Roughly one in six people (17.5 percent) around the world are affected by infertility, according to a new report from the World Health Organization (WHO). The report is described as a “first of its kind in a decade,” analyzing infertility data from 1990 through 2021. This includes data from 133 previously published studies on the prevalence of infertility.
Infertility is defined as not being able to conceive after one year or more of unprotected sex. The WHO called these new numbers “staggering.” Infertility affects both the male and female reproductive system and can cause significant emotional distress and financial hardship, and is still stigmatized and understudied.
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According to the Centers for Disease Control and Prevention (CDC), roughly one in five married women between 15 and 49 years of age experience infertility.
“The report reveals an important truth: infertility does not discriminate,” said WHO Director General Tedros Adhanom Ghebreyesus in a press release. “The sheer proportion of people affected shows the need to widen access to fertility care.”
The report found little variation in fertility rates across income levels in the new report. Higher-income countries experience infertility rates of roughly 18 percent and low- to medium-income countries see rates of close to 17 percent.
The report, however, did find differences among how much money people are spending on treatments and how accessible they are. Those in the poorest countries spent a significantly larger proportion of their annual income on one single cycle of in vitro fertilization (IVF) or other fertility care compared to those in wealthier countries. IVF is becoming increasingly unaffordable in the US, and just one cycle of IVF can cost between $10,000 and $25,000, according to reporting from The Washington Post,
Additionally, there was limited data available for countries in Africa and across southern Asia, further emphasizing the unequal access to fertility care and the “persistent need” for better data collection methods in those regions.
While there was some regional variation in infertility at the regional level, the WHO said that the differences were either not substantial or conclusive. The highest lifetime prevalence was found in the Western Pacific (23.2 percent) and the lowest was in the Eastern Mediterranean (10.7 percent).
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The report did not determine whether the global infertility rate is increasing or decreasing. The WHO also noted that most of the studies used in this report contained estimates based on female respondents, despite infertility being a condition experienced by both sexes. According to the CDC, hormonal disorders, disruptions to ejaculatory or testicular functions, and genetic disorders may result in infertility in males. Lifestyle factors like smoking and excessive alcohol or drug use, age, and body weight can also undermine the ability to conceive in both sexes.
Asima Ahmad, an endocrinologist and fertility expert who serves as chief medical officer and co-founder of Carrot Fertility, told CNN that the new report shows more people need fertility coverage and access to high-quality healthcare, and that inequities need to be addressed.
“These inequities, I’m not surprised that they exist on a global level, because we already see the inequities in the United States domestically, with how infertility impacts different populations and how some populations have limited access. And even with the access that they finally get, they, for example, will have a lower rate of success or even a higher rate of miscarriage,” said Ahmad, who was not involved in the new WHO report.
Ahmad also cited a lack of access to “clinically vetted evidence-based information” about the causes of infertility and how to recognize and treat it and that access to employer-provided fertility benefits is also a significant barrier to care in the United States.