Fertility Benefits Coverage: What are fertility benefits and what might they include?

Although the need for fertility benefits has long been overlooked, companies are slowly beginning to provide coverage for their employees.

Fertility or infertility benefits can range from paid time off to attend appointments, access to counselling, partial or full funding for IVF or fertility preservation procedures, at-home fertility testing kits, consultations and diagnostics. In this article, we'll outline:

• The fertility treatments that are currently available on the NHS
• How much coverage private medical insurance typically provides
• The current landscape of employer-funded fertility treatments
• Other ways employers can offer fertility benefits coverage

The most common types of fertility treatment

In the UK, several types of infertility treatment are available to help those struggling to conceive or who have received a diagnosis of infertility. Here's an overview of some of the most common fertility treatments and what each typically includes:

1. Intrauterine Insemination (IUI): Specially prepared sperm is placed directly into the woman's uterus, increasing their chances of reaching the egg.
2. In vitro fertilisation (IVF): IVF involves fertilising the egg with sperm in a laboratory dish. The resulting embryo is then transferred into the woman's uterus for implantation. IVF is recommended for a wide range of infertility issues, such as a low egg count or blocked fallopian tubes.
3. Intracytoplasmic Sperm Injection (ICSI): A variation of IVF commonly used when there are male fertility issues, ICSI entails injecting a single sperm into the egg. 
4. Egg Donation: This involves using donor eggs from another woman, fertilising them with the partner's sperm (or donor sperm), and transferring the resulting embryo into the uterus.
5. Sperm Donation: In cases where the male partner has fertility problems or there is no male partner - a same-sex couple or single parent, for example - donor sperm can be used for insemination or IVF.
6. Surrogacy: Another woman carries and gives birth to a baby on behalf of the intended parents. This may be an option if the woman cannot carry a pregnancy herself.
7. Frozen Embryo Transfer (FET): This technique involves freezing embryos from a previous IVF cycle for future use to avoid needing another retrieval. 
8. Gamete intrafallopian transfer (GIFT): Multiple eggs are collected from the ovaries and placed into a thin tube with the sperm. The gametes (both eggs and sperm) are then injected into the fallopian tubes using a surgical procedure called laparoscopy.

If you're starting fertility treatment yourself and looking more information on any of the above, we'd recommend booking a consultation with your GP, your Fertifa Patient Advisor or fertility specialist (reproductive endocrinologist), If you're a Fertifa patient, you can do this directly through the app 💜

The treatments currently available on the NHS

In the UK, the National Health Service (NHS) does provide fertility coverage for certain treatments, however, eligibility is dependent on age, sexual orientation and whereabouts you live. This is what's known as a 'postcode lottery' and access across the UK can vary dramatically from place to place.

Although the UK Government’s 2022 Women’s Health Strategy pledged to remove additional financial barriers to In-Vitro Fertilisation (IVF) for female same-sex couples in England, there are regional Integrated Care Boards (ICBs) in England that can have their own eligibility criteria. For example, some ICBs require up to 12 cycles of self-funded artificial insemination, before qualifying for NHS funded IVF.

This is far beyond what is recommended in guidelines provided by the National Institute for Health and Care Excellence (NICE). For information on what criteria are needed to qualify for NHS-funded fertility treatment in a specific region, please visit this NHS guidance page.

Here's an overview of what's available through the NHS:‍

Fertility testing

‍All patients are entitled to free initial fertility tests and genetic testing through the NHS. The NHS has also promised to cover any further diagnostic testing should you be referred to a specialist fertility clinic by your GP.

Fertility medication

‍Medications that promote ovulation such as Clomifene, Metformin and Gonadotrophin are usually available through the NHS. However, you will have to pay the £9.65 prescription charge (unless exempt).‍

Intrauterine insemination (IUI)

‍You may be eligible for IUI if:

- You cannot have vaginal intercourse

- It is not safe to have unprotected sex, for example, if you or your partner has a sexually transmitted infection (such as HIV) 

In-vitro fertilisation (IVF)

‍Although IVF is available through NHS, patients do have to meet eligibility criteria specific to where in the UK they live. However, most regions use the following guidelines set by the National Institute for Health and Care Excellence (NICE) as a basis for their criteria:

- For women under 40, three cycles of IVF treatment are offered provided the patient has been trying to conceive naturally for at least two years, or they have failed to get pregnant after 12 cycles of artificial insemination.

- For women aged 40-42, one cycle of NHS-funded IVF if:

• They meet the same criteria required for under 40s.
• Have never had IVF treatment before.
• Show no evidence of low ovarian reserve.
• Understand any potential implications of IVF and pregnancy for over 40s.

What's available using Private Health insurance

If you are struggling to conceive naturally, you may be considering private health insurance coverage for fertility treatments like IVF.

Typically, private health insurance coverage providers in the UK do not cover fertility treatment, as they deem it a "lifestyle choice" alongside procedures such as cosmetic surgery or transgender operations. Having said that, different providers do offer varying degrees of coverage as part of their health care plans. Here's an overview of some of the most common current trends:

• Many insurers will claim to "cover" IVF, but in reality only pay for initial fertility investigative testing.
• Some PMI health plans offer partial coverage for IVF treatment provided you have been a policyholder for a particular period of time. Even then, they may be selective about what they will cover.
• Others may refuse to cover any fertility-related diagnostic investigations if you've previously undergone IVF.

