The World Health Organization recently reported that one in six people worldwide experiences infertility at some point in their lifetime. Specifically, around 17.5% of the adult population experience it, showing the urgent need to increase access to high-quality fertility care. The new estimates show limited variation in the prevalence of infertility between regions. The rates are comparable for high, middle, and low-income countries, indicating that this is a global health challenge. Lifetime prevalence was 17.8% in high-income countries and 16.5% in low and middle-income countries.
This report provides insight into global and regional infertility prevalence by analyzing all relevant studies from 1990 to 2021, considering different estimation approaches. The search identified 12,241 records of potentially relevant studies across the world. Screening these records led to the selection of 133 studies in the report’s analysis. From these, relevant data points were used to generate pooled estimates for lifetime and period infertility prevalence.
Infertility is 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. It can cause significant distress, shame, and financial hardship, affecting people’s mental and psychosocial well-being. Despite the magnitude of the issue, solutions for preventing, diagnosing, and treating infertility – including assisted reproductive technology such as in vitro fertilization (IVF) – remain underfunded and inaccessible to many due to high costs, social stigma, and limited availability.
“The report reveals an important truth – infertility does not discriminate,” said Dr. Tedros Adhanom Ghebreyesus, Director-General at WHO. “The sheer proportion of people affected shows the need to widen access to fertility care and ensure this issue is no longer sidelined in health research and policy so that safe, effective, and affordable ways to attain parenthood are available for those who seek it.”
In most countries, fertility treatments are primarily funded out of pocket, often resulting in devastating financial costs. People in the poorest countries spend more of their income on fertility care than those in wealthier countries. High costs frequently prevent people from accessing infertility treatments or can catapult them into poverty due to seeking care.
“Millions of people face catastrophic healthcare costs after seeking infertility treatment, making this a major equity issue and, all too often, a medical poverty trap for those affected,” said Pascale Allotey, director of sexual and reproductive health and research at WHO, including the United Nations Special Programme of Research, Development and Research Training in Human Reproduction (HRP). “Better policies and public financing can significantly improve access to treatment and protect poorer households from falling into poverty as a result.”
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. It calls for help with quantifying infertility and knowing who needs fertility care and how risks can be reduced.
The WHO expects to release more guidelines on preventing, diagnosing, and treating infertility in the coming year.