Their concerns follow the release of the World Health Organisation’s first-ever global guideline on infertility, which urges countries to make fertility care safer, fairer, and more accessible. While the guideline has been widely welcomed, Nigerian experts argue that the country’s fragile healthcare system and harsh economic realities could limit its practical impact.
Infertility affects a significant number of Nigerian families. Available evidence suggests that about three in every 10 couples in the country experience some form of infertility. Global data paints a similar picture, with a new WHO report estimating that roughly 17.5 per cent of adults worldwide—about one in six—will experience infertility at some point in their lives. In Nigeria alone, professional bodies estimate that about 12 million people are affected.
The WHO guideline contains 40 recommendations covering the prevention, diagnosis, and treatment of infertility. It promotes cost-effective options at every stage of care and encourages countries to integrate fertility services into national health strategies, financing systems, and service delivery frameworks.
Describing infertility as a largely neglected public health issue, WHO Director-General, Dr Tedros Ghebreyesus, said millions of people are priced out of care or pushed toward unproven alternatives because of cost. He urged countries to adopt the guideline to expand access to affordable, respectful, and evidence-based fertility services.
However, specialists who spoke to PUNCH Healthwise cautioned that translating these recommendations into reality in Nigeria would be difficult without fundamental reforms.
He explained that while some patients respond to conventional treatment, many eventually need assisted reproductive techniques, which are expensive and largely unavailable in public hospitals. The situation is further complicated by the dominance of private fertility centres, where fees are often far beyond what the average Nigerian household can afford.
Fiebai noted that even in the few public institutions offering reproductive technology, costs remain prohibitive when compared with the national minimum wage of ₦70,000. In his view, discussions around affordability must begin with a realistic assessment of Nigeria’s economic situation.
He argued that infertility care cannot become affordable in isolation when millions of Nigerians struggle to access basic healthcare services. Without universal health coverage, he said, meaningful progress would remain elusive.
Questioning the feasibility of prioritising infertility care amid broader systemic failures, Fiebai pointed out that Nigeria still struggles to provide basic treatment for common conditions such as malaria. Until the economy stabilises and the health system is strengthened, he warned, the WHO guideline may have limited impact on the lives of ordinary Nigerians.
While acknowledging that wealthier individuals can eventually access fertility care, he stressed that equity would remain unattainable without a robust health insurance framework that protects vulnerable groups.
“The guidelines are important,” he said, “but they do not automatically translate into access. Until we fix the economic challenges and get the health system working, affordability will remain a mirage for most families.”
He explained that fertility care involves complex investigations, advanced technology, and highly skilled manpower, all of which require significant funding. As a result, governments are more likely to prioritise conditions that pose immediate risks to life and affect larger segments of the population.
Aimakhu added that fertility treatment cannot be treated like mass public health interventions such as immunisation or malaria control. Instead, it is highly specialised care that must be deliberately funded, either by individuals or through structured insurance schemes.
For fertility care to become more affordable, he said, it would need to be included in the national health insurance system, since “somebody must pay for it.” Even then, he argued, affordability cannot be discussed without first establishing adequate facilities, modern equipment, and well-trained personnel across the country.
He also highlighted the shortage of fertility specialists and supporting professionals, noting that limited human resources further restrict access to care.
Both experts agreed that while the WHO guideline represents an important global milestone, Nigeria’s path to affordable and equitable fertility care lies in broader economic reform, health system strengthening, and the expansion of universal health coverage. Until then, they warned, many couples will continue to face infertility alone, constrained not by lack of medical knowledge, but by the cost of care.