How To Talk With Your Boss About Fertility Treatments

More than 400 U.S. businesses help cover the cost of fertility treatments, according to Infertility IQ. While that might sound promising if you’re one of the many people affected by infertility—infertility impacts 1 in 8 Americans—its important to understand what exactly your company policy covers, how to access those benefits and whether you need to discuss your treatments with your manager or coworkers.

It took Amy Klein, author of The Trying Game: Get Through Fertility Treatment and Get Pregnant without Losing Your Mind, nearly four years of fertility treatments to conceive her daughter. She is also a new ambassador for reConceiving Infertility, a Hadassah initiative to destigmatize infertility and promote advocacy.

Klein shares her experience working full-time while using the fertility benefits offered by her company. She also offers some advice about the potential impact of COVID-19 on fertility treatments.

Lisa Rabasca Roepe: What is the first thing an employee should do if they want to take advantage of their company’s insurance benefits for IVF or egg freezing?

Amy Klein: The first thing you need to find out is what exactly is covered. Is your insurance limited to a certain clinic or doctor or network? Are only the egg freezing and IVF procedures covered or does the policy also cover medication? Medication can run thousands of dollars extra so you’ll need to figure what is included and what isn’t. Does the coverage include egg storage and embryo storage fees? If not, how much extra will that cost?

You also want to find out if there are certain prerequisites. For example, to qualify for IVF, you might need to do a certain amount of intrauterine inseminations (IUI) first. Are people who identify as LGBTQ exempt from coverage? Does the policy include surrogacy?

You also want to figure out if there’s a cap on insurance. Some policies only cover a certain number of IVF cycles or it only covers up to certain amount of money. Basically you want to know how much out-of-pocket money you’ll be shelling out.

Rabasca Roepe: Do you need to tell your boss or HR that you are will be undergoing treatment?

Klein: You should put it in writing to HR and your boss that you are undergoing fertility treatment or IVF. As I write in my chapter on work/life/IVF balance you should just send a simple letter to HR and your boss, so you have them on the record. For instance, something simple, like, “I’m going to do fertility treatment and I may be late a few mornings a week, but it will not affect my work in any way (except I cannot travel this month.)” That way, they can’t start giving you bad reviews all of a sudden because you’re coming in late.

Keep in mind that egg freezing and IVF have erratic, unpredictable schedules, so it’s best to keep the details as vague as possible. If they ask you for a schedule, tell them you will let them know when you know.

Rabasca Roepe: What if you start missing meetings and days at work because of treatment and you still don’t want to tell your boss? Any advice on what to say to your boss?

Klein: I do think you should let them know, even if it’s the vague. You could simply said, “I have a medical situation.” Nobody wants to bother someone with a medical situation. You can always put in a few late nights and make sure that they know, despite your (non-life threatening) medical situation, you’re on top of your game. But again, I advise you to fess up. With 1 in 8 couples in America experiencing infertility – and that’s not including pregnancy loss or other reproductive problems such as surgery for fibroids or endometriosis – you’d be surprised how supportive others can be, because they definitely know someone else who has experienced this.

Rabasca Roepe: If it looks like you’re going to miss a deadline because of treatment or because you’re just too sad/depressed/stressed to get it done, how could you ask for help?

Klein: We all have ups and downs in our productivity and life. Maybe you could get a colleague on board to cover for you or help you out. You can offer to pick up the slack for him/or her later. The likelihood is that you are covered under the ADA, since infertility is a disability. So talk to HR about what insurance coverage is – is it only monetary or does it include time off for treatment? The more vocal you are, the more you are helping advocate for others in the company.

Rabasca Roepe: If you decide to tell your boss about undergoing treatment, how can you set expectations about how much information you’re willing to share with coworkers and even with your boss about your progress?

Klein: I would suggest you ask the boss to keep it between the two of you, and if there’s a necessity to update the team, you can frame it as a medical issue or that you’re undergoing medical tests. If you decide to tell people you’re doing fertility treatment—and there’s absolutely no shame in that!—you can use my favorite line, “I’ll let you know if there’s something you need to know.” I didn’t want to be their teacher about fertility treatment and all things IVF.

Rabasca Roepe: What is the biggest misconception that managers and employees have about fertility treatments?

Klein: Managers and employees may worry its making you crazy or distracted but that wasn’t my experience. As an editor (who often covers for others on leave), I personally loved having an office to go to while I was doing treatment. I loved focusing on the work, focusing on the tasks at hand, not having to think about my body or my eggs or what was happening inside my body or upcoming appointments. I think it made me more focused! If a company is offering fertility benefits – and even paid family leave – and wants to be considered a family-friendly company, this is something that is part of that. I think most people don’t understand that fertility treatments affect women and men. I think it would help people to know that even with coverage, which helps takes off a big financial burden, it’s a very emotional process, and can be disappointing and dispiriting. But it’s important to keep up the rest of your life – especially work.

Rabasca Roepe: How Has COVID-19 Impacted Fertility Treatments?

Klein: Many clinics have been closed during March and April. Although most are starting to open up, they want to limit visits for patients, especially in infected areas like New York and New Jersey. CCRM, for example, a network of 11 centers in North America, pioneered a One-Day Workup Program so you can get everything done at once (sometimes it takes multiple visits). I think the hardest thing right now in delaying fertility or not having the kid you want is watching everyone online complain about their kids while you desperately want one.

Rabasca Roepe: What is the biggest misconception that people using fertility treatments have about the process?

Klein: I think that people just think it works. Just today, I heard a 30-year-old say, “I’m not going to freeze my eggs, I’ll just do IVF in the future if I don’t get pregnant naturally.” IVF is far from a guarantee! I thought IVF meant you’re using science and technology to create a baby. I did not know that it would take me almost ten doctors, nine rounds of IVF in three countries over four years (not to mention four miscarriages) to get that baby. Hopefully most people’s stories will be faster and less painful than mine – but it’s not always an easy process.

Rabasca Roepe: It took you nearly four years to have your daughter. What advice would you give someone going through fertility treatments now and feeling like it will never happen for them?

Klein: When you’re going through something – anything — you don’t know how it will end. My husband used to always say, “keep your eye on the ball,” meaning having a baby. That kid is now 4 ½, finally older than the amount of time I was trying to conceive her. When you’re going through fertility treatments, it’s important to take care of yourself. If that means focusing more on work, then go for it. If that means getting rid of nonessential duties, than go for it. One doctor once said, “This is a war and you’re going to need all your ammunition.” For me that meant taking care of myself the best way I knew how. Gather your friends, focus on the good things in your life and get your body and life ready for a baby – whenever he or she will come!