The World Health Organisation just rolled out a historic global guideline on infertility — the first of its kind — and honestly, it’s a big deal. This isn’t just another policy document; it’s a full-on blueprint for how countries should treat infertility with fairness, safety, compassion, and science-backed methods. And in a world where 1 in 6 people of reproductive age struggle with infertility, this guideline lands like a long-overdue course correction.
WHO is basically telling countries: “Stop leaving fertility care as a luxury service. Bring it into the national health system, make it accessible, make it affordable, and stop letting people go broke just because they want a child.” And that message hits differently, because right now, millions are navigating infertility alone — priced out of treatment or stuck with unproven options.
What WHO Is Calling For
Dr. Tedros Ghebreyesus, WHO’s Director-General, didn’t mince words. He called infertility one of the most overlooked public health challenges — not just medically, but socially and financially. The new guideline demands fertility care that is:
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Respectful
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Scientifically sound
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Affordable
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Integrated into public healthcare
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Emotionally supportive
This isn’t about fancy clinics; it’s about human dignity.
The guideline offers 40 major recommendations, covering prevention, diagnosis, treatment, and health-system implementation. WHO wants countries to use simple, cost-effective tests, avoid unnecessary procedures, support patients emotionally, and track treatment outcomes properly.
Key Takeaways From the New WHO Infertility Guideline
1. The Foundation: Principles for Proper Fertility Care
WHO wants fertility care built on solid basics:
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Only necessary and affordable diagnostics
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Respect for patient choice
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Access to psychological or peer support
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Clear treatment plans that consider risks, benefits, and cost
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Proper follow-up and recording of pregnancy outcomes
This pushes healthcare systems away from expensive guesswork and toward reliable, patient-centered care.
2. Preventing Infertility Before It Starts
WHO highlights simple but powerful prevention strategies:
Lifestyle & Education
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Share low-cost fertility information widely — schools, clinics, community centers
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Promote healthy behavior: good nutrition, physical activity, avoiding tobacco, weight management
Tobacco
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Give quick cessation advice to anyone who smokes
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Educate on how smoking damages fertility — especially in women
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Offer professional quitting support
STIs
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Teach couples planning pregnancy about STI-related infertility
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Encourage timely diagnosis and treatment of infections
3. Diagnosing Female Infertility the Right Way
WHO breaks down female-factor infertility into clear categories:
Ovulatory Problems
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If ovulation seems irregular, test key hormones: FSH, LH, thyroid hormones, prolactin
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Age is the primary indicator of ovarian reserve
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If needed, use AFC, AMH, or day 2–3 FSH
Tubal Issues
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Use HSG or HyCoSy to check tubal patency
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Pick whichever is feasible and affordable
Uterine Problems
Where equipment is available, WHO ranks tools:
4. Diagnosing Male Infertility
Simple and direct:
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If semen analysis is abnormal → repeat after 11+ weeks
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If normal → don’t repeat
5. When the Cause Is Unknown
Unexplained infertility should only be diagnosed when:
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A couple has tried for 12 months
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Both have normal exams
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The woman ovulates normally
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Tubes are open
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The man’s semen is normal
No shortcuts.
6. Treating Female-Factor Infertility
PCOS / Ovulatory Dysfunction
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Letrozole is the first choice
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If unavailable → clomiphene + metformin
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Lifestyle changes are essential
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If tablets fail → gonadotrophins
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If those fail → IVF
Hyperprolactinaemia
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Cabergoline preferred over bromocriptine
Tubal Disease
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Women under 35 with mild/moderate disease → try surgery first
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Severe disease → IVF
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Above 35 → IVF straight away
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Hydrosalpinx → remove or block tube before IVF
Uterine Septum
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No surgery unless there is a history of repeated pregnancy loss
7. Treating Male Infertility
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No clear recommendation for antioxidants — evidence is shaky
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For clinical varicocele:
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Treat surgically or radiologically
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Prefer microscopic surgery
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Only applies when not doing ART
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8. Treating Unexplained Infertility
WHO sets a clear ladder:
First-Line
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Expectant management for 3–6 months
(No IUI or medications at this stage)
Second-Line
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Controlled ovarian stimulation with letrozole or clomiphene
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Combine with IUI
Third-Line
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IVF
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No need for ICSI unless a male-factor issue exists
9. Implementation: How Countries Should Use the Guideline
WHO says nations should adapt the recommendations based on:
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Local population
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Available resources
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Social/cultural context
They must also:
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Train healthcare workers
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Update policies
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Improve data systems
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Ensure care is rights-based
10. Monitoring & Evaluation
Countries should track:
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Fertility service usage
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Treatment outcomes
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Patient experiences
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Existing fertility indicators
This ensures progress isn’t just on paper.
11. What Future Updates Will Cover
WHO plans to expand into:
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Obesity and other risk factors
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Environmental and workplace hazards
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Sexual dysfunction
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Fertility preservation
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Male infertility advancements
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New technologies including AI
Why This Guideline Matters Globally
Infertility isn’t just a medical condition — it carries:
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Emotional pain
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Social stigma
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Financial pressure
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Broken relationships
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Gender-based blame
WHO stresses that fertility care must be rooted in human rights, equality, and dignity. Dr Pascale Allotey summed it up perfectly: infertility care is not a privilege — it’s a matter of social justice.