Sexual and reproductive health

Infertility/subfertility: Controversies and innovative solutions

A mother carrying her baby on her back, Myanmar
Héloïse Dériaz

Infertility in developing countries is pervasive and a serious concern. Evidence shows that infertility rates are generally underestimated. Consequences range from severe economic deprivation, to social isolation, to murder and suicide.

Current practices and controversies

In addition to recently established WHO procedures for Guideline development, an innovate mechanism was planned and has been initiated to ensure developing country input throughout the process - from scoping and prioritization of the prioritized topics, to presentation of non-English language evidence for global consensus consultations. Through this process, gaps in knowledge and key areas of research required in developing countries and low resource settings will be identified.

Identifying research gaps

In 2001, a WHO consensus meeting of infertility experts including patient groups was held to discuss “Current Practices and Controversies in Assisted Reproduction.” and resulted in a glossary of 34 terms and 86 recommendations. These recommendations were not evidence-based WHO Guidelines but covered guidance for care which included identification of research gaps.

Assisted reproductive technologies (ART): Common terminology and management in low resource settings

In December, 2008, a second WHO consensus expert consultation of 70 participants from 32 countries was held to update the infertility Glossary - which expanded to 87 terms. The second half of the meeting addressed lower cost innovations for in vitro fertilization.

What would be a basic infertility package to offer in primary care?

This question was addressed during a pre-meeting consultation in 2008 and subsequently highlighted by HRP and the Global Forum in 2009.