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Infertility: a continually neglected component of sexual and reproductive health and rights

In a commentary co-authored by Jessica D. Gipson, associate professor in the UCLA Fielding School of Public Health's Department of Community Health Sciences and published by the Bulletin of the World Health Organization, the authors assert that health researchers cannot exclude infertility as part of the global sexual and reproductive health and rights agenda.

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Date: 
Wednesday, July 1, 2020
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Having a child if and when desired is a fundamental component of our life as humans. The rights of individuals to found a family and decide freely and responsibly the number, spacing and timing of their children, and to have the information and means to do so feature in international human rights documents as early as 1948. These rights serve as a foundation to address the reproductive needs of populations. Efforts to address reproductive needs have predominantly focused on preventing unintended pregnancies, pregnancies that are too early, too late or too many. However, these efforts neglect to fully acknowledge and address the magnitude and consequences of infertility, that is, pregnancies that occur later than desired or do not occur at all, despite being wanted.

The need to address infertility was a central component of the 1994 International Conference on Population and Development Programme of Action, which stated that all 179 signatory countries should make the prevention and appropriate treatment of infertility accessible. Yet, in the past 25 years, little progress has been made. In the 2018 Guttmacher–Lancet commission on Sexual and Reproductive Health and Rights, authors noted that infertility has not been prioritized by global public health policy-makers and has received far less attention when compared to other issues within these rights. Authors also noted the scarcity of domestic and international funding to support programmatic and research efforts on infertility, particularly in low-income countries.

Here we posit that with a predominant and narrow focus on the prevention of unintended pregnancy, the field of sexual and reproductive health rights (and we ourselves, as researchers in this field) have inadvertently contributed to the lack of attention to infertility, stunting efforts to address reproductive rights more holistically. We also discuss how the prevailing limited view of fertility has neglected the full range of human rights and hampered efforts to address infertility.

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written by Jessica D. Gipson, PhD; Marta J. Bornstein; and Michelle J. Hindin, PhD

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