Something to celebrate: Global Guidelines on Fertility Health Care
This year the World Health Organization issued its first guidelines on the prevention, diagnosis, and treatment of infertility (almost 50 years after the introduction of in vitro fertilization). Like many areas of women’s healthcare, the world has been slow to recognize the urgency and need for fertility health and disease prevention. Now one in every six women struggles with infertility. This statistic does not typically include miscarriage (though The Village considers them equals). One in seven pregnancies will end in a miscarriage. The impact of this global health issue on factors as big as world population decline is paramount. It’s time for global standards and public recognition.
The WHO guidelines recognize the global disparities in “availability, accessibility, acceptability, and quality” of fertility care. Though we live and write this from inside of the United States, the inequality of access and care within each individual state is a testament to the global inequality. The guidelines include a specific set of questions regarding the effectiveness, efficiency, and feasibility of processes for the prevention and treatment of fertility challenges. Based on internal research and some meta analysis, the findings of the organization confirm the importance of discussing fertility throughout adulthood, addressing challenges immediately upon recognition, respecting the cultural, religious, and economical differences of patients, and focusing on treatments that have an actual advantage, even if they are more invasive or costly.
For more specific details on each of the medical recommendations visit the guidelines directly on the WHO website: https://www.who.int/news/item/28-11-2025-who-issues-first-global-guideline-on-infertility
Because The Village exists to support the social, emotional, and behavioral needs of the fertility journey, we are most interested in the recommendations centered around education, counseling, and life planning. The WHO does recommend advisory services before and during treatment, and also along the adult developmental path. In fact, the WHO states that education materials and groups should be implemented. We couldn’t agree more.
In the research, young adults responded positively to fertility-related reading materials and conversation tailored to age groups. Counseling services provided inside of maternity and child health clinics received positive feedback. Something called “reproductive life plans” were provided in some instances and 95% of those receiving this service stated it “made them think about fertility in a different way”. 71% of women said the intervention “encouraged them to ask for new information about fertility” and 98% “wanted to talk” about it with their healthcare provider afterwards. 90% of women stated medical professionals “should routinely discuss” reproductive health care and planning.
In short, if we collectively want to solve the growing infertility crisis, conversations MUST happen (and continuously) throughout the life span.
We have found that most medical providers (and the general public) lack the conflict management and stress tolerance skills to effectively communicate about this topic with their patients. Without a doubt, NOT talking about fertility does more harm. Discussion of psychological and social support is “needed” and clinics should be responsible for either providing it internally or referring patients out for it. Treatment decisions should include discussion of benefits and harms both to the patient physically and mentally. Those decisions should also include analysis of the availability of resources, the costs long-term, feasibility, and personal preferences. Medical professionals do not typically have the expertise necessary to facilitate these discussions alone. This is why mental health professionals should be incorporated.
Fertility is complicated by the lack of affordable services in many countries. Although fertility awareness tools and services appear useful, methods of dissemination are debatable and variable. The value of using AI in the form of chatbots is still being determined. Most women prefer conversations with real people when it comes to discussing fertility. This isn’t possible in many spaces where infertility may bring threat beyond the personal grief and pain. This will take a global solution and collective action.
Ultimately, the decision to have children should be the individual’s right. How each woman makes the decision for herself depends on a great number of multilateral factors. Medical professionals must empower women throughout the life span to make health decisions in the interest of this choice, preserving their physical ability wherever possible, especially if the desire to have a child is named early.
Women can only make effective decisions if they are properly informed. Upcoming editions of the guidelines will include more information on pre-existing medical conditions which will surely help guide the frequency and direction of conversations with medical professionals and their patients over the life span. Knowing about genetic conditions and health complications early in life will save much of the social and emotional anguish so many women currently face. Women have a right to know about their reproductive health early in life.
Reproductive choice is a health imperative and “matter of social justice” and the publication of the WHO guidelines is a powerful statement in support of this right. The Village Fertility Co. aims to stay up to date on any and all policies and procedures that give voice to women’s reproductive concerns. The people-centered approach outlined by the WHO is one we can really get behind, and it gives us hope.
Julia Harkleroad, MS, LCMFT
