Although the challenges brought forth by infertility vary, the condition deserves attention as a critical public health issue. Infertility exists in every society and affects innumerable people. Its consequences are grave but, to a large degree, able to be prevented or ameliorated no matter what resources are locally available. Infertility is a public health issue because, like public health, it is socially constructed, existing at the crossroads of medical and social realms. In parts
of the world it is intimately linked with AIDS and STI epidemics, unarguably some of the most pressing health issues of the modern era. The field of public health should contribute its skills to infertility research, raising awareness of the scope and significance of unwanted childlessness, developing and enforcing public policies on infertility and its treatment, and involving society in the ethical debates raised by involuntary childlessness. Acknowledgement of infertility as a public health issue is necessary for the provision of comprehensive reproductive health services as mandated by human rights documents. These documents specifically discuss health care obligations raised by infertility. As professionals dedicated to the promotion of health, we must adhere to human rights ideals promoted and advocate for their use in order to provide everyone with the highest possible quality of reproductive health care. The provision of infertility services as a human right speaks to the obligation to listen to individual men and women’s reproductive needs before determining reproductive priorities. The need for health care should relate to the cultural realities of specific locations; where infertility is a pervasive and serious concern it should be addressed through health care programs.
Public health has traditionally been a radical advocate for social justice. This radical perspective is needed to alleviate the unequal burdens of disease and resource disparities which exacerbate the consequences of infertility. Historically, the field of public health has evolved in collaboration with scientific and social concerns, and as more is known about infertility and its treatment; the condition demands increased public recognition and support. Assurance of health is a public responsibility; despite the difficulty of capturing the suffering caused by infertility, it is a health impairment which must be recognized and addressed.
A critical barrier to public protection against ill health is ultimately not technology but a social ethic that unfairly protects the most numerous or the most powerful from the burden of prevention and treatment. Infertility directly affects an often silent minority, however the effects are serious and far reaching for society as a whole. The failure to consider unwanted childlessness a public health issue represents the triumph of market justice model with its emphasis on an individual’s ability and (reproductive) capacity and a failure of the public health ethic to promote health and well-being of all. Infertility is a manifestation of disease, not always treatable or preventable but deserving of attention and effort. The suffering experienced by infertile individuals is in fact made greater by the failure to recognize the condition as a concern to the public’s well-being. Public health is poised to contribute significantly to the development of health policy, social debate, prevention, and program development in order to alleviate the suffering cause by infertility; it is time to take action by recognizing that infertility is an issue which affects the public’s health.
