Gusto for Partners

Why Fertility Benefits Might Boost Employee Retention

Caleb Newquist Editor-at-Large, Gusto 
Let's talk about fertility blog

Workers haven’t quit quitting. More Americans quit their jobs in March 2022 than any prior month. Ever. What’s interesting is that many of those quits may be due to questions of reproductive resources.

Last year, Gusto’s economics team found that women left the workforce at higher rates than men in 2021 (4.3 percent to 3.7 percent) and a major reason was a lack of childcare. In fact, over 40 percent of working parents are considering leaving their job this year, and the burnout and stress may be just as severe among those who have not yet had kids, but are trying. According to a survey by Maven Clinic, at least four in five women experience some level of anxiety when thinking about their ability to become pregnant, and 40 percent of women with infertility experience mental health issues.

What interests me about this story — particularly the anxiety around fertility — is that it’s largely unaddressed in the narrative around why people quit. We often hear vague explanations of, “career opportunity, money, and flexibility.” But what if this is a real factor behind many of those responses?

The connection between fertility and mental health

For many, fertility challenges are existential. When that part of your life is out of balance or in question, it can alter everything. 

“Fertility can affect every aspect of someone’s life, from health and well-being to family, work, and romantic relationships,” writes Maven Clinic. And according to the National Library of Medicine, “While the infertility is not a disease, it and its treatment can affect all aspects of people’s lives, which can cause various psychological-emotional disorders or consequences including turmoil, frustration, depression, anxiety, hopelessness, guilt, and feelings of worthlessness in life.”

It’s quite an all-consuming, anxiety cocktail. And because just 15 percent of adults say they are comfortable discussing fertility in the workplace, it is effectively taboo. 

I have to imagine that many people in this situation are more comfortable citing other, less charged reasons for leaving their job — which could mean that “I need better benefits, can’t live with the low pay, and need more flexibility” could be code for, “I need to be able to cover treatments” or “reduce my stress” — a major factor in infertility. And that’s on top of the 48 percent of people who cited “childcare” as their reason for quitting in a Pew Research survey.

According to Brittany Hawkins, CEO of Elanza Wellness, a fertility coaching startup, these challenges invariably impact how people show up to work.

“It turns out more and more people are really struggling with a variety of reproductive health issues that affect every single area of their lives. For example, people struggling with the physical and mental symptoms of endometriosis miss about 16.9 percent of their work time because of the pain they’re going through. And these are all really common issues. And then you have the fact that more people are struggling with infertility than in past generations. “

And these factors compound to produce other sources of stress, like financial liabilities. 

“You have to think about the financial stress all of this causes. Not just starting a family, but, how will you pay for IVF? That can cost tens of thousands of dollars. People are taking out loans,” says Brittany. “A lot of the younger generation is actually deciding not to have kids because they’re so stressed out about various factors they feel are outside of their control, things like climate change and politics. All these things are creating this really significant pressure that is leaving a lot of people kind of just extremely stressed and confused about what to do.”

Here’s what this means for your firm and your clients: A respectable number of people are living in silent desperation, and it adversely affects their work. And also there are things you and your clients can do about it. 

Make fertility benefits a priority

At first glance, you might think it’s up to every business to decide between paying everyone on their team enough to afford their own treatments or provide fertility solutions as an express benefit. But the way some of these solutions are packaged make it an affordable add-on. And for the upside of helping folks on your team through one of the toughest challenges they will face — which may be quietly sapping their happiness and productivity — it seems worth considering.

Plus, offering these benefits can help with recruitment. While employees won’t discuss infertility at work, they are increasingly drawn to companies that offer this type of benefit. One-third of companies with over 500 employees provide such a benefit and 60 percent of women say they would opt for a company offering fertility benefits over a company that didn’t. Even Starbucks offers it to hourly employees. Though in practice, the Starbucks “benefit” is deducted from employees’ paychecks, and some have ended up in debt to the company.

60 percent of women say they would opt for a company offering fertility benefits over a company that didn’t.


One way to think about how to offer it as a benefit is to consider what employees would actually find helpful. In Starbucks’ case, it’s essentially a bribe. Luring people into a workplace with generous, but potentially dysfunctional benefits isn’t a good strategy — they’re likely to learn and leave. That’s why Elanza has focused its offerings on fertility coaching.

“We coach because the one throughline throughout a person’s entire life is their emotional health. Someone’s ability to increase their resilience and manage stress can make them a better partner, a better parent, and a better employee,” says Brittany. “People’s values have never been more important and finding ways to help them feel like you’re supporting them in whatever way necessary is really important. In our coaching program, we found that 40 percent of people were happier and less stressed, and specifically 20 percent less likely to leave their company as a result.”

Next time you’re playing people advisor, and running into issues of hiring, retention, and competitive benefits, consider that people’s stated reasons for leaving may actually be code for something deeper. Behind it, may be a desire for childcare and fertility benefits. And if that’s the deciding factor for 60 percent of women, it’s something worth considering.

Updated: June 10, 2022

Caleb Newquist
Caleb Newquist Caleb is Editor-at-Large at Gusto. In 2009, he became the founding editor of Going Concern, the one-of-a-kind voice on the accounting profession, serving in the role for 9 years. Prior to Going Concern, Caleb worked as a CPA for nearly 6 years in New York and Denver. He lives in Denver with his wife, two daughters, and two cats.

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