USC

Employer coverage of reproductive health could help destigmatize infertility

American companies have an opportunity to influence the conversation around infertility

Three times a week, Laura Cullinan would show up at the doctor’s office before going to work at her law firm in Chicago, hoping to get her blood drawn and ultrasound done quickly to make her morning meetings. Later, she would sneak into the bathroom at work with needles to inject herself with blood thinners. She was on her eighth round of in-vitro fertilization (IVF) and she couldn’t talk about it with anyone.

“It was such a private sadness,” she said. “And that was almost harder than anything.”

What she didn’t realize was that one in eight couples in the U.S. are battling infertility.

As women wait longer to have children and cultural, child-rearing standards shift, infertility, defined by medical experts as not achieving pregnancy after a year of unprotected sex, has affected an increasing number of American families.

The need for assisted reproductive technologies (ART), like IVF and intracytoplasmic sperm injection (ICSI), has fueled a global fertility services market that is expected to grow from $18.4 billion in 2020 to $28.2 billion by 2025, making it one of the fastest growing industries in the U.S., according to Allied Market Research.

However, American companies are behind the curve when it comes to offering medical benefits that cover their employees’ reproductive health struggles. While there are over 400 companies in the U.S. covering the cost of IVF treatments, according to Fertility IQ, 71% of patients paid for most or all of their IVF treatment out of pocket.

Part of the reason for this is that the intensely personal nature of the topic has kept it shielded from public discourse.

“You are more likely to talk about cancer in your family than you are to talk about infertility in your family,” said Dr. Khaled Kteily, founder and CEO of Legacy, a company working to destigmatize the conversation around fertility. “There’s a lot of stigma. There’s a lot of shame.”

Yet, according to Kteily, companies are in a unique position to bring positive change to what some leading health experts have described as one of the most pressing public health issues of our time.

“If you make this affordable or even free, if you make this convenient where you can do it from your home, this will be a no-brainer,” Kteily said.

Cullinan agreed that “the awareness and the ability to talk about it and to have it not be stigmatized” especially in the workplace, would help alleviate some of the hardest aspects of dealing with infertility – the secrecy.

After four years of either being pregnant, or trying to get pregnant, Cullinan can’t help but think about the families that were not as fortunate as her.

“We just feel so crazy lucky we have children, it’s a miracle,” she said.

Every round of IVF can cost up to $20,000 and it is highly likely that it will require multiple rounds to be effective. Laura’s eight unsuccessful rounds of IVF racked up a hospital bill of $100,000.

She was able to get most of it covered with her private insurance, but not everyone is as fortunate.

“I just can’t stop thinking about the people that don’t have this covered,” Cullinan said.  “No one can afford that.”