Due to these ambiguities, it is important to know exactly what infertility coverage is included in an insurance plan before taking out cover.

Employer-funded fertility benefits

Employees at Meta, Natwest, Lululemon, Virgin, Monzo, Bain Capital (and the list goes on!) all benefit from access to the fertility support. These employees get 24/7 access to Fertifa's clinical team, who have over 45 years of combined experience working in the fertility world, from some of the UK's best fertility clinics and hospitals.

At Fertifa, we provide employees with awareness and prevention, infertility diagnosis and treatment, financing, educational content, reimbursement services and ongoing care throughout the fertility journey.

An overview of current IVF coverage for employees in the UK

Fertility treatment benefits among companies who are not partnered with Fertifa can vary widely. Some companies offer comprehensive coverage, however, the vast majority of fertility insurance benefits offer limited to no financial contribution.

When it comes to IVF, there remains a massive gap between what employees in the UK expect, and what is currently being provided.

A recent study found that 61% of employees in the UK now expect their employer to offer at least partial coverage for IVF treatment. However, only 17% of companies currently offer this health benefit.

The need for financial support

IVF is an incredibly financially and emotionally taxing process. Given the strains, strict eligibility criteria, lack of funding and long waiting times currently seen in the NHS, the need for financial support to enable patients to go through private clinics is greater than ever. You just have to look at the stats to

• Roughly 84% of IVF patients funded the treatment themselves
• One cycle of IVF with medication/fertility drugs can cost upwards of £7,000
• Financial pressure is the leading cause of patients deciding not to complete their recommended 3 cycles
• 81% of patients considered stopping mid-treatment

Employer-sponsored health plans can be the difference in a successful fertility journey. If you would like more information on how to implement coverage for infertility treatment, book a call with a member of the Fertifa team - we are always happy to help! 

Aside from covering health care costs, how can employers offer support? 

Put a fertility policy in place

‍Creating a fertility policy is a simple and effective way of demonstrating your organisation's commitment to supporting employees with fertility issues, whether that’s now or in the future. If you would like guidance on how to draft a fertility policy, you can read our article here. At Fertifa, we have in-house experts who can help you draft a bespoke fertility policy for your employees. Remember, a fertility policy is not just a tick-box exercise, it needs to be part of a multi-faced approach to creating a supportive culture.

Manager and HR training

‍Running training programmes can be a great way for HR Teams to prepare managers for difficult conversations, and show them how to create a safe space for what is often an emotional and unpredictable time.

Reassure employees that receiving fertility treatment will not damage their careers

‍Fertility issues can put immense strain on physical, mental and financial well-being. According to a survey conducted by Fertility Network UK:

• 58% of respondents felt concerned that treatment would affect their career prospects
• 36% felt their career was damaged as a result of treatment.

It’s therefore crucial managers ensure they are reassuring employees that undergoing fertility investigations or treatment will not be detrimental to their careers. This is about creating a culture that's fully supportive of any path or journey to parenthood.

Be inclusive

‍LGBTQ+ people will likely find the road to family forming especially challenging. Be sure to show your appreciation for the heightened barriers they face and they do not feel discriminated against based on gender identity or sexual orientation. A survey of LBTQ+ women and non-binary people conducted by Stonewall and DIVA magazine found that 36% of respondents who had children had experienced barriers or challenges when starting their family.

Try to give your employees paid employment leave

‍Fertility treatment requires a considerable investment of time, often taking months to complete. Employees are still having to use their annual leave to attend appointments. Offering paid time off may become a legal requirement if the Fertility Treatment (Employment Rights) Bill is passed.

Until then, offering employees paid time off without having to take annual leave is a great way to demonstrate emotional and financial support.

Clinical support

Giving employees access to clinically-led and medical support for fertility treatment, through a company like us at Fertifa, is hugely impactful in supporting people through their fertility treatment, with very real outcomes. You can find out more about how this works here.

Will fertility coverage and benefits become standard in the UK?

Many individuals are campaigning for more companies to provide fertility benefits. Nickie Aiken MP, for example, has brought forward the Fertility Treatment Employment Rights Private Members’ Bill which, if passed by Parliament, will ensure those going through IVF are automatically entitled to paid leave for medical appointments.

Elsewhere, large organisations have already signed up to the Fertility Workplace Pledge, which asks UK employers make four commitments

1. Having accessible information

2. Building awareness in the workplace

3. Training staff on the realities of fertility treatment

4. Giving employees the right to request flexible working from day one of employment to help them pursue fertility services.

At Fertifa, we hope this trend of companies recognising the value of fertility benefits from both a business and employee well-being perspective continues, and that - with the help of greater legislation - they can become standard practice in the UK.

If you are either an employer or employee and have any concerns or queries about coverage for fertility services, your local GP or infertility specialist may be able to help. Alternatively, booking a discovery call with a member of the Fertifa team is a quick way to access specialist knowledge of the industry and to start implementing the most impactful fertility support for your employees 💜