June 23. 2024. 1:06

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EU impotent amid global infertility challenges


Infertility is a major health challenge globally, with one in six people worldwide experiencing it at some point throughout their lifetime, but EU action to address the issue remains limited.

Ancient Hindus believed that passing through a hole in a rock or a hollow in a tree would improve fertility, doctor Donald Johnston wrote in his classic work on the history of human infertility.

Pliny, a nature philosopher who lived in the Roman Empire, reported that eating the eye of a hyena with liquorice and dill would cause a woman to conceive within three days.

Solutions to help with infertility are clearly more advanced these days, but the struggle to get pregnant has remained a challenge for many.

The World Health Organisation (WHO) defines infertility as a disease of the male or female reproductive system featured by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.

For Tedros Ghebreyesus, director-general at the WHO, ‘an important truth is that ‘infertility does not discriminate’ meaning that it impacts people regardless of culture, social background or ethnicity.

A recent report released by the UN health agency found that globally one out of every six people is affected by the inability to have a child at some point in their life, regardless of where they live and what resources they have.

The report analysed all relevant studies from 1990 to 2021, considering different estimation approaches.

Based on the data, it is estimated that in 2022 close to 20% of the population experienced lifelong infertility, while over 10% experienced a period of infertility.

The lifetime prevalence of infertility was highest in the WHO Western Pacific Region, reaching over 20%, followed by the Region of Americas and the European Region, which reached 12%.

On the other hand, the lowest prevalence was found in the WHO Eastern Mediterranean Region, with around 10%.

These new estimates show limited variation in the prevalence of infertility between regions with comparable rates for high-, middle- and low-income countries.

This indicates that infertility is today a major health challenge globally.

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It’s a process during which the ovum is removed from the female during ovulation, and sperm fertilises them in a laboratory setting.

The fertilised egg – the embryo – is then transferred to a uterus.

But, according to WHO, such solutions for the prevention, diagnosis and treatment of infertility remain underfunded and inaccessible to many due to high costs, social stigma, and limited availability.

At present, in most countries, fertility treatments are primarily funded out of pocket, meaning that they are not covered by health insurance, often resulting in high financial costs.

“Millions of people face catastrophic healthcare costs after seeking infertility treatment, making this a major equity issue and, all too often, a medical poverty trap for those affected,” said Pascale Allotey, director of sexual and reproductive health and research at WHO.

High costs frequently prevent people from accessing infertility treatments or can catapult them into poverty due to seeking care.

According to Allotey, better policies and public financing can significantly improve access to treatment and protect poorer households from falling into poverty.

Addressing infertility is also central to achieving two UN Sustainable Development Goals (SDGs) – number three on ensuring healthy lives and promoting well-being for all ages and number five on achieving gender equality and empowering all women and girls.

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EU’s action remains limited

According to the European Society of Human Reproduction and Embryology, more than 25 million EU citizens are affected by infertility, and the cwouldountries’ action differs significantly, as the European Atlas of fertility treatment policies, released in December 2021, showed.

Widening the picture to 43 European countries, just 12 countries offered up to six funded cycles of intrauterine insemination – a process during which concentrated sperm are placed directly in the uterus around the time ovary releases one or more eggs to be fertilised.

Furthermore, the IVF treatment “appears to be a clear bias towards heterosexual couples at the expense of single people and LGBT couples”.

For example, 41 countries provide insemination with donor sperm to straight couples – yet only 19 countries offer this to female couples, and just 30 countries provide it to single women.

Commenting on the findings, Anita Fincham, Manager of Fertility Europe, said that every country deserves to be a perfect country with good regulations granting equal, safe and efficient access to fertility treatment to all who need it.

“Good regulations that consider rights and wellbeing of all parties involved, including children and donors,” she added.

However, the EU’s action on the matter remains limited. “The EU’s social policy does not include a specific strand for family issues,” EU health commissioner Stella Kyriakides warned once in reply to a parliamentary question.

She added that policy-making in this area remains the exclusive responsibility of EU Member States, reflecting different family structures, historical developments, social attitudes and traditions from one Member State to another.