Like most women in the U.S., Kelly spent much of her life worrying about avoiding pregnancy.
But when she and her husband were finally ready to start a family, getting pregnant proved to be complicated. After deciding to conceive despite the pandemic in 2020, Kelly found she was unable to get pregnant as quickly as she expected.
“You’ve been told your whole life you’re like the most fertile thing in the world, right? Like you get close to a guy and you’re afraid you’re gonna get pregnant. We just assumed it would happen really easily,” Kelly, 35, who asked to be identified only by her first name to protect her privacy, tells Fortune.
But Kelly is one of many Americans whose employer provides fertility benefits. That meant that she could start using, Ava, a fertility tracker that monitors women’s ovulation cycles. Instead of having to pay $279 for the device, Kelly’s employer-sponsored fertility benefits provided the FDA-cleared fertility tracking bracelet for free. Ava’s research shows that 30% of women who have been unsuccessfully trying to conceive, get pregnant within a year after using Ava.
That proved to be true for Kelly. Four months after she started tracking her cycles in May 2021, she found out she was pregnant, and is now six months along.
Infertility is a big issue in the U.S., especially as many Americans like Kelly are waiting longer to start families. About 1 in 8 couples, or 7.4 million Americans, struggle with infertility, according to the latest figures. And that number is likely low, given it’s based on the number of Americans who seek treatment, which can be so prohibitively expensive that many couples don’t even try.
A growing number of employers are taking note, and offering fertility benefits in an attempt to retain employees during an ongoing pandemic worker shortage in which employers are seeking to fill over 10 million jobs. These benefits could not help more Americans attain parenthood without going broke, but also reduce turnover and recruitment costs for companies
Tight labor market is a “perfect storm” for fertility benefits
U.S. companies have been slowly starting to provide fertility benefits to their employees for some time.
Fertility programs can vary widely—both in the range of the benefits covered and the financial limits. Some plans, for example, claim to have fertility benefits when they simply cover appointments with infertility specialists, while others offer unlimited IVF treatment and generous stipends for treatments like egg freezing and storage.
Some companies are even partnering with newer vendors like fertility benefits provider Carrot and Maven that offer services outside of a health care plan to act as the interface between employers and workers to provide more hand-holding through the process. Their services range, but many include helping find the right doctors and specialists, and connecting employees with early-stage infertility options like the Ava bracelet before moving onto more in-depth treatments.
About a third of small U.S. employers with less than 500 employees cover some type of infertility service, while 61% of large employers do the same, according to Mercer’s 2021 survey on fertility benefits. Among the companies ranked by Great Place to Work, 75% include fertility benefits in their employer plans.
The pandemic seems to have only accelerated that kind of work perk. Last year, the number of employers offering “family-building benefits”—including fertility treatments, adoption and foster support—grew by 8%, according to the 2021 FertilityIQ Workplace Index, a fertility education company. Nearly 800 employers globally now have some kind of family-building benefits.
And some companies that haven’t offered fertility benefits yet say they are considering it. Roughly one in four, or 27%, of employers provided coverage for IVF treatments and another 12% were considering offering it, according to a survey by Willis Towers Watson fielded in early 2021. Nearly 1 in 5 (18%) offered coverage for egg freezing procedures and 11% were considering it.
“In an effort to attract and retain employees, especially right now, employers are definitely evaluating their benefits, and fertility benefits is one of those,” says Theresa Adams, a senior advisor in the Society for Human Resource Management’s (SHRM) HR Knowledge Center.
That's especially true given that the U.S. had about 10.6 million open jobs as of the end of November, according to the latest jobs report. And turnover remains high—hires increased in November to 6.7 million, while the total number of workers walking off the job ticked up to 4.5 million during the same time period. This churn can be expensive for employers, not only in recruitment fees, but also lost productivity.
Putting strategies and benefits into place that mitigate this can be critical for employers to attract and keep their workers. Even before the so-called “Great Resignation,” 72% of employers reported the top reason for offering family-friendly benefits such as IVF support, parental leave and adoption benefits, was to help recruit and retain top talent, according to a 2020 survey by Willis Towers Watson.
That awareness has only sharpened as employees now have the upper hand in a competitive job market. “People have been reevaluating their priorities [during the pandemic],” she adds. And for many, that means investing and prioritizing family. “So they're looking for companies that offer family friendly benefits.”
Adams calls the current environment a “perfect storm” for boosting the number of employers who offer these benefits, pointing to not only the tight labor market and workers’ interest in family-friendly benefits, but also companies’ recent focus on diversity, equity, and inclusion
“I can't guess the future, but it's likely that we will see those numbers increase as employers are trying to attract and retain the people that they need and meet the needs of their workforce,” Adams says.
The cost benefit of fertility programs
While a majority of employers cite cost as a major barrier, these programs typically aren’t expensive for companies to deploy and maintain. Among the vast majority of employers surveyed by Mercer last year, 97% reported adding infertility coverage did not result in a significant increase in medical plan cost.
There’s also evidence that these types of benefits do help companies retain employees longer, Adams says. Among employees who received fertility benefits, 61% reported feeling more loyal and committed to an employer as a result, according to FertilityIQ. And 88% of those who had their IVF treatments fully paid for by their employer in 2017 returned to the same company after their maternity leave.
Kelly, for example, says she plans on sticking around at her company despite the very competitive job environment. “I do think that it definitely has played a role in me wanting to stay and wanting to kind of give it a good old college try,” Kelly says.
But many times, the fertility benefits currently offered don’t always align with the realities couples face.
Among companies that do provide fertility coverage, the average lifetime amount provided is about $36,000, according to FertilityIQ. And that average hasn’t shifted much in the last three years. And while that sounds generous, a single IVF cycle can cost upwards of $16,000—and that typically doesn't factor in the cost of medications, anesthesia, embryo biopsies and storage, or the frozen embryo transfer. Not to mention the fact that most patients need two or three cycles to become pregnant.
Kelly warns that it’s important to make sure that the fertility services a company does offer provide real support, rather than just something that looks nice. She compared it to giving someone $5 to go to a Michelin-starred restaurant—that’s not going to get you very far with the final bill.
“The more that we talk about it, the more benefits managers and companies employers will hopefully get on the ball,” Kelly says.
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