WHO issues first global guideline for infertility prevention, diagnosis, and treatment - Video

Infertility affects an estimated one in six people of reproductive age worldwide, yet access to effective and affordable fertility care remains limited, causing immense emotional and financial strain. Recognizing this, the World Health Organization (WHO) released its first-ever global guideline for infertility prevention, diagnosis, and treatment, aiming to make fertility care safer, more equitable, and integrated into national health systems.

Infertility is defined as the failure to conceive after 12 months of regular unprotected sexual intercourse and can lead to significant psychological distress and social stigma. The WHO guideline includes 40 evidence-based recommendations that cover all stages of infertility care, focusing on cost-effective prevention and treatments that are respectful of patients’ needs and preferences.

It emphasizes investing in education on fertility and risks such as age, untreated sexually transmitted infections, and tobacco use—encouraging lifestyle changes like healthy diet, physical activity, and smoking cessation to improve reproductive outcomes.

The guideline proposes a stepwise clinical approach for diagnosis and treatment. Initial management includes counseling on fertile windows and fertility promotion without medical treatment. For diagnosed infertility, it recommends progressing to treatments like ovulation induction, intrauterine insemination (IUI), and, if necessary, assisted reproductive technologies such as in vitro fertilization (IVF).

Recommendations are tailored to patient age and cause of infertility — for example, surgery may be suggested for mild tubal disease in younger women, while IVF is preferred for severe cases or older patients. The guideline also advises against unnecessary advanced treatments like intracytoplasmic sperm injection (ICSI) without clear indication.

WHO underscores the importance of integrating psychosocial support throughout fertility care to address depression, anxiety, and social isolation commonly experienced by patients. The guideline advocates for fertility care to be part of comprehensive sexual and reproductive health programs guided by principles of gender equality, reproductive rights, and informed choice.

Acknowledging existing research gaps, WHO plans future guideline updates to include fertility preservation, third-party reproduction, and the influence of pre-existing health conditions. This comprehensive framework seeks to reduce global infertility inequities, empower individuals with informed reproductive decisions, and ensure affordable, dignified care worldwide.

REFERENCE: Guideline for the prevention, diagnosis and treatment of infertility; World Health Organization; 2025; https://www.who.int/publications/i/item/9789240115774