

The guideline highlights the emotional, financial and social toll of infertility and calls for wider access to psychosocial support.

To strengthen prevention efforts, WHO urges investment in public information on fertility, including age-related factors, and the incorporation of such education into schools, primary health care and reproductive health services. 

It identifies untreated sexually transmitted infections and tobacco use as leading risk factors and recommends lifestyle interventions such as healthier diets, physical activity and tobacco cessation for people planning or attempting pregnancy.

The guideline also outlines clinical pathways to diagnose common causes of male and female infertility and advises clinicians to progressively advance treatment from basic fertility promotion to intrauterine insemination and IVF, depending on test results and patient preferences.

Dr Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, said successful implementation must be grounded in gender equality and reproductive rights.

“The prevention and treatment of infertility must be grounded in gender equality and reproductive rights. Empowering people to make informed choices about their reproductive lives is a health imperative and a matter of social justice,” she said.

WHO is encouraging countries to tailor the recommendations to local contexts and monitor progress. Future guideline updates will address fertility preservation, third-party reproduction and the impact of pre-existing medical conditions.