Fertility is becoming a workplace issue but employer support can create winners and losers
- Written by Krystal Wilkinson, Reader (Associate Professor) in Human Resource Management, Manchester Metropolitan University
Since the world’s first human baby was born by in vitro fertilisation (IVF) in the UK in 1978, over 10 million IVF babies have been born globally[1]. Assisted reproductive technologies (ART) have also become even more sophisticated[2], now including egg-freezing and intracytoplasmic sperm injection (ICSI).
But alongside these new fertility possibilities, the technology has also brought challenges. Access to publicly funded fertility treatment is not universal, and success rates are limited. This means many people globally are forced to pay privately – if they can afford it – often for multiple cycles of treatment. This can equate to tens of thousands of pounds[3].
For some, it might also mean travel overseas. Inequalities in access and care in the UK have been linked to factors such as patient sexual orientation[4], ethnicity[5], age and weight.
Infertility is a disease of the reproductive system affecting one in six people, or around 17.5% of the global adult population[6], according to the World Health Organization.
When policies are in place, they are not always inclusive of all employees and all fertility journeys. Our research[16] shows policies often neglect partners and non-normative families (same-sex couples and those pursuing motherhood alone). They often focus on a set number of days off for treatment cycle(s). This may not be sufficient and also fails to consider the needs of staff where treatment is unsuccessful.
And even when employees can access fertility treatments via progressive employment provisions, they often end up being penalised via discrimination or negative career consequences[17]. We found this during a study in which participants reported having to go part-time, switch career focus, leave jobs, or were just generally disadvantaged at work after embarking on a fertility journey.
Similar findings have been reported in international studies and surveys by campaign groups such as Fertility Matters at Work[18] and Pregnant then Screwed[19]. Since women are most likely to experience these negative career consequences, this means increased take-up of fertility treatment could further existing gendered inequalities in the workplace.
A more equitable future
To fully optimise the hope created by ARTs, governments around the world should expand publicly funded provisions as much as possible (bearing in mind other healthcare commitments) and ensure equitable access and care. Employment legislation should also protect workers from discrimination on the grounds of accessing ARTs and allow suitable time off.
There is some hope. The UK parliament is currently considering a private members’ bill[20] to allow people to take time off work for appointments and treatment, but unfortunately it hasn’t made much progress to date.
A few other countries have already taken action[21], however. Malta legislates for 100 hours’ paid IVF leave (per cycle, up to three cycles) split between the “receiving person” and their partner. Korea provides three days’ leave per year (one paid) and protection from discrimination. Japan has also introduced provisions for public workers.
Other recent UK developments include workplace guides[22] from professional body The Chartered Institute of Personnel and Development (CIPD) and government funding[23] for charities to develop resources aimed at small and medium-sized enterprises (SMEs). These are welcome.
But until the government can step up to provide universal cover, organisations should not think of fertility benefits strictly in terms of a cost-benefit calculation. Employers must take a compassionate and fully inclusive approach to supporting their employees’ fertility journeys.
References
- ^ born globally (www.eshre.eu)
- ^ become even more sophisticated (www.wiley.com)
- ^ tens of thousands of pounds (www.fertilityclinicsabroad.com)
- ^ sexual orientation (eprints.lse.ac.uk)
- ^ ethnicity (pubmed.ncbi.nlm.nih.gov)
- ^ 17.5% of the global adult population (www.who.int)
- ^ Women’s Health Matters (theconversation.com)
- ^ Five old contraception methods that show why the pill was a medical breakthrough (theconversation.com)
- ^ The orgasm gap and why women climax less than men (theconversation.com)
- ^ Science experiments traditionally only used male mice – here’s why that’s a problem for women’s health (theconversation.com)
- ^ psychological and social tolls (www.ncbi.nlm.nih.gov)
- ^ delayed childbearing (www.theguardian.com)
- ^ 2022 survey (www.cipd.org)
- ^ employer interest (journals.sagepub.com)
- ^ Research on this issue (www.researchgate.net)
- ^ research (www.mmu.ac.uk)
- ^ negative career consequences (onlinelibrary.wiley.com)
- ^ Fertility Matters at Work (fertilitymattersatwork.com)
- ^ Pregnant then Screwed (pregnantthenscrewed.com)
- ^ private members’ bill (bills.parliament.uk)
- ^ already taken action (ub-deposit.fernuni-hagen.de)
- ^ guides (www.cipd.org)
- ^ government funding (healthcareandprotection.com)
