The WHO Wants to Redefine “Infertility”: Game Changer or Medical Overreach?

Infertility has traditionally been defined as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. This longstanding clinical benchmark has guided diagnosis, treatment decisions, insurance approvals, and access to publicly funded fertility interventions. But now, the World Health Organization (WHO) has proposed a broadened and more inclusive definition—and it’s triggering widespread debate among physicians, public health experts, and ethicists alike.

The new definition proposed by WHO seeks to recognize not only biological inability to conceive, but also social and personal barriers. Under this approach, infertility would encompass anyone unable to have a child—regardless of gender, sexual orientation, marital status, or partner availability.

Is this proposal a leap forward in reproductive equality, or does it risk eroding the clinical foundations of medical diagnoses? Below, we unpack the implications of this redefinition and what it could mean for reproductive medicine.

1. What Is the Current Definition of Infertility?

The conventional definition, cited by WHO and medical bodies globally, reads:

“A disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

This classification includes both primary infertility (no prior pregnancies) and secondary infertility (difficulty conceiving after a previous successful pregnancy). Crucially, it frames infertility as a medical disorder rooted in the reproductive systems of two people attempting to conceive naturally.

However, the traditional framework inherently excludes single individuals and same-sex couples, even when they require assisted reproductive technologies (ARTs) like IVF to have biological children. The current definition doesn’t account for those whose inability to conceive is not due to biological dysfunction, but due to social circumstances.

2. What Does the WHO’s Proposed Redefinition Say?

The WHO’s new draft language suggests a broader, more inclusive diagnostic lens:

“A clinical diagnosis of infertility should be made irrespective of the presence or absence of a male or female partner.”

This shifts the concept of infertility from a strictly biological failure to a wider issue of unmet reproductive intention. In effect, it aims to universalize access to ARTs and fertility treatments for all individuals who wish to reproduce but are unable to—whether due to physical, relational, or societal barriers.

3. The Case for Redefinition: A Game Changer

Many advocates in reproductive health see this as a progressive evolution. They argue the redefinition is necessary to reflect modern social realities.

Equality and Reproductive Autonomy

This proposal extends reproductive rights beyond heterosexual couples to include single individuals, same-sex couples, and others previously excluded from the infertility diagnosis. It affirms that everyone has the right to try for a family using medical support, not just those facing biological challenges.

Broader Access to Care

By defining infertility based on reproductive intent rather than sexual configuration, this could pave the way for wider insurance and state coverage of ARTs for non-traditional candidates, potentially expanding access for underserved populations.

Destigmatization of Infertility

Traditional definitions often imply something is medically “wrong” with a person or couple. Expanding the term reduces this stigma, recognizing that barriers to parenthood can be societal, psychological, or circumstantial—not just physiological.

4. The Clinical Pushback: Medical Overreach?

Not all responses have been enthusiastic. Many in the medical community view this as an inappropriate blurring of clinical definitions and sociopolitical ideals.

Medicalizing a Social Condition

Is someone without a reproductive partner truly infertile in a clinical sense? Critics worry that redefining infertility in terms of intent, rather than biology, risks turning a social experience into a medical diagnosis.

Insurance Implications

If infertility becomes a diagnosis for anyone unable to conceive, will health systems be forced to fund fertility care for all who wish to become parents? This could generate enormous strain on already-limited ART resources and insurance reimbursement frameworks.

A Slippery Slope

If reproductive intent alone constitutes a diagnosis, where does the redefinition trend stop? Critics speculate that it could lead to the medicalization of a range of human experiences—from loneliness to childlessness to desire.

5. The Impacts on Fertility Clinics and Practice

Fertility clinics may face both logistical and ethical challenges under this broader definition.

Clinicians might increasingly see patients who are not biologically infertile but instead are socially constrained—such as single individuals or same-sex couples requesting IVF or surrogacy support.

As demand rises, there could be longer waitlists and growing pressure on limited medical infrastructure. Resource allocation becomes more complex—should a single woman with no fertility issues have equal priority for ART as a heterosexual couple with tubal factor infertility?

Furthermore, some jurisdictions may require legal clarification regarding coverage, parental rights, and donor access under this broader definition of infertility.

6. Ethical and Societal Questions Raised

Redefining infertility raises multiple philosophical and ethical concerns:

Should reproductive desire alone justify access to medical treatment?

Can already strained healthcare systems afford to extend fertility care to all individuals who desire children?

Do clinics risk becoming facilitators of wish-fulfillment rather than providers of medical intervention?

In lower-income countries or areas with limited healthcare budgets, allocating resources toward expanded ART services may mean diverting funding from maternal or infant care—presenting an ethical dilemma for public health policymakers.

7. Could This Impact Global Fertility Trends?

Interestingly, this expanded definition may contribute to shifting global family-building patterns:

The demand for services like elective egg freezing, donor insemination, and IVF is rising among individuals who delay childbearing for personal or economic reasons.

Redefining infertility may normalize and support such choices, potentially increasing pressure on governments to cover or subsidize fertility treatments more widely.

Additionally, national reproductive policies may evolve in response, especially in countries facing demographic decline or aging populations where increasing birth rates is a priority.

8. Where the Medical Community Stands

Reactions from healthcare providers and institutions are deeply mixed.

Some applaud the move as a compassionate, forward-thinking reflection of contemporary family structures and reproductive aspirations.

Others worry that this redefinition undermines the precision of medical diagnoses, moving medicine toward ideology rather than evidence-based practice.

However, almost everyone agrees that definitions are powerful. They don’t just shape language—they influence research funding, clinical access, insurance coverage, and public policy.

Changing the definition of infertility has the potential to trigger a cascade of structural, ethical, and financial consequences across the healthcare ecosystem.

9. What Doctors Should Do Now

Even though WHO’s new definition isn’t yet adopted universally, its influence is already being felt. Physicians—particularly in gynecology, endocrinology, and family medicine—should prepare for the possible consequences.

Key steps for clinicians include:

• Monitoring policy developments within local health authorities and insurance systems
  
  
• Being aware of the broader interpretations of “infertility” that patients may use in consultations
  
  
• Engaging in continuing education about ethical considerations around reproductive rights and ART access
  
  
• Advocating for clear, equitable, and clinically sound guidelines to govern access to fertility services
  

Doctors may also need to sharpen their communication skills to navigate sensitive conversations with patients who feel excluded or marginalized by the traditional definitions.

10. Final Thoughts: Language Matters in Medicine

In medicine, terminology is more than semantics—it is structure. It determines who qualifies for treatment, who is acknowledged as having a condition, and who gains access to care.

By proposing to redefine infertility as including social and circumstantial limitations to reproduction, the WHO is fundamentally altering our clinical and ethical framework around one of life’s most deeply personal desires: the desire to parent.

Whether this new approach will empower patients or overcomplicate care delivery is still unfolding. But it’s clear that this redefinition demands attention—not just from public health authorities, but from every practitioner involved in reproductive medicine.

Physicians must remain vigilant, balanced, and patient-centered in the face of evolving definitions that seek to bridge biology and social justice.