In Nigeria, infertility remains a silent but widespread burden. Reports indicate that between 10% and 30% of couples experience infertility at some point in their lives. In several clinics across the country, many women endure years of stigma, marital strain and the heartbreak of unmet dreams while seeking a child.
Alternatives include high-risk fertility procedures, which involve huge costs. A single cycle of in vitro fertilisation (IVF) in Nigeria now costs roughly ₦2.1 million, a 250% increase since 2019, and the treatment often requires multiple cycles, pushing costs well beyond the means of many middle-income couples.
Affected couples are forced to make risky trade-offs between the hope for a child and their financial stability.
Notably, infertility has been elevated to a global public-health priority, following the release of the first comprehensive guideline on diagnosis and treatment by the World Health Organisation
The guideline reframes infertility as a matter of equity, health rights and systemic responsibility, not merely a medical condition affecting individuals.
This shift is significant because infertility, though widespread, has long been neglected in national health policies, especially in low- and middle-income countries where care is largely paid for out-of-pocket and remains accessible only to a small fraction of the population.
The new WHO guideline provides governments with a blueprint for building a complete, humane, scientifically grounded fertility-care system. It contains 40 evidence-based recommendations that redefine how countries should approach infertility, beginning with prevention.
It highlights issues like untreated sexually transmitted infections, unsafe abortions, poorly managed reproductive-tract infections and delayed access to care as major contributors to infertility.
The guideline emphasises practical, cost-effective prevention measures such as fertility education in schools, community awareness of fertility-related risks, lifestyle interventions (including diet, exercise and tobacco cessation) and early treatment of infections.
Beyond prevention, WHO introduces a progressive, stepwise model for diagnosis and treatment designed to avoid the widespread practice of pushing couples straight into costly assisted reproductive technologies like IVF.
Under this model, clinicians first provide structured counselling, assessment of fertile periods, and basic fertility advice.
When needed, individuals can then progress to more advanced procedures such as intrauterine insemination or IVF, but only based on clinical indication, medical evidence and patient preference.
The guideline also places strong emphasis on patient-centred care, stressing that fertility care must be respectful, confidential, non-discriminatory and grounded in reproductive rights.
This is especially relevant in Nigeria, where the burden of infertility disproportionately falls on women, even though male-factor infertility accounts for nearly 50% of cases globally.
By insisting that both women and men receive equal evaluation and support, WHO seeks to dismantle long-standing biases that fuel stigma, marital conflict and gender-based emotional harm.
Another major innovation is the inclusion of psychosocial support as a core component of fertility care. WHO acknowledges that infertility is emotionally exhausting and can trigger depression, anxiety, social isolation and domestic tension.
The guideline, therefore, recommends continuous access to counselling, mental-health support and peer networks throughout the fertility journey.
The WHO’s call for equitable fertility care aligns with broader global goals of reproductive rights, gender equality and health equity. Implementation will require coordination: ministries of health, reproductive-health providers, insurers, civil-society groups and communities must all play their part.
The guideline could, in the long run, open the door to a future where infertility is treated with the urgent attention it deserves.
This new intervention is a reminder that fertility care is not a privilege but a right. Hence, Nigeria’s health system, society and policymakers must turn compassion into action. It calls on countries to integrate fertility services into national health strategies, financing frameworks and insurance schemes.
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