Will family-building benefits expand in 2025?

The future of reproductive healthcare in the U.S. remains uncertain, and access to fertility treatments like IVF is no exception. But family-building solutions company WIN Fertility still believes there's room for optimism in the new year.

"There continues to be a lot of uncertainty in the political landscape within states and nationally, and we continue to monitor that very closely for many patients," says Shelly MacConnell, chief strategy officer at WIN. "I don't have an exact prediction as to what is going to happen, but these benefits continue to be very popular and very important to people."

For MacConnell, it's clear that fertility benefits are becoming increasingly common despite the overruling of Roe v. Wade opening the door for legal trouble, which Alabama providers saw firsthand last year. The Alabama Supreme Court's decision to give stored embryos used for IVF the same protections as children under their Wrongful Death of a Minor Act of 1872 brought fertility treatment to a halt before the governor added exceptions for IVF providers. 

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Yet, employers aren't backing off. In fact, 42% of U.S. employers offered fertility benefits in 2024, up from 40% in 2022, according to the International Foundation of Employee Benefit Plans. McConnell notes that industries like tech and financial services continue to lead the way in adopting and expanding family-building benefits. Among WIN's clients, there has been a 518% increase in employers who offer fertility benefits since 2020 and a 195% increase in utilization. Meanwhile, fertility preservation benefits like egg and sperm-freezing have become a big part of the conversation.

"Seventy-two percent of our clients offer fertility preservation for people who have gone through certain chemotherapy treatments or other treatments that will likely render them infertile or really diminish their fertility," says MacConnell. "And 32% of our clients offer it when it's elective — when someone wants to do it but may not have an underlying medical condition. I expect that will be higher in 2025."

Employers are also showing increasing interest in donor services, meaning when someone needs a donor egg or sperm in order to have a viable pregnancy, according to MacConnell. She also predicts that more employers will add adoption and surrogacy benefits to their offerings in 2025.

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"About 45% of our clients today offer surrogacy and adoption benefits, and that has been increasing every year — we expect it will probably be another 5% or so increase in 2025," says MacConnell. "We're seeing continued interest in [employees] having access to an equitable benefit."

Still, in the wake of rising healthcare costs, MacConnell acknowledges that there is well-earned concern around benefits expansion on limited budgets, as well as the care costs associated with pregnancy itself.

"High-risk pregnancies are escalating healthcare costs for employers," she explains. "Early intervention is key, and there's a real opportunity to work with populations to increase the health of those pregnancies and the outcomes."

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MacConnell advises employers to consider adding access to doula networks as well as nutritional support that focuses on metabolic health and insulin resistance. According to the National Institute of Health, 20% of women struggling with infertility have insulin resistance, which also causes type 2 diabetes. She stresses the importance of a maternity program that not only offers solutions but enables patients to track their symptoms so they're aware of irregularities in their health before it's too late. 

MacConnell is confident family-building benefits won't lose steam and encourages employers to look into potential solutions for their own workforce. As families become more intentional around when and how they grow, benefits that support them become not just desired but expected.

"We do see an increased focus in women preparing for pregnancy, not just once they are pregnant, but in the years preceding it," says MacConnell. "And we see employers trying to make an impact and offer meaningful benefits — having a resource to help guide you through that is increasingly important."