Coalition for Fertility: “We urge policymakers to treat involuntary childlessness as a human rights issue”

FoR: Thank you for agreeing to do this interview. You are both from Fertility Europe and you initiated the Coalition for Fertility. Why did you set up this Coalition?

AF: At Fertility Europe, most of us have personal experience with medical infertility. Therefore, the main focus of those engaged in Fertility Europe and our national member organisations has been on advocating for better provisions for patients experiencing medical infertility, which we found to be surprisingly insufficient in many countries. From the very beginning, we’ve worked closely together with ESHRE as our main partner in advancing evidence-based fertility care and raising public awareness on infertility. However, we gradually expanded our scope to involuntary childlessness, going beyond medical infertility, and we realised that there are many other stakeholders who are also active on this topic. With the Coalition for Fertility, we’re aiming to bring these groups together.

KK: Also, we felt that there is currently a momentum to address this topic at  a European level. In 2021, the European Parliament adopted a report on sexual and reproductive health and rights in the EU. This called on member states to ensure access to fertility treatments and to address infertility as a public health issue. We felt that now is the time to build a Coalition for Fertility, to bring together experts, scientists, advocates and patients and work toward systemic change to advance reproductive rights and fertility care.

FoR: Can you give a brief overview of the Coalition members?

AF: In total, there are 12 member organisations. The two core partners are Fertility Europe and ESHRE who are both hosting the secretariat. Then we have other medical societies and patient organisations, an organisation working on sexuality education, advocates for sexual and reproductive rights and LGBTI rights, and organisations working on related areas of health, particularly mental health and women’s health. We also started a collaboration with the United Nations Population Fund (UNFPA), although it is not a Coalition member.

FoR: What is the added value of having a Coalition with so many diverse partners?

AF: One of the main reasons why the collaboration with our Coalition partners is so valuable is that it’s a great forum for discussion. We’re realising that it’s becoming difficult to discuss fertility and involuntary childlessness at a political level because these topics are being misunderstood. In our discussions, we can learn from each other and together create an informed, educated view that we can pass on to policymakers.

KK: Also, our voice is heard better if all the different groups send a common message rather than each of us acting alone.

FoR: So, what exactly is the Coalition advocating for?

AF: We believe that every individual and couple has the right to decide whether, when and how many children they want to have, and it’s the responsibility of states to support people in those decisions. We urge policymakers to treat involuntary childlessness as a human rights issue. Reproductive autonomy is a critical matter of social justice.

KK: Many of the barriers to access fertility treatment are man-made. At the end of the day, it’s not about medical treatment, it’s about human dignity. Regardless of the circumstances or background, everybody should have the opportunity to try to have a child, if they choose so.

AF: Also, young people should be better educated on infertility and the related risks We advocate for the universal implementation of comprehensive sexuality education including fertility education.

FoR: Most regulations on access to fertility treatment and education are made at the national level, whereas the Coalition is active at the European level. What do you think the EU can do to address these issues?

KK: Indeed, it’s up to national governments to regulate the healthcare systems in their countries. But we should not forget that the EU has the competence to set standards for equality and fundamental rights. Also, even if the EU cannot make binding legislation on healthcare systems, they can make recommendations to member states and provide funding for research and projects. We have seen the EU being very active in other areas of health, such as cancer or mental health. This shows that when an issue is prioritised, meaningful progress can be achieved.

FoR: What are the next steps for the Coalition?

AF: This year, we’re working on a series of policy papers to give more depth to the content of the joint declaration that all Coalition members have signed. We also keep developing relationships with members of the European Parliament, the European Commission and the United Nations.

KK: Our ultimate aim is to drive lasting policy changes that ensure equitable access to fertility care across Europe. We want infertility to be fully recognised as both a public health and a reproductive rights issue. A key step towards this vision is the establishment of an interest group within the European Parliament dedicated to fertility and reproductive health, ensuring continued dialogue, advocacy, and policy development at the highest level.

FoR: Where can our readers learn more about the Coalition for Fertility?

AF: They are welcome to visit our Coalition website and to follow Fertility Europe and ESHRE on social media to stay up to date on our latest activities.