The Status of Global Infertility

By: Friday Faraday

The state of reproductive health has been in a flux for decades. Most people might be surprised by the “decades” part, especially when it comes to Roe v Wade being overturned and the fight for access to mifepristone for the entire US. The truth is that the alarm for reproductive health began to sound in the early 90’s during the International Conference on Population and Development (ICPD). There a strong Programme of Action was endorsed by 179 countries to take a strong stance on many topics, including reproductive health that would merge the need for fertility control along with the prevention and treatment of infertility. Since you are here reading this post you can probably tell that much wasn’t done after that because infertility is a big issue that isn’t talked about enough.

So, in 2023 with the battle for reproductive rights still raging on across several topics, what is happening with that status of the least talked about issue around the world?

The Realities

The decline in the fertility rate was first noticed in the United States and other growing countries during times that there was a decline in economic progress, such as the Great Depression in the 1930’s and the Energy Crisis in the 1970’s. A jump to the present day and the World Health Organization (WHO) details that 1 in 6 adults (17.5% of the adult population) has been affected by infertility in their life. When we think of numbers, that 1 in 6 or 17.5% doesn’t sound or look too high when talking about billions of people, and in our everyday lives we know people that either had children recently or are currently pregnant, but for the ones we don’t see or choose not to see, that’s where the most overwhelming struggles is the most real.

Since there hasn’t been a powerful stance that has equaled a national or international interest toward infertility the effects of it have gone unknown for most people. Of course, there is always the counter argument that the world is overpopulated and there is a level of scarcity of resources, and that could be a reason why infertility is talked about enough. No matter what the reason is, the reality is that many people that make the choice to start building a family are unfortunately met with hurdles and disappointments that can open them up to feeling shame, anxiety, and depression because of something that is out of their control.  

Being that this is a global issue affecting people from different cultures, it is not as simple as finding peace with infertility and going about your life, or even using a surrogate and other forms of assisted reproductive technologies. The continuation of a family’s name by having children can have such effects as future sources of income for a household, social security for parents in their old age, and marriages that can result in the growth of property. Life is experienced differently in other parts of the world and should not be viewed through the same lens as in the US and other high-income countries. 

Money & Health Care

Another argument that can be made as to why infertility isn’t talked about enough are the options for family building. With surrogacy and other assisted reproduction techniques growing in popularity and advancements it is not out of reach for intended parents to fulfill their dreams — if you can afford it. The cost of reproductive health is not just mentally and emotionally. Many of the fertility treatments available present a large financial challenge for many people in both low and high income countries, sometimes costing a person’s entire annual income or more because these additional options are not covered with most health care. The suggestion to have countries that have universal health care include fertility treatments has been vocalized by many organizations, including the WHO.  

In a call to action, the WHO recommended that countries offer universal health coverage of fertility treatments, pointing to many European countries as well as Morocco (which has made fertility treatment available in the public sector) and Indonesia (which includes it in primary care services) as leading the way. (Gaffney)

The WHO has clearly defined infertility as “a disease of the reproductive system,” but there is a halt to having it covered under insurance for many countries, including the US.

Treating infertility like a disease is not a far stretch as the connection between fertility and hormone-altering chemicals is constantly being researched as these chemicals can be found in objects that we use in our everyday lives such as water bottles, cleaning supplies, and food packaging. The connection between these products being produced more after the 1950’s and the start to the decline of fertility is consistently being researched.  

The Important Bits

The world as a whole has advanced assisted reproductive technologies in the last several decades, and while there are folks that make the decision to not have children, there are those suffering from infertility taking their choice to have children away from them. The option for surrogacy or other methods can be out of reach financially for a lot of intended parents, and while that is a treatment for the disease of infertility, which is mostly not covered by many health care plans, it is often not seen as that. It is then left to many families to cover the huge financial cost while already dealing with the emotional and mental cost. Acknowledging infertility as a disease is one step, but having health care that treats infertility like the disease it is and covers it can be a giant leap forward to helping so many families.