However, the World Health Organization (WHO) has issued its first comprehensive Guideline for the Prevention, Diagnosis, and Treatment of Infertility (2025), delivering a stark reminder: one in six people of reproductive age will experience infertility during their lifetime. Globally, this translates to roughly 17.5% of adults facing challenges in conceiving.

WHO defines infertility as “a disease of the male or female reproductive system” characterized by the inability to achieve pregnancy after 12 months of regular, unprotected intercourse. 

The guidelines highlight that infertility may result from female factors, male factors, both, or remain unexplained. Yet, stigma disproportionately targets women, while male infertility is often ignored. 

Evidence shows that up to 36% of women struggling with infertility face intimate-partner violence, and many suffer anxiety, depression, and social exclusion.

Age and Lifestyle: Risks Often Overlooked

The guidelines stress prevention and early intervention, emphasizing age as the most significant predictor of fertility decline. 

For women, fertility gradually drops after 32, with a sharper decline after 37, while men experience slower but notable reductions in fertility after 40. 

WHO urges public education using low-cost strategies through schools, workplaces, and healthcare settings to ensure that couples understand these biological realities.

Lifestyle factors also play a significant role. Smoking, excessive alcohol, poor diet, and obesity increase infertility risk. 

WHO reiterates the importance of providing brief advice on quitting tobacco during every healthcare visit, noting that smoking particularly affects women’s fertility. 

Untreated sexually transmitted infections remain another preventable cause, yet stigma and misinformation often delay testing and treatment.

Making Infertility Care Accessible and Fair

When couples face infertility, WHO recommends cost-effective, evidence-based care. Excessive diagnostic testing without clear justification should be avoided, and mental health support should be integrated from the start. 

In treatment, newer approaches are emphasized. For example, Letrozole is preferred for women with PCOS-related anovulation, and “expectant management”—trying naturally with lifestyle guidance—should precede invasive procedures. 

In vitro fertilization (IVF), long considered a default solution, is now recommended only as a third-line option in many cases, potentially reducing financial and emotional burdens.

Kenya’s Cultural and Social Landscape

In Kenya, infertility carries profound cultural, social, and religious significance. Motherhood, in particular, is often viewed as central to identity and marital success. 

This pronatalist perspective, coupled with widespread misconceptions, results in stigma that disproportionately burdens women. 

In regions like Kisumu County, infertile women face verbal abuse, accusations of barrenness, familial pressure for men to take additional wives, and even intimate-partner violence.

These social pressures often drive couples toward costly, secretive treatments or traditional healers, delaying evidence-based care. Despite affecting an estimated 4.2 million Kenyans, infertility remains a “hidden epidemic” of shame and misinformation. 

However, advocacy efforts, such as the Merck Foundation’s “More Than a Mother” campaign in partnership with First Lady Rachel Ruto, are pushing for education, policy reforms, and recognition that infertility is a shared health concern.

A Call to Action for Modern Couples

The WHO guidelines send a clear message: biology cannot be postponed indefinitely for career milestones or personal ambitions. 

Couples should learn about fertility facts early, adopt healthy lifestyles, and seek timely medical advice. For those over 35 who have tried for six months, or younger couples who have tried for a year, prompt consultation with qualified healthcare providers is crucial.

WHO has placed infertility firmly on the global reproductive-health agenda. Ignoring these guidelines is not merely a personal risk—it has implications for families, societies, and the well-being of future children.