UK Edition
Single men will get the right to start a family under new definition of infertility
Single men and women without medical issues will be classed as “infertile” if they do not have children but want to become a parent, the World Health Organisation is to announce.
In a move which dramatically changes the definition of infertility, the WHO will declare that it should no longer be regarded as simply a medical condition.
The authors of the new global standards said the revised definition gave every individual “the right to reproduce”.
Until now, the WHO’s definition of infertility – which it classes as a disability – has been the failure to achieve pregnancy after 12 months or more of regular unprotected sex.
But the new standard suggests that the inability to find a suitable sexual partner – or the lack of sexual relationships which could achieve conception – could be considered an equal disability.
The World Health Organisation sets global health standards and its ruling is likely to place pressure on the NHS to change its policy on who can access IVF treatment.
Legal experts said the new definition, which will be sent out to every health minister next year, may force a law change, allowing the introduction of commercial surrogacy.
However the ruling is also likely to lead to accusations that that the body has overstepped its remit by moving from its remit of health into matters of social affairs.
Under the new terms, heterosexual single men and women, and gay men and women who want to have children would be given the same priority as couples seeking IVF because of medical fertility problems.
Dr David Adamson, one of the authors of the new standards, said: “The definition of infertility is now written in such a way that it includes the rights of all individuals to have a family, and that includes single men, single women, gay men, gay women.
"It puts a stake in the ground and says an individual's got a right to reproduce whether or not they have a partner. It's a big change.
"It fundamentally alters who should be included in this group and who should have access to healthcare. It sets an international legal standard. Countries are bound by it."
Critics last night called the decision “absurd nonsense” as they raised concerns that couples with medical infertility could lose the chance for a child if NHS authorities rewrite their rules.
Under current NHS policies, fertility treatment is only funded for those proven infertile, and those where fertility is unexplained but attempts at conception have failed.
Guidance from the National Institute for Health and Care Excellence (Nice) says women under the age of 42 should be offered three full cycles of IVF, with access for same-sex couples if surrogacy or privately funded fertility treatment fails.
But few areas achieve this, with rationing deepening across the NHS amid financial pressures. Last month figures from the charity Fertility Fairness showed the real provision of free IVF on the NHS is at its lowest since 2004.
The new definitions drawn up by WHO’s international committee monitoring assisted reproductive technology will be sent to every health minister for consideration next year.
Gareth Johnson MP, former chair of the All Parliamentary Group on Infertility, whose own children were born thanks to fertility treatment said: “I’m in general a supporter of IVF. But I’ve never regarded infertility as a disability or a disease but rather a medical matter.
“I’m the first to say you should have more availability of IVF to infertile couples but we need to ensure this whole subject retains credibility.
“This definition runs the risk of undermining the work Nice and others have done to ensure IVF treatment is made available for infertile couples when you get definitions off the mark like this. I think it’s trying to put IVF into a box that it doesn’t fit into frankly.”
Jonathan Montgomery, Professor of Health Care Law at University College London, said the health service would be forced to review its policies in light of the new standards.
However, he said it was unlikely that the NHS would adopt the WHO standards wholesale. The legal expert said there could be other consequences to altering the definition of infertility.
In the UK, it is illegal to pay surrogates, resulting in a severe shortage of women wanting to take on the role. Similarly, there is a national shortage of sperm and eggs, with donors only able to receive expenses.
“Because wanting to have children would be defined as a disability, it could well strengthen the case of gay couples to be allowed access to commercial surrogates,” he said.
“This might force the UK to think again about surrogacy.”
Josephine Quintavalle,from Comment on Reproductive Ethics said: “This absurd nonsense is not simply re-defining infertility but completely side-lining the biological process and significance of natural intercourse between a man and a woman.
“How long before babies are created and grown on request completely in the lab?”
A Department of Health spokesman said it would consider the WHO’s final advice when published but the NHS was under no obligation to follow it.
The controversy broke as the American Society for Reproductive Medicine annual congress heard that the 10 millionth IVF baby would be born by the end of 2020.
Official figures estimate that by 2013 6.5 million had been born using the technique since the first IVF birth in 1978.