In 2016 the number of women having children over 40 was higher than the number of under-20s having children for the first time since World War II. As women increasingly put off having children in order to focus on building careers there’s more demand than ever for fertility treatments.
In the UK, 50,000 people begin fertility treatments every year in the hope of having children, and issues around work, women and healthcare raise questions about whether fertility treatment such as IVF should be covered by employee benefits.
Is infertility really just a private medical matter, or do employers have some responsibility when it comes to workers who are struggling to have a family?
Number of US employers supporting fertility treatment is rising
One in every 50 babies born in the UK is the result of IVF treatment and six out of every ten IVF cycles are funded privately. Long NHS waiting lists and a combination of specific requirements mean that in the majority of cases people are paying between £6,000 and £10,000 out of their own pocket for one cycle, and in top clinics prices can even go north of £15,000.
In the United States prices are higher, with one cycle costing anywhere between $12,000 and $20,000, but due to the nature of healthcare packages offered by companies to employees, this is increasingly being covered by employers.
Last year a survey by Willis Towers Watson revealed that two-thirds (66 per cent) of employers in the US expect to offer fertility benefits by 2019, up from 55 per cent in 2017. Results also showed that 71 per cent of the employers offering fertility benefits did so to support their inclusion and diversity goals and objectives, 59 per cent said it was to help recruit and retain top talent and 49 per cent saw it as necessary in order to be recognised as a “best place to work”.
That said, fertility benefits do not necessarily include IVF, and in many places only offer much less effective treatments such as intrauterine insemination, or do not cover the full cost of IVF cycles. There’s an acknowledgement here then that fertility is an increasing concern to employees, but there is still a long way to go before fertility treatment is seen as a standard benefit.
UK employees reluctant to talk about fertility treatment at work
While the debate about employee benefits and fertility in the US seems to be making some progress, in the UK things are a little more complicated. The Fertility Network UK says that employees are often reluctant to tell their bosses about fertility treatments that they are having, let alone ask for support.
There are a number of reasons for this: firstly, employees often worry that their personal issues related to fertility will not be taken seriously, they also worry about confidentiality being breached, and perhaps the most concerning point for many is that the concern that it could negatively affect their career prospects.
Natalie, a 42-year-old product marketing manager from London, decided to have IVF treatment after being told that she was too old to qualify for treatment on the NHS. “I decided not to tell my employers about my treatment and found myself feeling incredibly isolated”, she says.
“I had spent so many years focusing on my career and felt a sense of shame around my decision. I didn’t want my boss to think I had changed my priorities and I was worried that if the IVF didn’t work, I would have affected my image in the workplace”.
With the already heated discussion taking place around sexism at work, balancing the gender pay gap, the fallout of #MeToo and countless harassment scandals it’s not surprising that women feel that issues around fertility may not be a priority for their employers. If women struggle already with the issues around natural pregnancies, like paid maternity leave and their position in their office when they return to work, adding additional complications that come into play around IVF – days needed to visit clinics, the fact that more than one cycle of IVF is often necessary and the side effects of treatment – certainly make fertility a tough issue to address in the workplace.
What responsibility do employers have in terms of employee infertility?
But is infertility really just a private medical matter, or do employers have some responsibility when it comes to workers who are struggling to have a family? If there is already support for paid parental leave and, in the US for example, a push to make company-sponsored insurance plans cover birth control, is fertility treatment not the next issue that has to be tackled?
After all, infertility is officially recognised as a disease by the World Health Organization, which it defines as “the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”. This means that it now falls into a unique space where disability, medical treatment and pregnancy intersect, thus making it a thorny issue. Couple with this the fact that infertility is extremely common – one in seven couples face problems trying to conceive, according to the NHS – and it becomes clear that this is a concern that is only going to become increasingly relevant to employers.
The issue is that there is not yet any clear guidance about the responsibility that a workplace has to employees suffering from infertility, so HR departments and managers are finding themselves having to make calls on these issues themselves.
This can create huge disparities between the level of cover that is offered from company to company. As IVF often requires more than one cycle to be effective, this raises the question about how many cycles may be offered, how much of the treatment and care should be covered, and even until what age should women be allowed to try IVF. These are all questions that companies may not have thought about just yet, but as fertility treatment becomes increasingly normalised as part of employee benefits, companies will have to start coming up with answers.