By Dr. David Adamson
This article originally appeared in Employee Benefit Plan Review, Volume 79 • Number 7
Infertility affects roughly one in six1 people globally, making it one of the most common medical conditions impacting working adults today. Despite its prevalence, infertility remains one of the least understood, and least supported, healthcare issues in the workplace. Many employees face not only physical and emotional challenges but also systemic barriers such as financial strain, lack of insurance coverage and lingering social stigma.
The evolving demands of today’s workforce, combined with shifting family structures and growing awareness of reproductive health equity, are pushing fertility care to the forefront of employee benefit planning. Forward-thinking companies are recognizing that family-forming benefits are no longer optional, they’re strategic. These programs can improve employee well-being, boost retention and help dismantle outdated taboos around reproductive care.
Fertility Care: From Fringe to Forefront
Historically, fertility benefits were seen as niche offerings, relevant to only a small subset of the workforce. But that view is rapidly changing. As people delay parenthood for career, education, or financial reasons and as LGBTQ+ individuals and single parents by choice seek reproductive care, more employees are finding themselves navigating infertility or complex family-building journeys.
These demographic shifts, along with falling fertility rates,2 have elevated reproductive care as a workforce issue, not just a personal one. Fertility is not solely a women’s health issue or a lifestyle decision, it is a recognized medical condition that connects directly to inclusivity, mental health and employee engagement in the workplace.
However, most employer-sponsored health plans still provide limited or no coverage for fertility care. A single in vitro fertilization (IVF) cycle can cost $12,000–$25,000 out-of-pocket,3 often requiring multiple attempts to achieve a successful pregnancy. Fertility preservation, egg and sperm freezing, donor-assisted reproduction and surrogacy can add thousands more.
For employees, these costs often make family-building inaccessible. For employers, the lack of support contributes to stress, distraction, turnover and disengagement. The business case for action is clear.
Fertility Benefits and The Employee Experience
Employees navigating infertility often face emotional stress4 levels comparable to those associated with chronic illnesses. The process can be invasive, uncertain and mentally exhausting. When these experiences go unsupported at work, the impact is widespread, ranging from absenteeism and burnout to loss of trust in the organization.
Recent surveys have found that 88% of employees said they would consider switching jobs for better fertility coverage.
In contrast, when employers offer family-forming benefits, they communicate a clear message that they recognize their employees’ needs and are committed to supporting them. These benefits provide access to critical services such as:
- IVF and IUI treatments;
- Fertility preservation (e.g., egg and sperm freezing);
- Donor and surrogacy assistance;
- Genetic testing and reproductive counseling;
- Adoption reimbursement; and
- Mental health support tied to reproductive care.
Beyond recruiting and retention, comprehensive benefits also promote productivity. Employees who are not forced to hide their challenges or fight for basic care are more likely to stay focused, engaged and loyal. For high-performing talent, support during life’s most sensitive moments can define how they view their employer for years to come.
Removing Financial and Structural Barriers
A key obstacle to fertility care is cost but it is also one of the most solvable. Employers have several levers to offer meaningful support without breaking the bank.
One solution is the use of bundled payment models, which offer packages for multiple IVF cycles at a negotiated, flat rate. These models not only reduce per-cycle costs but also increase the chance of success, as many people need more than one round to achieve pregnancy. Pay-as-you-go plans are another effective tool, allowing employers to cover services only when used, instead of paying fixed per-employee rates regardless of utilization.
Partnering with fertility care networks can further reduce costs through negotiated rates and evidence-based care that avoids unnecessary interventions. These networks also provide support services, reducing administrative burden on HR teams and improving employee navigation of complex treatments.
Research5 shows that nearly all employers offering these types of fertility benefits report no significant increase in overall healthcare costs. In fact, they often reduce long-term expenses related to high-risk pregnancies, unmanaged stress and employee turnover.
Destigmatizing Reproductive Health At Work
Even when benefits are available, many employees hesitate to use them. The fear of being perceived as less committed or of revealing sensitive health issues prevents people from seeking support. This stigma disproportionately affects women, LGBTQ+ individuals and employees from underrepresented racial or cultural backgrounds, many of whom already face systemic barriers in healthcare.
Companies have an opportunity and responsibility to challenge these dynamics.
Destigmatizing infertility starts with making it visible. That means normalizing fertility-related conversations within broader health and wellness programs and training managers and HR leaders to respond with empathy and discretion. It also means updating internal policies and language to be inclusive of all family-building paths, not just traditional biological parenthood within a heterosexual marriage.
Some employers are going further by integrating mental health counseling into fertility benefits, hosting internal forums or peer support groups and ensuring that all employees have equal access to services. These actions do not just benefit a subset of employees, they strengthen the entire workplace culture.
Leadership also plays a crucial role. When senior leaders acknowledge family-forming journeys, whether through personal stories, policy endorsement or internal communications, it signals that these issues are not taboo. It gives employees permission to speak up and seek care.
Inclusive Design Matters
A truly inclusive family-forming benefit strategy must address both the range of services and the range of people who need them. Benefits should be structured to support all employees, regardless of gender, sexual orientation, marital status or family-building path.
This includes coverage for:
- LGBTQ+ family-building via donor sperm, egg, or surrogacy;
- Single parents by choice;
- Fertility preservation for medical or personal reasons; and
- Cultural or religious sensitivity in reproductive care choices.
Benefits should also be flexible and accessible. Telehealth for consultations, concierge navigation support and flexible treatment schedules are now standard in top-tier plans. They allow employees to receive care without compromising their work or personal obligations.
By offering personalized, inclusive support, employers ensure that all employees, not just a privileged few, can pursue family-building with dignity and confidence.
A Long-Term Investment In People
Fertility care may seem like a private issue but its impact plays out in public ways, in employee morale, performance, retention and trust. When employees feel that their employer supports not just their professional growth but their life aspirations, they are more engaged and more loyal.
Inclusive fertility benefits acknowledge the realities of today’s workforce, which is increasingly diverse, often postponing parenthood and seeking workplaces that align with their values. They demonstrate that a company’s values extend beyond profit to their people.
In a competitive talent market, the ability to support employees holistically is no longer optional. It’s a differentiator. As reproductive healthcare continues to evolve, companies that respond with speed and empathy will be better positioned for long-term success.
