The World Health Organization (WHO) has sounded an alarm, urging countries across the world to make fertility care safer, more equitable and financially accessible.
Releasing its first-ever global guideline recently for the prevention, diagnosis and treatment of infertility, the global health agency has drawn attention to what it calls a growing yet neglected public health crisis.
Infertility today affects one in six people of reproductive age – an unprecedented scale that experts warn could deepen if urgent action is not taken.
The WHO also notes that despite the rising need for care, access remains a privilege available to only a few. In many regions, fertility treatments are entirely paid out of pocket, pushing couples into crushing debt. In some countries, just one cycle of IVF can cost more than twice the average household’s annual income, forcing many to abandon treatment or seek unsafe shortcuts.
“Infertility is one of the most overlooked public health challenges of our time,” WHO Director-General Dr Tedros Adhanom Ghebreyesus cautioned. “Millions face this journey alone—priced out of care, pushed toward unproven treatments, or forced to choose between parenthood and financial security.”
The guideline puts forth 40 recommendations aimed at reshaping global fertility care. It calls for early prevention strategies, inclusion of fertility services in national health packages, and cost-effective, evidence-based care.
The WHO stresses integrating fertility education into schools, primary healthcare and reproductive facilities, enabling young people to make informed choices about their reproductive future.
Significant attention has been directed towards preventable causes — including untreated sexually transmitted infections, lifestyle-related factors, delayed childbearing, smoking, and obesity — all now recognized as contributors to declining fertility.
The guideline also recommends routine lifestyle counselling, timely clinical diagnosis and a tiered treatment pathway, ranging from natural conception support to advanced assisted reproductive technologies such as IUI and IVF.
But beyond biology, infertility has a human cost, notes the WHO.
The emotional grief of unsuccessful conception often spirals into depression, anxiety, marital strain and social isolation. Highlighting the urgent need for psychological counselling as part of standard infertility management, the WHO has stressed on ensuring that treatment addresses both medical and emotional wellbeing.
Countries have been encouraged to adopt the guidelines in line with local realities, backed by stronger policy, funding support and rights-based reproductive care.
The WHO guidelines come at a critical time for India, where infertility has silently grown into a major public health concern. An estimated 15–20 million couples in the country are currently struggling to conceive, with prevalence rates varying between 3.9% and 16.8% across regions.
For a nation soon to become the most populous in the world, the rising infertility burden is often overlooked while silently reshaping family patterns, emotional well-being, and financial stability.
According to the experts, the causes reflect sweeping socio-economic shifts — delayed marriage, rising age at pregnancy, sedentary lifestyles, stress, obesity, pollution exposure and untreated reproductive infections.
Alarmingly, secondary infertility is on the rise, suggesting that reproductive health challenges are no longer limited to couples trying for the first time but include those who previously conceived successfully.
Contrary to traditional belief, the burden is not borne by women alone. Male infertility accounts for nearly 40–50% of cases, frequently linked to reduced sperm count, poor sperm motility, hormonal imbalances and environmental factors. Female infertility, on the other hand, is commonly associated with ovulatory dysfunctions, hormonal disorders, PCOS, endometriosis, and age-related decline in egg quality.
Yet medical causes are only one part of the story — the social consequences are often far more scarring.
Stigma, silence and blame continue to fall disproportionately on women, despite science proving equal responsibility across genders.
Many women face emotional distress, discrimination within families, and sometimes even marital breakdown, pushing infertility beyond the realm of biology into a deeply embedded gender and societal issue, say the experts.
