dr Jeremy Thompson has devoted his career to reproductive research. As a professor at the University of Adelaide, he has published more than 200 publications. From 1999 to 2004 he was head of the IVF laboratory at reproducedand in 2019 he was a co-founder fertilitya company developing micromedical devices to improve embryo growth environments and IVF success rates.
In the more than 40 years since the birth of Louise Brown, the first person to be conceived through in vitro fertilization (IVF), public perceptions of IVF have changed drastically, much to the benefit of the community 186 million people struggling with infertility worldwide.
More than 55,000 Americans give birth to a baby conceived through IVF every year; worldwide the number of Annually born IVF babies (pdf) is around 500,000.
The demand for fertility treatments has steadily increased over the years and recently there has been a growing trend for employers to offer fertility services to their employees.
In the battle for talent, companies such as Boston Consulting Group, Spotify and LinkedIn Offer generous fertility packages. In 2020, more than 42% of US employers with more than 20,000 employees covered IVF treatment. However, for companies with more than 500 employees, only 27% covered IVF.
However, IVF is emotionally and physically taxing, even when successful. Employers can take a few simple steps to help create a supportive work environment for employees undergoing treatment.
IVF: Understand the implications and provide financial support for employees
Unfortunately, as interest has increased, IVF success rates have not kept pace. After decades of research and clinical practice, an IVF cycle is still more likely to fail than succeed.
For the approx 7.4 million Americans For those struggling with infertility, this is a devastating and costly truth. In the US, most women under the age of 37 need at least three IVF cycles to have a 50 percent or better chance of having a child. A single IVF cycle can cost anywhere from $10,000 to $25,000. At these prices, it’s no wonder more and more employees are taking advantage of fertility benefits as part of compensation packages. Unfortunately, without financial support or privilege, successful fertility treatment is impossible for many families.
Any financial support is helpful, but companies should commit to doing the most significant coverage they can afford so it’s really effective. IVF success rates increase with each cycle. By providing insurance coverage for at least three cycles, companies can increase the likelihood of employees successfully conceiving while avoiding starting treatment they cannot afford.
In addition to providing financial support, businesses and HR leaders need to learn about IVF. Without understanding the timelines, complexity and uncertainty of the IVF process, employers will find it difficult to provide the necessary support to employees undergoing treatment.
Much of the media coverage of IVF includes happy success stories or catastrophic failures (e.g. parental mix-ups during embryo implantation). However, the reality is that most IVF journeys – successful or unsuccessful – consist of an extended period in which the normality of daily life for patients oscillates between exciting highs and disappointing lows. By building their understanding of the IVF experience, leaders can approach an employee’s fertility journey with empathy and compassion.
Provide some downtime during the IVF process
The time frame for pre-diagnosis and pre-treatment varies from patient to patient, but employers should be aware that it can be months before a patient starts hormone therapy. In addition, employers should be aware that employees must take time off work to attend multiple visits to a clinical specialist to determine the cause of infertility.
Once a cause has been identified, most women must undergo a pre-treatment regimen, which involves taking a cycle of birth control pills to suppress their own hormone production. Unfortunately, they’re likely to experience the side effects of the pill: nausea, headaches, sore breasts, bloating, and mood swings, to name a few.
After the pre-treatment, the patients receive a two-week hormone therapy in which they self-administer hormone injections. These injections often cause discomfort — bloating, nausea, fatigue, and sinus pain are common side effects. In addition, some patients also experience hot flashes, headaches, brain fog, blurred vision, and irritability.
A lot of anxiety accompanies the hormonal treatment phase, since the ability to administer the right dose of ovarian stimulating hormone at the right time each day directly affects the number of eggs released. Flexible work arrangements are necessary as they help employees undergoing IVF to have frequent doctor’s appointments and daily hormone injections without undue stress. Business trips from pre-treatment to egg retrieval are not possible as patients have to go to clinics for follow-up appointments, including ultrasound and blood tests.
Suppose an employee feels comfortable confiding in their line manager or a member of the HR team about their fertility journey. When this happens, these leaders can help during the pre-treatment phase by not planning work trips, anticipating the need for additional capacity, and equipping their teams accordingly. Employees undergoing IVF are likely to experience intense physical side effects for weeks, and they need to be able to rest without falling behind with their work commitments. Since it’s already a stressful time, managers should help protect these employees from additional workplace stressors.
Reduce work stress throughout IVF treatment
Pass through as an employee Egg collection and treatmentManagers can help employees with work-life balance and relieve them of worries about career setbacks while managing the anxiety associated with this time.
After all the physical and emotional pre-treatment stress, it’s possible that a clinician may not be able to collect eggs during retrieval. Therefore, employers should give employees time off in case the egg retrieval fails.
After successful egg retrieval, a patient has to wait between four and seven days to know if the process has resulted in a viable embryo. Embryologists expect to produce one to two viable embryos from eight eggs. However, implanting a viable embryo comes with its own risks, and staff must wait two weeks after implantation to know if it resulted in a successful pregnancy.
Waiting for a cycle to succeed is an anxious time. An employee can be distracted – they cannot focus 100% on their work – and managers should respond with compassion rather than in a way that causes additional stress.
Providing counseling services to staff throughout IVF
Employees are drawn to fertility benefits for the prospect of a healthy baby, but IVF treatment fails in nearly one in two people. The emotional cost of unsuccessful cycles or pregnancy losses cannot be quantified.
Above all, companies should offer counseling services for employees fighting childlessness. In addition, employees need support from professionals who can support their mental health and well-being.
These supports cannot be temporary. The IVF process can take months or years. After a failed cycle, most specialists recommend patients wait a few months before trying again, which means a co-worker’s infertility struggle — and the agony that comes with it — can be something they bring to work for an extended period of time .
It is also important that grief counselors are available to help in the event of an unexpected pregnancy loss. While any pregnancy loss is heartbreaking, miscarriages come with various types of grief for individuals undergoing IVF. They carry the weight of everything the patient has gone through—and will go through again—in trying to conceive. Most employees are physically able to return to work after such a loss, but that doesn’t mean they don’t have internal struggles.
Most importantly, counseling services need to be available for the so-called “IVF veterans” — the roughly 40% of people who have had three or more IVF cycles and escaped without a baby in their arms. Professional counselors can help them discuss their options, get in touch with their grief, and create a new vision for their lives.
As fertility benefits evolve from a “nice-to-have” add-on to a standard part of compensation, caution is warranted. The benefits have a positive impact on the lives of many people; However, until technological advances in the lab increase IVF success rates, many people will also discover that fertility benefits cannot compensate for broken dreams. The companies that offer these services must be willing to help their employees with successful and unsuccessful fertility journeys.
