WHO Issues First Global Guideline on Infertility Prevention and Treatment

The World Health Organization today released its first global guideline on the prevention, diagnosis and treatment of infertility, urging countries to make fertility care safer, fairer and more affordable. Infertility is estimated to affect 1 in 6 people of reproductive age at some point in their lives.

Demand for related services is rising worldwide, yet access remains severely limited in many places. In numerous countries, tests and treatments for infertility are funded primarily out-of-pocket, often resulting in catastrophic financial costs. In some settings, a single round of in vitro fertilization can cost double the average annual household income.

The guideline contains 40 recommendations aimed at strengthening prevention, diagnosis and treatment. It promotes cost-effective options and calls for integrating fertility care into national health strategies, services and financing.

Certain menstrual conditions, being underweight or overweight, tobacco use and some medical treatments such as those for cancer can increase the possibility of infertility. The guideline stresses the need to address leading risk factors including untreated sexually transmitted infections and tobacco use.

It recommends lifestyle interventions such as maintaining a healthy diet, physical activity and tobacco cessation for individuals and couples planning or attempting pregnancy. The document also calls for increased investment in providing information on fertility and infertility, including factors such as age, in schools, primary health care and reproductive health facilities.

Informing people about fertility early can help them make reproductive plans. The guideline defines infertility as the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.

The guideline outlines clinical pathways to diagnose common biological causes of male and female infertility. It provides guidance on progressing treatment from simpler approaches, such as advice on fertile periods and fertility promotion, to more complex options including intrauterine insemination or in vitro fertilization, taking into account clinical findings and patient preferences.

Infertility can cause significant distress, stigma and financial hardship, affecting mental and psychosocial well-being. The document emphasizes the importance of ensuring ongoing access to psychosocial support for those affected.

The World Health Organization is encouraging countries to adapt the recommendations to local contexts and monitor progress. Successful implementation will require collaboration across health ministries, professional societies, civil society and patient groups.

The approach should align with comprehensive, rights-based sexual and reproductive health strategies that empower people to make informed decisions about whether and when to have children. The guideline acknowledges gaps in current evidence and areas for future research, with upcoming editions expected to address topics such as fertility preservation, third-party reproduction and the impact of pre-existing medical conditions.

Many cases of infertility are treatable with the right care. Individuals concerned about fertility are advised to consult a health care provider.