Infertility
Infertility is a global health issue affecting millions of people of reproductive age worldwide. Available data suggests that globally one in six people experience infertility in their lifetime. Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Primary infertility is the inability to have any pregnancy, while secondary infertility is the inability to have a pregnancy after previously successful conception. WHO’s International Classification of Diseases provides more information on the many primary and secondary causes of infertility in both women and men.
Infertility may occur due to male factors, female factors, a combination of male and female factors or may be unexplained. For both women and men, however, lifestyle factors such as smoking, excessive alcohol intake and obesity have been associated with higher chances of infertility.
Every human being has a right to the enjoyment of the highest attainable standard of physical and mental health. Individuals and couples have the right to decide the number, timing and spacing of their children. Addressing infertility is therefore an important part of realizing the right of individuals and couples to found a family.
A wide variety of people globally may require infertility management and fertility care services. Disparities in access to fertility care services adversely affect the poor, unmarried, uneducated, unemployed and other underserved and marginalised populations.
Infertility has significant negative impacts on the lives of infertile couples. Women in particular are at greater risk of violence, divorce, social stigma, emotional stress, depression, anxiety and low self-esteem. In some settings, fear of infertility can deter women and men from using contraception if they feel socially pressured to prove their fertility at an early age because of a high social value of childbearing. Infertility can also have negative economic impact when households incur catastrophic out-of-pocket expenditure to access treatment.
Availability, access, and quality of interventions to address infertility remain a challenge in most countries. Prevention, diagnosis and treatment of infertility are often not prioritized in national policies and are rarely covered through public health financing. A lack of necessary equipment and trained personnel, together with the high costs of treatment, are additional barriers preventing universal access to fertility care. While assisted reproduction technology (ART) has been available for over three decades, it is still largely unaffordable in many parts of the world.
The World Health Organization is committed to addressing infertility and is currently working on a programme on infertility research and fertility care. It is also developing guidelines on the prevention, diagnosis and treatment of male and female infertility, as part of global norms and standards.
WHO is engaging with countries to address infertility within an enabling legal and policy environment and to support the generation of data on the burden of infertility. WHO is working with relevant stakeholders including academic centres, ministries of health, UN organizations, non-state actors and other partners to strengthen political commitment, and health system capacity related to fertility care.
