Sexual and reproductive health

Diagnosis, management and treatment of subfertility and infertility

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.

Generating practice guidelines

The revision and updating of the “WHO global Guidelines for infertility diagnosis, management and interventions for treatment” (1992) and the WHO manual for the investigation and diagnosis of the infertile couple” (1993) was initiated in January 2012. A small Steering Committee with six Expert Working Group Chairs, local Swiss experts, as well as Presidents, Chairpersons and representatives of ASRM1, ESHRE2, FIGO3, GFMER4, ICMART5 and IFFS6 came to the table to share experiences, to present their current (or in-process) guidelines and to recommend a collaborative process for moving forward to generate global guidelines.

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.

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.

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.


  • American Society for Reproductive Medicine (ASRM)
  • European Society for Human Reproduction and Embryology (ESHRE)
  • International Federation of Obstetrics and Gynaecology (FIGO)
  • Graduate Foundation for Medical Education and Research (GFMER)
  • International Committee for Monitoring Assisted Reproductive Technologies (ICMART)
  • International Federation of Fertility Societies (IFFS)
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