What are fertility benefits? Reproductive endocrinologists weigh in

Fertility benefits are steadily rising in importance among top employers, and for good reason. Long treated as niche, fertility care is now in the mainstream, both due to increasing need and to the significant barriers to access. By offering fertility benefits, employers are looking to mitigate the impacts of exorbitant costs, inaccessible care, and the combined physical and mental toll of the family-building journey.

However, awareness of the need for fertility support is rising in tandem with the number of approaches to meet it. A number of vendors have emerged offering different approaches to supporting employees' fertility needs: some offer narrowly-focuses support on reimbursement for fertility services, while others focus on holistic fertility needs including but not limited to access to providers, clinics, and coaching.

But there is more to fertility and family-building than ovulation and hormone tests and IVF cycles, and there are many steps that employees can take before turning to IVF or IUI. And for the 70% of LGBTQIA+ individuals looking to expand their families, fertility support based on a diagnosis of infertility leaves them out of the conversation entirely. The question remains: how should employers think about fertility care in the workplace, and what should they look for in the sea of fertility care vendors?

We sat down with Drs. Brian Levine and Wael Salem, board-certified reproductive endocrinologists with CCRM, a leading clinic network in the US and Canada, to better understand the features that define best-in-class fertility benefits, and how employers can deliver evidence-based care that meets the needs of their entire population.

“What I wish I could do is connect them with educational resources and other kinds of support that could help with the natural anxiety many people have about starting a family — that's a huge need.” - Dr. Brian Levine

What are fertility benefits?

Fertility benefits refer to a range of employer-sponsored programs and services designed to support employees in their journey to parenthood. These reproductive health benefits are intended to address various aspects of fertility, reproductive health, and family-building. They can include financial assistance for fertility treatments such as in vitro fertilization (IVF), coverage for fertility medications, access to fertility specialists, and support services such as counseling.

What can fertility coverage and benefits include?

In recognizing the unique and personal nature of family planning, employers increasingly offer fertility benefits to support their employees on their journeys to parenthood. A comprehensive fertility benefits package goes beyond the traditional offerings of other health benefits and acknowledges the diverse needs of individuals who are navigating fertility challenges. Various components can be encompassed within family-forming benefits:

Education and guidance

Providing education and guidance is a fundamental aspect of fertility benefits. Employers can offer resources and information to help employees understand reproductive health, different fertility services, and family planning methods. This may include workshops, classes, or access to educational materials that empower individuals to make informed decisions about their fertility journey.

As reproductive endocrinologists, Drs. Levine and Salem are responsible for working with individual patients to tailor treatment plans that make sense for their circumstances. However, they often find themselves meeting with patients far earlier in their respective journeys than clinical guidelines recommend. Drs. Levine and Salem say that most benefits over-emphasize medical treatments, and in some cases, even drive employees to pursue them before they are necessary.

The two physicians believe this is primarily due to patients' lacking access to what Dr. Salem refers to as "common sense optimization of fertility," including proper timing of intercourse, avoidance of spermicidal lubricants, and even ED treatment.

Mental health and emotional support

The emotional toll that family planning can take should not be overlooked when it comes to offered fertility benefits. An infertility diagnosis, barriers to fertility treatments, and cost concerns, amongst other factors, can significantly affect a person's wellbeing.

A study conducted across infertility clinics in northern California, for example, revealed that 56% of the women and 32% of the men surveyed reported significant symptoms of depression and 76% of the women and 61% of the men reported significant symptoms of anxiety.

Statistics such as these underpin why comprehensive family-forming benefits must include mental health and emotional support. This support can include counseling services, support groups, and access to mental health professionals who specialize in fertility-related issues, fostering a holistic approach to employee wellbeing.

Drs. Levine and Salem believe providing access to mental health support and proper preconception care can make a meaningful difference, but many health plans do not adequately cover these services.

"I have many patients seeking treatment because they're anxious about their ability to get pregnant in the future, but they actually don't need to pursue something like IVF yet," Dr. Levine says. "What I wish I could do is connect them with educational resources and other kinds of support that could help with the natural anxiety many people have about starting a family — that's a huge need."

