Fertility Benefits in the Workplace: A Growing Trend Amid Rising Costs and Shifting Priorities

Employers across the U.S. are increasingly offering fertility benefits, driven by state mandates and a desire to attract and retain talent. According to a 2025 survey by the Kaiser Family Foundation (KFF), 67% of insured workers are covered by self-funded health plans exempt from state infertility insurance laws, yet 50% of large employers now provide IVF coverage, up from 27% in 2020, according to Mercer. This shift reflects a broader trend as workers demand more support for family planning.

Why Are Fertility Benefits Expanding?

Fertility benefits are expanding due to two primary factors: state-level mandates and employer-driven strategies. As of 2024, 14 states and Washington, D.C., require at least some employer health plans to cover IVF, according to RESOLVE: The National Infertility and Family Building Association. California, New Jersey, and New York have broadened their mandates since 2020. However, self-funded employers—those bearing financial risk for medical claims—are exempt from these rules, leaving many workers without coverage.

Employers are also voluntarily adding fertility benefits to remain competitive. A 2026 survey by the International Foundation of Employee Benefit Plans (IFEBP) found 30% of employers cover IVF, up from 14% a decade ago. Companies like Carrot Fertility, which partners with over 1,000 employers, including Forbes, offer tailored solutions to manage costs. “Every IVF cycle avoided saves approximately $30,000 for the employer,” said Carrot CEO Tammy Sun, emphasizing cost control as a key selling point.

How Do State Mandates Affect Coverage?

State mandates vary widely. While 50 states and D.C. have some form of infertility insurance laws, only 14 require IVF coverage. These mandates often exclude small employers, who are more likely to face state insurance mandates. For example, New Jersey’s law covers IVF but excludes businesses with fewer than 50 employees. Meanwhile, self-funded plans, which account for 67% of insured workers, are not bound by state rules, leaving gaps in coverage.

The Trump administration’s 2024 proposal to allow employers to offer limited fertility coverage as a pre-tax benefit has further complicated the landscape. The Department of Labor’s proposal would cap lifetime benefits at $120,000 and exclude elective egg freezing, aiming to balance cost control with access.

What Are the Costs and Challenges?

IVF remains expensive, with the average single cycle costing $23,474, according to the American Society for Reproductive Medicine. Even with insurance, out-of-pocket expenses can be significant. Jaclyn and Dustin Glass, a New Jersey couple, paid $8,000 for two IVF cycles, a fraction of the national average. However, many workers face higher costs. Egg freezing, which costs around $16,000 per cycle, is now covered by 18% of employers, up from 2% a decade ago, according to IFEBP.

Rising healthcare costs are prompting some employers to cap fertility benefits. Mercer reports 54% of large employers with IVF coverage impose lifetime dollar limits, with a median of $20,000. Others restrict the number of covered cycles, typically to three. Despite these limits, demand remains high: the CDC recorded 98,289 births via assistive reproductive technology in 2022, up 45% from 2013.

How Do Employers Balance Costs and Employee Needs?

Employers are adopting strategies to balance costs and employee needs. Platforms like Carrot Fertility and Maven Clinic offer preventive care, such as metabolic health programs, to reduce the need for IVF. “Early interventions can lower costs and improve outcomes,” said Dr. Neel Shah, chief medical officer at Maven Clinic. “It’s about providing a comprehensive approach to fertility care.”

However, some employers are scaling back. Deloitte recently cut parent leave and adoption stipends for non-core staff, citing a need to “modernize talent architecture.” Yet, experts argue that fertility benefits remain critical for retaining talent. “A reproductive-age workforce is essential for business growth,” Shah said. “Without these benefits, companies risk losing top talent.”

What Can Workers Do to Advocate for Coverage?

Workers seeking fertility benefits should start by understanding their employer’s plan type. Fully insured plans must follow state mandates, while self-funded plans are exempt. Tools like RESOLVE’s state tracker can help identify local requirements. Employees are advised to:

• Partner with colleagues to build collective demand for coverage.
• Frame fertility benefits as a workforce issue, not a personal one.
• Explore alternatives like fertility counseling or adoption assistance if IVF coverage is unavailable.

As the U.S. birth rate declines—except among older mothers—fertility benefits are becoming a key factor in workplace competitiveness. With no federal mandate, the future of coverage