Between demographic targets and personal desire: lived experiences of infertility.

Infertility is a globally prevalent disease affecting approximately 1 in 6 people at some stage in their lives. Despite its profound personal significance, access to fertility care remains uneven, shaped by legal, financial, cultural and infrastructural barriers. While declining fertility rates have prompted some policymakers to frame medically assisted reproduction within demographic strategies, we argue that fertility care must be fundamentally understood as a matter of individual rights, reproductive autonomy and self‑fulfilment. International human rights instruments increasingly recognize equitable access to fertility treatment as a core component of reproductive health, yet country-level disparities in eligibility, public funding and available treatment options persist. These inequalities disproportionately affect marginalized groups, leading many to delay or abandon treatment or to seek cross‑border care. The fertility journey is further burdened by emotional strain, stigma, workplace challenges and financial and psychological uncertainty. Individuals who remain involuntarily childless after treatment may require long‑term psychosocial support, underscoring the need for patient‑centred, rights‑based policies that extend beyond medical intervention. Ensuring fair access to fertility care, improving outcome reporting and integrating psychological and social support are essential to addressing infertility as both a private struggle and a broader public health issue.