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Rachel and her partner want to start a family, but have been told they cannot conceive naturally. Like tens of thousands of other couples in the UK each year, they are now embarking on fertility treatment.

Yet as Rachel grapples with the uncertainty of medical procedures and tests, she faces an additional pressure: possible disciplinary action by her employer, the local council where she is a health worker.

After informing her manager she was beginning treatment, Rachel was told she would not be allowed time off: “It’s not in the company policy.” Instead, she has been taking sick and unpaid leave — prompting a warning even before her most intensive treatments begin.

“The more regular my appointments are, the more difficult it’s going to be,” she says. “It’s such a long waiting list to even get on to fertility treatment that I don’t want to fall at the final hurdle. But if I don’t have a job, I wouldn’t be able to have a baby anyway. It’s Catch 22.”

More than 10mn babies have been born using IVF since the treatment was first used in 1978. Yet while pregnancy is a protected characteristic under UK equality law, receiving treatment to conceive is not and lacks the protected status of antenatal care. The same is true worldwide, with only a handful of countries — Japan, Malta and South Korea — introducing progressive policies on fertility at work.

A survey by reproductive healthcare provider Fertifa and UK charity Fertility Network UK (FNUK) found that almost one in five people in treatment ended up leaving their jobs as they were struggling to balance the two. This “is sadly not surprising” says FNUK’s Claire Heuclin especially given employers’ limited understanding of the links between fertility treatment and mental health. “People often find themselves unable to manage . . . For many, quitting their jobs or changing roles is the only option to maintain their own mental wellbeing.”

Now, as companies globally introduce reproductive healthcare policies — from time off work to egg freezing to funding for IVF — the tide may be changing.

In the UK, Conservative MP Nickie Aiken is among those pushing for legislative change, including ensuring paid time off for fertility appointments and protection from discrimination. However, with the UK’s coming general election barring any new policy, she is setting her sights on a voluntary “fertility workplace pledge” in which employers commit to supporting staff to work flexibly around appointments and to train line managers about fertility.

“It just keeps the subject out there,” says Aiken. “It’s just about lifting the taboo, lifting the secrecy, giving women the support and the space they need.” If employers “embrace” the changes, she believes retention will improve.

Big employers including Bain Capital, Unilever, Apple and Google are among the companies starting to offer fertility policies, often even including financial support for treatment.

In the UK, requests from employees prompted insurer Zurich to adopt a suite of refreshed family policies in 2019, including surrounding fertility treatment. Staff can now take eight days of paid leave for each cycle of fertility treatment, for two cycles. Steve Collinson, head of people, says prospective employees refer to Zurich’s family-friendly policies “all the time”. The policies “help us to attract people who might not have been interested in a career in financial services or insurance [and] to keep hold of people.”

In Fertifa’s survey, 78 per cent of participants said fertility support was “very important” when considering a new job. Laura-Rose Thorogood, founder of support group LGBT Mummies, echoes this: “People are looking at the long term and seeing this as a monumental journey that they’re going to go on, so they will move.”

This, however, depends on workers being able to change job. Krystal Wilkinson, a reader in human resources at Manchester Metropolitan University who has researched fertility benefits, says without legislation only a lucky few are supported to balance work and treatment. “You’re very much at the mercy of: is this an understanding, compassionate manager?” Parents who do not give birth, but still go through treatment with their partner, are also often overlooked. “A lot of people come to us and say, I’m not the gestational mum . . . So I’m having to miss out on scans, [egg] transfers, collections,” says Thorogood.

So while some highly-valued staff in progressive companies now enjoy benefits and flexibility around fertility, Wilkinson says the experience of workers such as Rachel is still common. “Some people are supported to have kids, and some aren’t.”

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