Infertility is a threat to the human right to decide if, when, and how often to have children. Moreover, for many people it can be an extremely distressing and stigmatising experience. The ability to provide treatment equitably for infertility hinges in part on adequate monitoring systems to evaluate need. However, the accuracy of estimates of infertility are strongly determined by the quality, inclusiveness, and availability of data sources. This talk will review recent evidence on the prevalence and measurement of infertility globally, drawing attention to persistent measurement challenges which result in the systematic marginalisation of the ‘invisible infertile’—that is, people whose experiences of infertility fall outside of prevailing reproductive imaginaries of who ‘can’ and ‘should’ reproduce, resulting in invisibilisation of their reproductive experiences and needs. Disproportionately, these exclusions fall along well-worn lines of marginalisation, resulting in more limited access to care for people in Global Majority countries, racially marginalised, LGBTQ, poor, HIV-positive, disabled, institutionalised, geographically remote, and otherwise structurally marginalised groups. The Integrated Fertility Survey Series and the Demographic and Health Surveys will be examined as examples of these kinds of systematic exclusions. The practice of biomedicine cannot be divorced from the social contexts within which scientific advances and medical care occur. This talk will illustrate how taken-for-granted reproductive imaginaries have shaped the epidemiological fathomability of infertility and, linked to this, monitoring tools. The talk will also consider how sociocultural norms and geopolitics shape who is perceived to be in need of medical care, resulting in the stratification of reproduction globally.