Fertility and the workplace: why companies should start the conversation

One in six people worldwide experiences infertility, yet most workplaces remain silent on the topic. While employees navigate emotional appointments, hormone treatments, and the physical demands of assisted reproduction, they often do so without acknowledgment or support from their employers—creating an invisible burden that affects both wellbeing and performance.

The conversation around fertility in the workplace has reached a critical turning point. With 13.4% of U.S. women aged 15-49 experiencing impaired fecundity and fertility services becoming increasingly common—12.2% of U.S. women have used infertility services—employers can no longer afford to treat fertility challenges as a private matter. The silence isn’t neutral; it’s actively harmful to employee retention, productivity, and organizational culture.

The hidden cost of fertility challenges at work

Employees undergoing fertility treatments face a complex web of logistical and emotional demands that directly impact their work lives. Frequent medical appointments—sometimes several per week during active treatment cycles—require precise scheduling that rarely aligns with traditional work hours. Medication protocols demand exact timing that can’t be adjusted around meetings or deadlines. Hormone fluctuations affect mood, energy, and cognitive function while employees attempt to maintain standard performance levels.

Without workplace support, many employees resort to using vacation days for medical procedures, fabricating excuses for appointments, or powering through physical discomfort during critical work moments. This hidden struggle manifests as diminished productivity, increased stress, and eventual burnout. The employees who feel they must choose between advancing their fertility journey and maintaining their professional standing often face an impossible calculus that benefits neither their health nor their employer.

The impact extends beyond individual performance to organizational stability. When talented employees feel unsupported during fertility challenges, turnover increases. The financial investment in recruiting and training replacements far exceeds the cost of implementing supportive policies. More importantly, the loss represents a failure to retain institutional knowledge and maintain team cohesion during a vulnerable period when targeted support could strengthen rather than sever the employment relationship.

Why the stigma persists

Despite 42% of Americans having used fertility treatments or knowing someone who has, workplace conversations about fertility remain remarkably absent. The stigma operates on multiple intersecting levels that keep the topic confined to whispered conversations rather than policy discussions.

Fertility challenges occupy an uncomfortable intersection of medical condition and deeply personal experience. Unlike other health issues that receive clear workplace accommodations—pregnancy, cancer treatment, chronic illness—fertility struggles lack a defined script for disclosure or support. Employees fear judgment about their reproductive choices, timeline, or methods. The intimate nature of conception and reproductive health makes the topic feel inherently private, even when the practical demands of treatment become impossible to hide.

Gendered assumptions compound the problem substantially. While infertility affects men and women nearly equally—with causes distributed 33% to male factors, 33% to female factors, and 33% to combined or unidentified factors—the workplace burden falls disproportionately on women. Women typically manage the medication protocols, attend more frequent appointments, and undergo the physical procedures, regardless of the underlying cause. This reality intersects with persistent workplace biases about women’s commitment and reliability, making disclosure feel particularly risky for female employees concerned about career advancement.

The absence of visible role models perpetuates the cycle. When leadership doesn’t acknowledge fertility as a legitimate workplace concern, employees take their cues from that silence. They compartmentalize, they hide, and they struggle alone—creating a self-reinforcing pattern where the next person facing fertility challenges also feels they must remain invisible. The cultural norm becomes concealment rather than support.

The business case for TTC support at work

Progressive companies recognize that women’s health workplace inclusivity isn’t simply a moral imperative—it’s a strategic advantage in talent retention and organizational performance that directly affects the bottom line.

Consider the demographics shaping your workforce. Women of prime reproductive age represent a significant portion of professional talent across industries. Female fertility begins declining at age 30, and by age 40, the probability of conception per menstrual cycle drops to approximately 10%. This means many high-performing employees at critical career stages are simultaneously navigating fertility challenges while managing leadership responsibilities, complex projects, and professional advancement.

When organizations implement fertility-friendly policies, they signal a fundamental commitment to valuing employees as whole people rather than productivity units. This cultural shift reverberates through every level of the organization. Employees feel safer disclosing health needs without fear of professional repercussions. They experience measurably less stress when managing appointments because they’re not constantly calculating how to maintain the fiction that everything is fine. They maintain stronger engagement with their work because they’re not devoting cognitive resources to managing secrecy, covering tracks, and suppressing the emotional weight of their experience.

The retention impact proves particularly pronounced among women in male-dominated industries, where the absence of support often pushes talented professionals toward competitors with more inclusive policies. In competitive talent markets, fertility benefits and flexible support systems become meaningful differentiators that attract candidates who anticipate needing this support or who value working for employers that demonstrate genuine commitment to employee wellbeing beyond surface-level perks.

What inclusive fertility policies look like

Meaningful support for employees facing fertility challenges requires more than adding IVF coverage to health insurance—though comprehensive medical coverage certainly forms a crucial foundation. True women’s health workplace inclusivity addresses the daily realities of fertility treatments through specific, actionable policies that recognize both logistical and emotional needs.

Flexible scheduling for medical appointments represents the most immediate and impactful intervention. During active IVF cycles, monitoring appointments occur early in the morning and may change daily based on follicle development and hormone levels. Employees need the ability to arrive late or leave early without exhausting paid time off or manufacturing elaborate explanations. Clear policies that explicitly include fertility-related appointments in flexible work provisions remove ambiguity, reduce stress, and normalize what should be a straightforward accommodation.