Consultation and diagnostics

Dr. Salem notes that a more expansive definition of fertility care is better supported by scientific evidence—it's also far more patient (and employer) friendly due to positioning invasive, expensive treatments like IVF as reactive rather than proactive treatments.

"There's a lot of misinformation around what kind of treatment needs to be done, even among those with access to fertility support through work," says Dr. Salem. "The vast majority of infertility care is actually really simple and inexpensive. We should start by optimizing preconception care, adjusting lifestyle factors, or timing ovulation. But based on my experience in the clinic, I think a lot of people aren't getting this kind of support."

Dr. Levine notes that some of his patients feel compelled to pursue treatments like IVF or egg freezing due to anxiety about their fertility. "I do think there is an aspect of fear at play. We want pregnancy to happen right away. But totally healthy people would only be expected to get pregnant 20% of the time in a given month. So, you have this big gap between the individual's experience and the way their healthcare has been set up to help them. You're either getting IVF, or you're on your own."

Fertility benefits that cover consultations with a fertility specialist and testing to identify underlying issues and/or confirm an infertility diagnosis can enable employees to receive personalized insights into their reproductive health and personalized guidance related to preconception, optimizing fertility, and fertility treatment options. This can help alleviate anxiety and pave the way for informed decisions and timely interventions.

Assisted reproductive technology

Fertility benefits commonly encompass cover fertility treatment that is more advanced such as assisted reproductive technologies including in vitro fertilization (IVF), intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), surrogacy, and other procedures. These technologies offer effective solutions for various fertility issues and are often a critical component of comprehensive fertility benefits for same-sex couples, couples facing medical infertility, and single parents.

Fertility preservation procedures

For some individuals, fertility preservation procedures are a vital factor in their employee benefits packages. Forms of fertility preservation include egg freezing, surgical sperm retrieval and freezing, and embryo freezing. Such procedures offer employees the opportunity to preserve their fertility before undergoing treatments that could otherwise affect reproductive health and also give them the opportunity to try adding to their family in the future.

Surgery

Certain fertility issues require surgical interventions. Fertility benefits can extend to cover surgical procedures aimed at addressing reproductive challenges, providing employees with necessary medical interventions to improve their chances of conception. Such surgical interventions may include fallopian tube surgery, laparoscopy to treat endometriosis, or varicocelectomy to treat a varicocele (a vein enlargement).

Fertility treatment medications

Coverage for fertility medications is an important component of fertility benefits. It is particularly important given that fertility medications offer many people a viable option in their family-planning journey before fertility treatments such as IUI or IVF. These medications, which may include hormones or other pharmaceuticals, are often prescribed to improve fertility parameters such as sperm count, eliminate infection, regulate the menstrual cycle, or induce ovulation.

Aligning incentives between patients, providers, and vendors

According to Dr. Salem, the fact that so few of his patients seem to have access to proactive preconception and fertility services speaks to the misaligned incentives between patients, providers, and benefits vendors.

“When your only options are to go to a clinic, it gives this warped idea of what fertility is about,” says Dr. Salem. “When you have more personal support that helps you make the right decisions for your wellbeing, that helps everybody—the patient, the provider in the clinic, and the employer or insurer ultimately responsible for cost of care.” 

For employers providing healthcare for their workforce, offering that kind of support requires a better understanding of all that goes into a healthy experience in the first place, Dr. Salem says. “Excellent fertility care starts with providing reliable, accessible information for the individual,” he says. “It should help to dispel misconceptions about how long getting pregnant should or shouldn't take. It should also help contextualize tests that people might be taking on their own, and offer simple ways to improve the likelihood of getting pregnant, including adjustments to diet and exercise. And finally, if necessary, it should help people determine when they need to seek help through a fertility clinic.”

Dr. Salem says that solutions that focus on in-clinic treatment ultimately fail to meet the breadth of needs within an employee population. 

“A fertility benefit that is designed to provide financial coverage for treatment alone does not make sense to me,” he says. “It excludes the vast majority of infertility cases where people need support and guidance and are vulnerable to misinformation. It's not enabling everything that healthcare can actually do to help people grow their families.”

