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An equal burden of infertility amid unequal access to treatment

The WHO’s first guideline on infertility takes a broad approach to addressing this global issue, focusing on ways to provide more equitable, sustainable access to fertility services.

Jeremy Farrar (The Jakarta Post)
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Geneva, Switzerland
Sat, November 29, 2025 Published on Nov. 27, 2025 Published on 2025-11-27T08:57:11+07:00

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Baby in waiting: A gynaecologist performs an ultrasound on a pregnant woman on Aug. 3, 2025 at a non-profit health clinic in Sukadana, West Kalimantan. Baby in waiting: A gynaecologist performs an ultrasound on a pregnant woman on Aug. 3, 2025 at a non-profit health clinic in Sukadana, West Kalimantan. (AFP/Bay Ismoyo)

T

his week, the World Health Organization released its first guideline that addresses infertility. This publication marks a major shift in the response to this issue globally, highlighting how it can be addressed in a fairer, more sustainable way to meet people’s needs and the rising demand for fertility services around the world.

In public health, we examine patterns: Who is impacted or at risk of a health issue, where and why. Infertility, a biological condition affecting reproductive health, affects approximately one in six people globally in all countries, across all income levels and backgrounds.

Yet while prevalence is comparable across these categories, access to care is not. In many countries, accessing medically assisted reproductive treatments means that people must pay out-of-pocket costs that exceed average GDP by 200 percent, thereby creating a major poverty trap for those seeking care.

WHO recognizes infertility as a global public health and reproductive rights issue, calling for its inclusion in universal health coverage. The newly released guideline emphasizes that fertility care, which includes prevention, diagnosis and treatment of infertility, must be available, safe, effective and equitable. The guideline advocates for national policies that include infertility services in primary care, financing and health insurance packages, including in low- and middle-income countries.

Infertility is a largely preventable and treatable medical condition, not a matter of fate, and is not exclusive to any gender or group. It has profound emotional, psychological and social impacts on individuals, couples, families and communities.

For those affected, managing infertility often comes with a whirlwind of emotions, a constant roller coaster of frustration, disappointment and anxiety. Addressing infertility requires an individual clinical, evidence-based approach that is free from stigma and moral judgment, ensuring people with infertility can access the right options for them, alongside the emotional support they need.

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Most countries are experiencing declining total fertility, with global rates falling around 1 percent annually. This is accompanied by increased life expectancy, aging populations and delayed childbearing.

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