Guidelines for the prevention, diagnosis and treatment of Infertility
WHO Releases First Global Infertility Guideline with Key Contribution from MedEA Scientific Committee Member
The World Health Organization (WHO) has published, for the first time in its history, a Global Guideline on Infertility, an extensively anticipated document within the medical and scientific communities. Built through robust systematic reviews, rigorous evidence appraisal, and broad international collaboration, the guideline establishes unprecedented global standards for the prevention, diagnosis, and treatment of infertility.
MedEA – Medical Education Academy is proud to highlight the central role played by Prof. Dr. Sandro C. Esteves, member of the Scientific Committee for both Female and Male Infertility, and Head of the Male Infertility Subarea.
Prof. Esteves served as a Topic Leader for the male infertility component and as a member of the WHO Guideline Development Group (GDG), representing the Americas and contributing directly to the formulation of the final recommendations.
In addition to his work on the WHO guideline, Prof. Esteves is recognised for his role in developing two major classification systems in reproductive medicine:
• the POSEIDON criteria, which transformed the assessment and management of low-prognosis women undergoing ART, and
• the APHRODITE criteria, an emerging framework that modernises the approach to male infertility by integrating physiology, endocrine profiles, and personalised therapeutic strategies.
Highlights of the WHO Global Infertility Guideline: recommendations and remarks on male infertility
The guideline emphasises that semen analysis, while fundamental, is not sufficient on its own. A thorough clinical evaluation — including detailed medical, reproductive, and sexual history and physical examination — is essential.
Lifestyle modification, smoking cessation, prevention and treatment of sexually transmitted infections, and general health promotion are highlighted as pillars of male reproductive health.
The WHO found insufficient evidence to recommend for or against antioxidant therapy, underscoring the need for high-quality research in this area.
The guideline recommends treatment exclusively for clinical (palpable) varicocele, supported by consistent evidence of benefit. Subclinical varicocele (detected only by imaging) was not recommended due to lack of demonstrable improvement in reproductive outcomes.
Diagnostic pathways adaptable to different healthcare settings were included, facilitating consistent clinical practice across regions with varying levels of resources.
Importance for Medical Education
and the Mission of MedEA
This WHO guideline has significant implications for the educational mission of MedEA:
• it consolidates infertility care teaching based on current, internationally validated evidence;
• it encourages alignment of clinical practice across countries;
• it enhances training frameworks, courses, and educational programs targeting infertility;
• it provides an essential new reference for professional development, certification, and continuing medical education.
The contribution of Prof. Esteves reinforces MedEA’s commitment to scientific excellence and the dissemination of high-impact, evidence-based medical knowledge.
About MedEA
Statement from
Prof. Sandro C. Esteves
“It was an honour to contribute to the development of this historic WHO guideline. The depth of collaboration, quality of evidence, and commitment to equity make this document a true milestone in reproductive healthcare. I believe it will have a direct positive impact on educational and training initiatives, including those led by MedEA.”