Around 17.5 per cent of the adult population — roughly 1 in 6 worldwide — experience infertility, according to a new report by the World Health Organisation (WHO).

It highlights the urgent need to increase access to affordable, high-quality fertility care for those in need.

What is infertility? 

• The WHO defines infertility as 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. Infertility impacts millions of people worldwide, often with devastating consequences. 

• Infertility can be primary or secondary. Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when at least one prior pregnancy has been achieved.

• Understanding the magnitude of infertility is critical for developing appropriate interventions, for monitoring access to quality fertility care, and for mitigating risk factors for and consequences of infertility.

• Despite the magnitude of the issue, solutions for the prevention, diagnosis and treatment of infertility – including assisted reproductive technology such as in vitro fertilisation (IVF) – remain underfunded and inaccessible to many due to high costs, social stigma and limited availability.

Why addressing infertility is important?

• Addressing infertility is an important component of sexual and reproductive health and rights, but in most countries, infertility policies and services are inadequate. 

• It is central to achieving Sustainable Development Goal (SDG) 3 – Ensure healthy lives and promote well-being for all at all ages, and SDG 5 – Achieve gender equality and empower all women and girls. 

• 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. Infertility can negate the realisation of these essential human rights.

• Addressing infertility can also mitigate gender inequality. Although both women and men can experience infertility, women in a relationship with a man are often perceived to suffer from infertility, regardless of whether they are infertile or not. Infertility has significant negative social impacts on the lives of infertile couples and particularly women, who frequently experience violence, divorce, social stigma, emotional stress, depression, anxiety and low self-esteem. 

• At present, in most countries, fertility treatments are largely funded out of pocket – often resulting in devastating financial costs. People in the poorest countries spend a greater proportion of their income on fertility care compared to people in wealthier countries. High costs frequently prevent people from accessing infertility treatments or alternatively, can catapult them into poverty as a consequence of seeking care.

Some key findings:

• The report analysed existing studies conducted from 1990 to 2021 and showed that about 17.5 per cent of adults across the world were affected by the inability to have a child.

• Estimates of infertility prevalence are similar across countries regardless of country income level. Lifetime infertility prevalence was 17.8 per cent for high-income countries and 16.5 per cent for low and middle-income countries. Period infertility prevalence was 12.6 per cent for high-income countries and 12.6 per cent for low and middle-income countries.

• The available data indicate that estimated lifetime prevalence of infertility is highest in the WHO Western Pacific Region (23.2 per cent) and lowest in the WHO Eastern Mediterranean Region (10.7 per cent). 

• For primary infertility, estimated pooled lifetime and period prevalence were 9.6 per cent and 9 per cent respectively. For secondary infertility, estimated pooled lifetime and period prevalence were 6.5 per cent and 4.9 per cent respectively.

• While the new report shows convincing evidence of the high global prevalence of infertility, it highlights a persistent lack of data in many countries and some regions. 

• It calls for greater availability of national data on infertility disaggregated by age and by cause to help with quantifying infertility, as well as knowing who needs fertility care and how risks can be reduced.

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