“Right now, there is a dearth of evidence-based resources. Many solutions on the market are giving people too much care or not enough—usually too much on the medical side and less on the support and guidance side.” - Dr. Brian Levine

The value of adding fertility benefits to your employee benefits package

Fertility coverage for employees has some obvious benefits for individual employees and can make a drastic difference to their overall wellbeing. When employers offer fertility benefits, it can be the main contributor to becoming a parent for some employees. However, fertility benefits can also be advantageous to an organization and impact individual employees and the overall workforce in other ways too.

Promotes diversity, equity, and inclusion

Incorporating fertility coverage into employee benefits fosters a workplace culture that is not only inclusive but also attuned to the diverse reproductive needs of its workforce.

In a survey of people across the U.S., UK, Canada, India, and Mexico, three-quarters felt fertility benefits were an important part of an inclusive company culture. Acknowledging the varied paths to parenthood that encompass individuals of differing sexual orientation, marital status, gender identity, and socio-economic background creates a more equitable environment that resonates with a broad spectrum of employees.

Reduces financial burden

The financial implications of fertility treatments, including procedures such as intrauterine insemination (IUI), donor sperm and donor egg usage, and artificial insemination can be substantial. Employers offering fertility benefits ease this financial burden for their employees. By providing financial support for fertility treatments and medication costs, organizations empower their workforce to pursue family-building options without facing overwhelming financial strain.

Improves employee retention

Fertility benefits contribute significantly to employee satisfaction and loyalty as when employers offer inclusive benefits that encompass fertility coverage, employees feel supported in their personal, as well as professional lives.

Research by Brabners revealed that 9 in 10 employees who face fertility challenges will change jobs for a company that has fertility benefits, over half (53%) will stay longer with their employers if they cover the cost of fertility treatment and 88% of employees who feel unsupported during IVF treatment quit or think of quitting.

Attracts top talent

In a competitive job market, offering fertility benefits can be a distinguishing factor that attracts the most highly skilled candidates. Prospective employees increasingly consider the inclusivity and comprehensiveness of benefits packages when evaluating potential employers.

By providing fertility benefits, organizations signal a commitment to employee health and family-building, positioning themselves as desirable employers for individuals seeking workplaces that are family-focused and prioritize holistic wellbeing.

Designing an inclusive, outcomes-based fertility program

To Dr. Levine, fertility is at a tipping point. Advancements in research and technology are making certain treatments more effective, and there is growing recognition from both employers and health plans that fertility is a core component of healthcare. What's needed are solutions that are capable of delivering the right support at the right time for individuals and their families.

“Right now, there is a dearth of evidence-based resources,” says Dr. Levine. “Many solutions on the market are giving people too much care or not enough—usually too much on the medical side and less on the support and guidance side.”

Dr. Salem agrees. An effective fertility benefit, he says, should be founded on a team-based approach that positions fertility doctors like himself as part of a broader ecosystem of support. “I would like to see fertility treated with the breadth and depth it deserves,” says Dr. Salem. “The care I provide as a physician is one component, but there are lots of other aspects. And the patient needs someone who is their guide through the whole experience.”

Still, Dr. Levine is optimistic about the future of fertility health care, especially when he considers how far the space has come since he first started practicing. “It is absolutely incredible to see the extent to which employers and insurers have embraced fertility — as a provider, I am ecstatic,” says Dr. Levine. “But for patients, making IVF cost less is really the floor of what we can do. We can give so much more to people. We have to.”

Building better fertility benefits with Maven

Supporting your employees on their journeys to parenthood contributes to a more content workforce that is empowered to thrive in both their homes and their careers. By offering fertility treatment coverage and family-forming benefits, you not only enhance organizational loyalty but also boost overall workplace productivity.

In fact, 83% of our Fertility & Family Building members report heightened productivity during fertility treatment. There has never been a better time to establish a comprehensive fertility benefits program that caters to the diverse needs of your employees.

Maven Clinic is the leading women's and family healthcare clinic, offering an inclusive fertility and family-building program. With 24/7 access to clinical, emotional, and financial support, our program supports members to make informed choices about their reproductive health and fertility treatments, according to their unique circumstances and preferences. Because of Maven's comprehensive support, 25% of Fertility members are able to achieve pregnancy without assisted reproductive technology.

Request a demo today and discover how Maven Clinic's personalized fertility and family-building benefits can make a difference to your employees and your organization.