Infertility is estimated to affect as many as 186 million people worldwide. Although male infertility contributes to more than half of all cases of global childlessness, infertility remains a woman’s social burden. Unfortunately, areas of the world with the highest rates of infertility are often those with poor access to assisted reproductive techniques (ARTs). In such settings, women may be abandoned to their childless destinies. However, emerging data suggest that making ART accessible and affordable is an important gender intervention. To that end, this article presents an overview of what we know about global infertility, ART and changing gender relations, posing five key questions:

1. why is infertility an ongoing global reproductive health problem?
2. what are the gender effects of infertility, and are they changing over time?
3. what do we know about the globalization of ART to resource-poor settings?
4. how are new global initiatives attempting to improve access to IVF?
5. what can be done to overcome infertility, help the infertile and enhance low-cost IVF (LCIVF) activism?

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