WHO guideline on infertlity 2025

Send a textWHO 2025 Infertility Guideline — Key TakeawaysInfertility = no pregnancy after 12 months of regular unprotected intercourse.It affects 1 in 6 people worldwide, regardless of country income level.🔹 Why this mattersInfertility is a health and human rights issue.People deserve accurate information, access to diagnosis/treatment, and support without stigma.WHO emphasizes cost-effective, evidence-based care that avoids unnecessary testing.🔵 1. PreventionEducate the public early about fertility, age-related decline, and when to seek help.Lifestyle actions: quit smoking, reduce alcohol, maintain healthy weight, exercise.Prevent and promptly treat STIs, a major global cause of tubal disease.🔵 2. DiagnosisFemaleIf cycles are regular → confirm ovulation with mid-luteal progesterone, not routine ultrasound.Assess hormones only if clinically indicated: FSH, LH, E2, PRL, TSH.Check tubal patency with HSG or HyCoSy.Evaluate the uterine cavity with SIS (preferred) or 3D ultrasound.MaleSemen analysis:Abnormal → repeat after ≥11 weeksNormal → no need to repeatUnexplained InfertilityNormal exam, normal ovulation + tubes, and normal semen → classify as unexplained.🔵 3. TreatmentFemalePCOS:First-line: LetrozoleIf unsuccessful → Gonadotropins → IVFTubal disease:Age <35 + mild/moderate disease → Surgery firstSevere or age ≥35 → IVF preferredHydrosalpinx:Salpingectomy or tubal occlusion before IVF improves outcomesMaleVaricocele:Treat surgically or radiologically rather than observationMicrosurgical repair preferred when availableUnexplained infertilityBegin with expectant management (3–6 months)If unsuccessful → Stimulated IUI (S-IUI) with letrozole or clomipheneIf unsuccessful → IVFUse IVF alone, not routine ICSI, unless true male factor exists🔵 4. WHO emphasizesListening to patients, addressing psychological stress, and offering supportUsing systematic, not excessive, diagnostic testingChoosing treatments based on effectiveness, feasibility, and costDocumenting treatment outcomes for continuous quality improvement