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It’s time for Lauren’s first injection. She doesn’t usually mind needles, but this time, the person holding the syringe is her husband—and his only training consists of a 3-minute video.
Tears stream down her face afterward. The injection hurts, and this is only the first day of at least 10, with multiple injections in the morning and evening. She dries her tears, walks into her office, and dials into her first meeting—as if it’s just another work day.
Last week, Lauren spent hours on the phone between meetings, talking to a financial advisor, a nurse, and the pharmacy in preparation for this week. By the end of what ended up being 13 days of injections, her thighs and stomach are covered in purple bruises, and her arms are sore from having blood drawn at the clinic every other day.
She’s relieved when the surgery is finally over, but spends the following week dealing with pain and extreme discomfort. She tells herself it's worth it if it works.
Lauren is dialed into a meeting and is waiting for it to start when the call comes. She quickly turns off her camera and mutes herself to talk to her doctor. He tells her he’s sorry, but the news isn’t good. Lauren hangs up the phone and turns her camera back on to join the meeting as her world crashes down around her.
Infertility is common, often devastating, and on the rise
You may be assuming Lauren has a serious illness. She doesn’t—she’s been trying to have a baby for over two years and just went through an in vitro fertilization (IVF) retrieval cycle. Her doctor was calling with the worst possible news. She and her husband made two embryos, but the test results came back, and neither were healthy enough for a transfer.
Working with people like Lauren is a huge part of my job. I’m a Licensed Professional (Clinical) Counselor who specializes in supporting individuals experiencing infertility.
There’s a good chance more than one of your employees is living a version of Lauren’s story. Infertility is common and increasing. A new report published by the World Health Organization showed approximately one in six adults globally experience infertility, and four in ten in the U.S. have either undergone IVF or know someone who has.
What is infertility?
Infertility occurs when someone is trying to get pregnant for 12 consecutive months and is unable to conceive—unless they’re over 35 years old, then it’s six consecutive months.
As people age, fertility declines, although there’s variance among individuals. The clients I work with are usually women who’ve waited to have kids due to their careers, and either because of age or a previously undiscovered fertility issue, are unable to get pregnant.
It’s important to note both men and women can have health conditions contributing to infertility or age-related fertility decline. Non-binary and transgender people also experience infertility, and their journeys are likely to be a bit different.
Fertility treatment is emotionally, physically, and financially costly
IVF is the most financially, emotionally, and physically demanding fertility treatment, particularly for the woman undergoing the process. It requires months of preparation, early morning monitoring appointments, multiple daily injections, physical discomfort, stress, and a roller coaster of emotions—all while working for many.
Lauren is fortunate to have a manager she trusts enough to share what she’s going through. This makes it much easier to put in the last-minute “sick day” request for a retrieval—this date is set with only three days' notice.
It might be surprising to learn there are likely employees in your organization who have gone through multiple failed rounds of fertility medications, IUI procedures, IVF retrievals, and embryo transfers throughout the year while still meeting deadlines and contributing to meetings.
Many employees don’t tell anyone at work about their fertility treatment and instead go through it in silence.
The mental health impact—shame, grief, and uncertainty
Many of the people I work with experience a lot of shame around their inability to conceive. There’s also guilt regarding not being able to give their partner a child, their parents' grandchildren, or their children a sibling. People question themselves and wonder whether they wanted it enough, ate the right things, and took every possible step to get pregnant.
Grief is another common emotion in people experiencing infertility. There’s grief about things not going the expected way. I’ve had clients say, “I can’t believe we’re making a baby in a lab.” One client, still groggy from the sedation after her IVF retrieval, said to her husband through tears, “Is this what we have to do to make a baby?”
The emotional impacts are heavy, layered, and ongoing.
People generally understand grief and bereavement belong in the workplace when they’re due to the loss of a loved one, or for a serious health diagnosis. I hope people also understand grief over infertility is something that belongs in the workplace as well, and deserves the same level of support.
A myriad of physical challenges
There’s invasive testing for all fertility treatments, repeated ultrasounds, bloodwork, urine samples, injections, amplified hormones, retrieval, and transfer procedures, and then the medications and their side effects.
These can cause a lot of emotional fluctuations, layered on top of the existing emotional burdens, especially the hormone medications.
IVF poses a huge financial burden
One IVF cycle costs, on average, over $20,000. Most fertility patients undergo at least two cycles, putting cumulative costs at $40,000-$60,000. In the U.S., laws and coverage of fertility treatment vary widely.
Most of my clients pay some or all of the costs out of pocket. It’s also important to note there’s no guarantee of success for people using IVF. They may have to go through multiple rounds without getting pregnant or losing the pregnancy.
How workplaces can offer support
In my experience, everyone struggles with balancing fertility treatment with work. It’s difficult to convey how many appointments and procedures are part of treatment, especially IVF. Combined with the emotional and financial load, it burdens employees significantly.
There’s also still stigma around infertility, which is one of the first barriers employees face in getting connected with resources and support at work.
Practical support
One of the most important forms of workplace support involves reducing stigma around infertility to create psychological safety. Employees must feel comfortable disclosing infertility for HR, benefit leaders, and supervisors to provide resources, benefits, and schedule flexibility.
I tell my clients it’s a case-by-case basis, but if they feel safe telling their supervisor or direct manager they’re undergoing fertility treatment, they should do so. This information gives the manager context for why an employee might suddenly have a lot of appointments.
Here are some additional strategies and tactics for providing support:
- Offer comprehensive fertility benefits and a comprehensive mental health benefit
- Have a written policy for fertility support: here’s a guide and a toolkit
- Offer flexible schedules to allow the time off employees need for monitoring appointments and retrievals
- Acknowledge the ebb and flow that’s often needed for many employees during this time—during some months, they may only be able to give 80%
- Promote awareness and confront stigma through training and education
- Form employee resource groups for those navigating infertility, ask them what they need, and implement their recommendations
Mental health benefits are vital
Every single person who deals with infertility is stressed and dealing with some type of anxiety and/or depression. They deserve specialized, comprehensive mental health support, just as with any other life-altering diagnosis.
As an example of what this can look like, Spring Health offers:
- Therapy including specialized providers who understand how demanding, exhausting, and emotionally draining this can be. Women’s health is a specialty filter when looking for a provider.
- Coaching to help navigate issues such as wellness, hormone health, and pre/post natal challenges.
- Moments is our clinically-validated, on-demand library of digital family support exercises.
- Care Navigation, with check-ins from a licensed clinician to help members get the right support and find the right resources
- Education and awareness, such as webinars and Wellsprings on processing grief and loss.
Providing this level of support will strengthen employees as they are going through heavy stressors like infertility and help keep them from developing more severe mental and physical health conditions—or from quitting their jobs abruptly. An ounce of prevention is worth a pound of intervention.
Two final thoughts
I want to leave workplace leaders with a couple of final thoughts.
What would it be like for an employee to have the courage to ask for help as they’re undergoing fertility treatment—and receive it so they can work while also feeling supported?
Work is an important part of many of my clients' identities. They don’t want to choose between their job and getting pregnant. I’ve had multiple clients quit their jobs to focus on fertility treatment, and that wouldn’t have been necessary if they’d had enough support from their manager and employer.
Next, consider the importance of implementing a written infertility policy. This ensures employees don’t have to deal with the additional uncertainty of whether they’re covered for treatment, can take the time off they need, and ultimately, whether their workplace is where they feel safe seeking support.
The benefits you offer are what hold people’s hearts, signaling your genuine concern for their well-being and cultivating a sense of being cared for by the organization. Learn how you can further support family well-being by providing mental health benefits that offer fast access to care.
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