Employers have made it a point to help employees start their families by adding benefits that include IVF, adoption, fostering and surrogacy support. But what about
Over the last few years, family-building benefit solutions provider WINFertility reported seeing a 150% increase in fertility preservation treatments — which refers to any and all clinical efforts to delay the family-building process past what used to be considered conventional. Among the different strategies and procedures they offer, they saw a 500% increase in
"Employers are starting to realize that covering family building and fertility in their benefits is good for business," says Dr. Roger Shedlin, CEO and President of WINFertility. "And that extends to fertility preservation as well."
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As of 2020, almost one in five large U.S. employers offered egg-freezing benefits to their employees, according to a recent study conducted by Mercer. That's up from only 6% in 2015. This
"Fertility preservation is amazingly empowering to employees and their partners because it puts the power of choice in their hands — it does not have to be either/or when it comes to career and family," Dr. Shedlin says. "We've talked to women, particularly over the age of 35, and those who chose to wait are generally very happy with that decision. The vast majority of them have been able to advance in their careers, in their relationships and in their lives."
Dr. Shedlin recently sat down with EBN to discuss the ins and outs of fertility preservation and what employers needs to know in order to make a successful benefit offering.
What is driving this sudden boost in fertility preservation efforts?
In many respects, it's the same factors driving the increase in the use of fertility and family- building treatments and support in general. These include demographic factors, such as delayed childbearing. According to the CDC, the average age of mothers at their first birth is now 27, which is up considerably from 21, in 1972. And in some cities like New York and San Francisco, it's even in the early 30s. And, of course, as age increases, fertility rates can drop. Another factor is that the specialty of reproductive endocrinology is actually getting better as the technology improves. In fact, the professional society of reproductive medicine considered egg freezing experimental up until 2021, then changed its status as the physicians performing the procedure got better, and as societal norms have changed. Folks didn't talk about this before. Now they do, and the more people that talk about it and see their coworkers and friends do it, the more it drives demand. You've also got an increased focus on family-building and preservation following the COVID pandemic. And then perhaps most importantly, which I've saved for last, is that this is being covered much more by employers. It's good business to do it, because it helps improve recruitment and retention for their workforces in a labor market that's still tight.
A rise in demand can trigger a lot of changes in accessibility. Are we going to see the same happen with egg-freezing efforts?
The good news is that these services are readily accessible and quite a large number of reproductive endocrinologists perform them. So from an accessibility and access perspective, there's plenty of capacity in terms of costs, unlike other medical procedures — particularly ones involving specialty drugs — where we have seen some cost inflation over time as these drugs and the services increased. But with egg freezing, that's countered by not only the fact that we're seeing more third party coverage, but like any benefit, and especially any family-building benefit, there are ways to make sure that the most efficient use of benefit dollars comes into play, and that includes helping patients navigate to the provider that's going to do the best job. Egg freezing involves harvesting a certain number of eggs that can be retrieved. It's important to go to a good provider that allows you to retrieve the necessary number of eggs that is viewed as adequate to preserve fertility in one cycle, as opposed to having to do two cycles, for example. In addition, this ensures the appropriate use of medications, as well as the appropriate cost structure of the procedures that are utilized.
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What are some of the most important things that should be considered by all participating parties — employees and employers — before getting involved in an egg- freezing process?
Cryopreservation — the technical term for these procedures — really is the good part of an IVF cycle. Instead of creating embryos, the eggs are harvested and they're frozen. But with that comes the fact that there needs to be, and should be, clinical support and education along the way so that patients know what to expect and they have support on how to do what needs to be done. The best practice is to provide resources for patients going through that process, and that can include nurse advocates as well as other experts, and even behavioral health resources to support along the way and explain the implications of this. We are ideally looking out for the best interests of the patient and the employer, so we created a benefit that's structured appropriately and that empowers the patient to utilize those benefit dollars most efficiently, and also provides the best patient experience in terms of education and emotional support.
Why is it important for employers to take stock in women's mental health in family- building processes — especially when it involves preservation methods?
That brings out the importance of how the emotional and physical needs are really tied in together. When rolling out these benefits, it is important to provide the opportunity to publicize not only their availability, but also how common these concerns are. And then in terms of the administration of the benefit, to provide clinical support in terms of nurses and behavioral support, like coaching. Those factors, as well as the promotion of discussion with other women who are going through and have been through the procedure, has led to a significant increase in the openness and the drop of any stigma whatsoever in discussion of inclusive family-building options, including fertility preservation.