Protected time off for procedures acknowledges that retrieval and transfer procedures require recovery time that standard sick leave policies often don’t adequately cover. While these procedures are performed as outpatient services, the physical effects—cramping, bloating, fatigue, hormonal adjustment—can persist for days and affect an employee’s ability to perform at their usual level. Designating specific leave for fertility procedures, separate from standard sick leave or vacation time, normalizes this need and prevents employees from choosing between treatment and preserving time off for other life events.

Emotional support infrastructure matters as much as logistical accommodations because the psychological toll of fertility challenges can equal or exceed the physical demands. The emotional rollercoaster of fertility treatments—hope during preparation, anxiety during procedures, disappointment with negative results, grief over failed cycles—affects mental health and work performance in ways that purely practical accommodations can’t address. Access to counseling services, whether through Employee Assistance Programs or dedicated mental health platforms, provides crucial support during a profoundly challenging experience. Digital wellness tools designed specifically for women navigating fertility challenges, including guided meditations and stress-reduction techniques, help employees manage the emotional demands of treatment cycles without requiring additional time away from work.

Manager awareness training bridges the critical gap between written policies and daily implementation. Many managers genuinely want to support their team members but lack knowledge about fertility challenges or fear saying the wrong thing. Training that covers basic fertility facts, appropriate ways to discuss accommodations, and how to maintain confidentiality while providing support creates a more responsive environment. Managers who understand that fertility challenges affect men and women, that treatments follow unpredictable timelines that can’t be scheduled around quarterly goals, and that outcomes remain uncertain regardless of effort can respond with appropriate flexibility and empathy rather than frustration or suspicion.

Inclusive language in benefits communications signals organizational values before employees ever need to request support. When benefits materials and HR discussions explicitly mention fertility support alongside pregnancy and parental leave, employees understand that all stages of family-building receive recognition and support. This proactive communication reduces the emotional labor of advocating for accommodations and creates a cultural foundation where seeking support feels normal rather than exceptional.

Connecting fertility support to comprehensive women’s health

Fertility challenges don’t exist in isolation—they’re part of a continuum of women’s health needs that span reproductive years and beyond. Organizations that support employees through fertility treatments create a foundation for supporting them through pregnancy, birth, and the postpartum period, building lasting loyalty through consistent care.

The transition from fertility treatment to pregnancy, when successful, brings its own distinct challenges that benefit from the same supportive infrastructure. Employees who conceived through IVF often experience heightened anxiety during early pregnancy, fearing the loss they’ve worked so hard to prevent. Those same flexible scheduling provisions that accommodated fertility appointments become crucial for prenatal care, particularly for high-risk pregnancies that require frequent monitoring. The emotional support resources that helped during treatment cycles continue supporting mental health through pregnancy and into the early postpartum weeks, when mood disorders and adjustment challenges are common but often unaddressed in traditional workplace policies.

This integrated approach to women’s health workplace inclusivity recognizes that supporting employees across their reproductive journeys—from trying to conceive through postpartum recovery—creates sustained performance and lasting organizational commitment. It’s not about implementing isolated policies for discrete life events, but rather building an organizational culture that acknowledges and supports the reality of women’s health needs throughout entire careers. Companies that invest in this comprehensive approach don’t just retain individual employees through specific challenges—they build reputations as employers of choice for the entire demographic of women in professional roles.

Taking the first step

For organizations beginning this journey, perfection isn’t the prerequisite—conversation is. Start by acknowledging that fertility challenges affect your workforce at rates that make silence a choice rather than a neutral position. Include fertility support in discussions about health benefits and workplace flexibility. Survey employees anonymously about their needs and experiences to understand the specific gaps between current policies and actual needs.

Consider forming an employee resource group focused on family planning and fertility support, creating space for employees to connect, share resources, and advocate for policy improvements without shouldering the burden individually. Partner with benefits consultants who specialize in reproductive health coverage to understand the full spectrum of available support options, from medical treatments to counseling services. Review existing policies for unintentional barriers—does your sick leave policy require advance notice that’s impossible during active treatment cycles? Does your flexible work policy exclude part-day absences that fertility appointments often require?

Most importantly, encourage leadership to model openness about the prevalence and legitimacy of fertility challenges. When executives or senior managers share their own experiences with fertility struggles, or simply acknowledge how common these challenges are, they create permission for others to speak up without fear of professional consequences. This cultural shift, more than any single policy line item, transforms workplaces from environments of enforced silence into communities of authentic support.

Building workplaces where fertility conversations are normal

The case for fertility support in the workplace isn’t complicated: employees experiencing fertility challenges need flexibility, understanding, and concrete resources to maintain both their treatment protocols and their professional performance. Companies that provide these elements retain talent, strengthen culture, and demonstrate authentic commitment to employee wellbeing rather than just claiming it in recruitment materials.

As fertility rates continue declining and more people delay childbearing to later reproductive years, fertility challenges will become increasingly common in professional workplaces across all industries. Organizations that act now to normalize these conversations and implement supportive policies will lead in both talent retention and cultural innovation. The companies that wait will find themselves losing talent to competitors who recognized earlier that supporting employees through fertility challenges is simply good business practice.

The conversation around fertility in the workplace has already begun in progressive organizations—the question is whether your company will be part of shaping that future or struggling to catch up when talent shortages make the cost of inaction impossible to ignore.

Ready to support your team through every stage of their wellness journey? Beginning offers evidence-based mental health and wellness tools specifically designed for women, including resources for managing the stress and emotional challenges of fertility treatments. Explore how comprehensive digital wellness support can enhance your organization’s commitment to women’s health workplace inclusivity.