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What the U.S. can teach European startups about widening access to fertility treatment

Editor’s Note: This article has been contributed by guest writer Jenny Saft.

In 2019, I decided to freeze my eggs. Having previously lived in San Francisco where egg freezing was commonplace, and often subsidised by employers, I assumed that access to fertility and family-forming services would be similar in the UK. I was wrong. My experience opened my eyes to how far Europe is lagging behind the US when it comes to access to fertility treatment.

Infertility is a widespread issue. Recent figures from the World Health Organisation show that one in six individuals will struggle with fertility during their lifetime, and a significant number will struggle with stress and mental health issues as a result. A further 69% of workers have reported that fertility issues harmed their careers. So, for startups who want to properly support staff, fertility and family-forming services should form a central part of employee benefits policies.

Delivering inclusive fertility benefits means startups can support employee well-being and improve staff loyalty, foster an inclusive workplace culture and attract top talent by offering more meaningful employee support. Sound interesting? This is what the US fertility benefits model can teach European startups about fertility.

Start by subsidising costs 

The US healthcare system revolves around private healthcare, which comes at a crippling cost to individuals. But as a result, it’s commonplace for employers to pay for health insurance packages for staff in the US, which will often include fertility support. In fact, it’s estimated that over half of US employers offer fertility support, adoption and surrogacy benefits to staff. By comparison, paying for private healthcare and fertility care for employees in Europe is the exception, rather than the rule, particularly for smaller companies. In the UK, this is largely due to the presence of the NHS. But this does not mean access to fertility care in Europe is in any way straightforward or affordable.

In the UK, NHS wait times, spiralling costs and a “postcode lottery” system are making it harder for people to access fertility treatments for free. And the picture is similarly complex across the rest of Europe: Germany refuses to grant same-sex couples and single women access to state-funded fertility care, and Ireland completely lacks funding for fertility treatment, to name just two examples. This lack of support forces many people to go private to access fertility care. But, for a significant number of people, the eye-watering cost of fertility treatment means they are unable to access the support they so desperately need (or accrue a crippling amount of debt in order to do so).

By subsidising fertility costs, companies can immediately ease the financial burden and stress associated with fertility treatments for their teams, dramatically improving the mental health and wellbeing of employees who require fertility support. It might sound expensive: but it’s important for employers to remember that not every employee will need to use the benefit. However it will have an enormous impact for those who do.

Plus, helping employees pay for fertility and family-forming services can be hugely beneficial for your employer brand, enabling you to showcase your commitment to employee health and wellbeing and demonstrating your support for staff’s concerns and priorities outside of work.

Policies must be comprehensive to be inclusive

The US market is leading the way when it comes to inclusive fertility and family-forming services. Companies like Lyft, Walmart, Zoom and Fox offer staff an extensive range of options when it comes to fertility benefits. And US fertility providers like Kindbody and Maven ensure businesses are helping companies offer a full range of services, from IVF and surrogacy to menopause and gynaecological support. The picture is vastly different in Europe. Many European company fertility policies revolve around egg freezing and IVF. While it’s important to offer these services, offering these types of treatment exclusively is not inclusive.

Startups that want to support all employees must take a leaf out of the US’s book and introduce holistic policies which cater to the needs of all staff and all types of families. This means offering a full range of fertility and family forming support including surrogacy, adoption services, fertility testing and even fertility coaching.

Sadly, in Europe, non-commercial surrogacy remains much less accessible than it is in the States: in countries like Italy, Spain and France it’s still banned. But for companies in countries where it is possible to access non-commercial surrogacy like the UK, offering surrogacy support as an employer can have a huge impact, particularly for male same-sex couples who would otherwise be unable to have a biological child. Subsidising costly adoption fees can also help support a range of workers who are dreaming of starting or growing their family.

Offering and enabling fertility treatment are two separate issues

The normalisation and widespread adoption of fertility and family-forming benefits policies in the US has also resulted in more open attitudes towards fertility issues at work. This is not to say that infertility has completely escaped the taboo label; but in general, the US’s openness towards fertility support in the workplace is much more advanced than in Europe.

It is impossible to widen access to fertility and implement inclusive fertility policies without first ensuring the company’s cultural attitudes align with that mission. Fostering inclusive attitudes to fertility by encouraging open conversations around fertility, family-forming and parenthood are key. This might involve asking staff what they want and need from a fertility policy; and making sure fertility policy information is readily accessible, and that its use is encouraged. It’s also important that the company is set up to support parents in other ways too; for example, through comprehensive and inclusive parental leave policies for new parents.

Promoting pro-fertility treatment attitudes towards work can help to ease employees’ fears that accessing treatment will negatively impact their position at work.

Taking a holistic approach to policies is key

Companies looking to learn from their US counterparts should also look at their approach to fertility and family-forming support in the round. Many US companies including Walmart and Salesforce provide counselling and therapy sessions alongside clinical fertility treatment options to help staff manage the emotional burden of fertility struggles.

Providing the infrastructure to emotionally support staff during this often challenging time ensures staff can continue to thrive both in and outside of work during their fertility journey. It also demonstrates to staff that policies are genuinely there to offer support to staff that need it – rather than being solely for optics.

Alongside mental health support, flexible working policies or “fertility leave”, which enables staff to take time off to attend appointments or for treatment side-effects, can be another great way for European startups to provide additional support to employees undergoing fertility treatment.

The US model is far from perfect (currently, only 14 states require insurance plans to cover infertility). But the US fertility industry is leading the way when it comes to building inclusive fertility and family-forming policies which improve access to fertility; and Europe is few years’ behind.

So, for startups looking to offer more inclusive, effective benefits, drawing from the successes of the US model can be a valuable tool. I’d also encourage you to look to European companies like SoundCloud and the Co-op, which are already offering fertility support to staff to widen access to fertility, protect and enhance employee wellbeing, and cultivate an inclusive culture that enables the business and its people to thrive.

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Jenny Saft
Jenny Saft
Guest writer Jenny Saft is CEO and co-founder at Apryl: a Berlin-based fertility benefits platform helping companies across Europe offer staff access to inclusive fertility and family forming services - everything from egg freezing through to adoption and IVF. She was inspired to start Apryl following her own experience of freezing her eggs. In addition to founding Apryl, Jenny is an an Angel investor, investing in early-stage startups through the Atomico Angel Programme.
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