YOUR HEALTH FERTILITY MATTERS
Infertility affects millions of people of reproductive age worldwide –
and has an impact on their families and communities. Estimates suggest
that between 48 million couples and 186 million individuals live with
infertility globally.
( WHO )Why addressing infertility is important? 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 is therefore an important part of
realizing the right of individuals and couples to found a family.7 A
wide variety of people, including heterosexual couples, same-sex
partners, older persons, individuals who are not in sexual
relationships and those with certain medical conditions, such as some
HIV sero-discordant couples and cancer survivors, may require
infertility management and fertility care services. Inequities and
disparities in access to fertility care services adversely affect the
poor, unmarried, uneducated, unemployed and other marginalised
populations. 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.
In some settings, fear of infertility can deter women and men from
using contraception if they feel socially pressured to prove their
fertility at an early age because of a high social value of
childbearing.
In such situations, education and awareness-raising interventions to
address understanding of the prevalence and determinants of fertility
and infertility is essential.Addressing challenges Availability,
access, and quality of interventions to address infertility remain a
challenge in most countries.
Diagnosis and treatment of infertility is often not prioritized in
national population and development policies and reproductive health
strategies and are rarely covered through public health financing.
Moreover, a lack of trained personnel and the necessary equipment and
infrastructure, and the currently high costs of treatment medicines,
are major barriers even for countries that are actively addressing the
needs of people with infertility. While assisted reproduction
technologies (ART) have been available for more than three decades,
with more than 5 million children born worldwide from ART
interventions such as in vitro fertilization (IVF), these technologies
are still largely unavailable, inaccessible and unaffordable in many
parts of the world, particularly in low and middle-income countries
(LMIC).
Government policies could mitigate the many inequities in access to
safe and effective fertility care. To effectively address infertility,
health policies need to recognize that infertility is a disease that
can often be prevented, thereby mitigating the need for costly and
poorly accessible treatments.
Incorporating fertility awareness in national comprehensive sexuality
education programmes, promoting healthy lifestyles to reduce
behavioural risks, including prevention, diagnosis and early treatment
of STIs, preventing complications of unsafe abortion, postpartum
sepsis and abdominal/pelvic surgery, and addressing environmental
toxins associated with infertility, are policy and programmatic
interventions that all governments can implement.
In addition, enabling laws and policies that regulate third party
reproduction and ART are essential to ensure universal access without
discrimination and to protect and promote the human rights of all
parties involved. Once fertility policies are in place, it is
essential to ensure that their implementation is monitored, and the
quality of services is continually improved.WHO response WHO
recognizes that the provision of high-quality services for
family-planning, including fertility care services, is one of the core
elements of reproductive health. Recognizing the importance and impact
of infertility on people’s quality of life and well-being, WHO is
committed to addressing infertility and fertility care by:
Collaborating with partners to conduct global epidemiological and
etiological research into infertility.
Engaging and facilitating policy dialogue with countries worldwide to
frame infertility within an enabling legal and policy environment.
Supporting the generation of data on the burden of infertility to
inform resource allocation and provision of services.Developing
guidelines on the prevention, diagnosis and treatment of male and
female infertility, as part of the global norms and standards of
quality care related to fertility care.Continually revising and
updating other normative products, including the WHO laboratory manual
for the examination and processing of human semen.Collaborating with
relevant stakeholders including academic centres, ministries of
health, other UN organizations, non-state actors (NSAs) and other
partners to strengthen political commitment, availability and health
system capacity to deliver fertility care globally.Providing
country-level technical support to member states to develop or
strengthen implementation of national fertility policies and services.
