Infertility affects one in six: WHO

GENEVA — Around one in every six adults experiences infertility, the World Health Organisation (WHO) recently estimated as it called for an urgent increase in access to fertility care.

The WHO determined that around 17.5 per cent of adults worldwide are affected by infertility at some point, and found little variation between regions and wealthy and poorer countries. 

“Globally, an estimated one out of every six people are affected by the inability to have a child at some point in their life,” WHO chief Tedros Adhanom Ghebreyesus said in the foreword to a fresh report on the issue.

“This is regardless of where they live and what resources they have.”

Across their lifetime, 17.8 per cent of adults in high-income countries and 16.5 per cent in low- and middle income countries were affected by infertility, it found.

Tedros said the report — the first of its kind in a decade — revealed “an important truth: infertility does not discriminate”. 

The WHO designated the issue a “major health challenge globally”, but stressed the difficulty of comparing the situation in various regions due to a lack of data from a number of countries.

‘Jury still out’

Infertility is classified 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.

The report did not examine the causes of infertility, and did not seek to determine trends over time, or infertility differences between the sexes.

Instead, it provided a first estimate of the global and regional prevalency after experts ploughed through piles of studies conducted around the world between 1990 and 2021.

The WHO warned that there were significant variations in the data gathered, including some countries only including adults up to a certain age, and others with no age cut-off, insisting on the need for better data.

“We cannot, based on the data we have, say that infertility is increasing or constant... The jury’s still out on that question,” James Kiarie, head of the WHO’s Contraception and Fertility Care unit, told reporters.

Tedros agreed.

“Infertility affects millions,” he said, lamenting that “even still, it remains understudied, and solutions underfunded, and inaccessible to many, as the result of high costs, social stigma and limited availability”.

Stigma, inequity

Pascale Allotey, head of the WHO’s Sexual and Reproductive Health and Research division, also highlighted the stigma associated with infertility and the inequity in access to treatment.

“The cost of fertility care is an immense challenge for many people,” she told reporters, warning this is “a serious equity issue and very frequently a medical poverty trap”.

At the same time, “procreation comes with a significant societal pressure”, she said, pointing out that in many countries “pregnancy remains critical to the perception of womanhood and... of a couple”.

“Failure is often met with stigma,” Allotey said, pointing out that people with infertility often suffer “anxiety and depression, with ramifications for people’s mental and psychosocial wellbeing”.

There is also “an increased risk of intimate partner violence associated with infertility”, as relationships are tested,” she warned.

The WHO is calling on countries to include infertility treatment as part of their reproductive health policies, services and financing.

“We want to make sure that we break the silence on infertility,” WHO fertility research scientist Gitau Mburu told reporters.

Tedros also insisted that “the sheer proportion of people affected show the need to widen access to fertility care and ensure this issue is no longer sidelined in health research and policy”. 

“Safe, effective, and affordable ways to attain parenthood [must be made] available for those who seek it.”