Picture this: Sarah and Zach are a heterosexual couple in their late 30s, and they’re nervous about how long it will take them to get pregnant, because Sarah has friends who had to undergo treatment. Thanks to her benefit portal, she decides to talk to a fertility coordinator, who introduces her to resources such as nutrition counseling and access to a wearable ovulation tracker. Sarah gets pregnant after 3 months and, thanks to her benefits, has access to prenatal yoga. In the end, she has a healthy pregnancy and delivers a healthy baby.

In another case, Emily is a single mom by choice and wants a second child. During her first pregnancy, she needed a C-section, because the baby was breech. She assumed that, because she’d had one C-section, she would need one for her second birth. Emily used her benefits to get pregnant via intrauterine insemination using a donor. Then, after exploring her new company’s benefits, she scheduled a call with a midwife, who asked her if she wanted to attempt a vaginal delivery. Emily then worked with a doula, talked to her doctor, and changed her birth plan. She went into labor and had a vaginal birth. 

These are just two examples that Allen Niemynski, Account Executive for Enterprise Sales at the fertility and family-forming benefits platform Carrot Fertility, provided during a From Day One webinar, titled “How Fertility Benefits Can Save a Company Money.” He acknowledges that it might seem counterintuitive at first, as family forming benefits are notoriously expensive. But fertility challenges can result in frequent doctor’s appointments and medical treatments with side effects that lead to absenteeism and other expensive consequences. Fertility benefits can help lower overall costs by retaining valuable employees, helping meet DEI goals, and, by intervening early in the process with less invasive options, curbing high-cost claims. Retention always takes significant resources, as replacing and training a new employee can require six to nine months.

In fact, what would have happened without access to these benefits? Many companies would have required that Zach and Sarah try getting pregnant for one year before covering assisted reproductive technology–first, intrauterine insemination, followed by IVF (in vitro fertilization). Each round of IUI costs $4,000, while IVF costs $21,000 per round, and many people require more. Preventative care allowed Zach and Sarah to get pregnant without intervention.

In Emily’s case, C-sections increase costs; by avoiding a C-section, someone working at a self-insured company would save around $20,000–and would have a safer birth experience. Since education is still lacking, only 13.3% of women opt for a VBAC (vaginal birth after cesarean). That’s where robust pregnancy resources come in: talking to a doula reportedly reduces C-section rates when the alternative is medically safe.

Fertility benefits allow employees not to use their insurance plan to access these resources, so employers  save even more money when employees manage to grow their families without intervention thanks to preventative measures. 

Providing personalized care means, say, offering IVF if it’s right for the patient. In certain cases, though, IVF can cause more harm than good and have bad business consequences. Niemynski likens IVF to treating back pain with back surgery. “More than 66% of Carrot members selected non-invasive interventions over surgery as a first line,” he said. For example, one of the first-line resources is discounted access to an ovulation tracker, which measures five different parameters and identifies fertile windows. Here again, the need for education can come into play, as there’s a general lack of awareness that one can only conceive during a limited amount of time in a cycle.

“In the last 10 years, fertility benefits were mainly focused in the tech sector, but that’s changing,” said Niemynski. “We’re seeing industries, across all sizes, embrace fertility benefits, and it’s because we really need to. One out of eight couples experiences fertility challenges.” Historically, fertility has been a taboo subject, but people have become increasingly comfortable with sharing their personal stories. 

Male infertility is also being discussed more and more: the sperm count dropped 60% in the last 40 years. Despite the misconception that most fertility challenges lie within women, 40% of issues actually start with men. “Everybody needs the option to start the family they want,” said Niemynski. 

Carrot’s benefits extend beyond fertility strictly speaking, and Niemynski favors the phrase “family forming.” Family-forming benefits can help companies reach DEI goals by providing options to the LGBTQIA+ workforce and by boosting equity, ensuring that all employees have access to high-quality care. Supporting a diverse workforce makes smart business sense, as diverse companies experience better business outcomes.

Niemynski explains the case of Michael and Nick, a same-sex couple who want to adopt a child. Intending to adopt in the United States, they assume they’ll go through the agency route. But their benefit portal routes them to an expert, who lets them know about common costs associated with foster-to-adopt, agency, and independent options. Michael and Nick inquire about self-guided options and research platforms that operate without an agency. A self-guided route, through which the majority of costs are related to legal work, means that the couple can spend $10,000-15,000, as opposed to $30,000-60,000. They chose this option and welcomed their babies. A benefit package covering up to $20,000 for family forming would completely support this journey. Adoption-related family-forming benefits are crucial for the LGBTQIA+ workforce: 26% of same-sex couples adopt, but only one out of five companies offer adequate resources. 

In parallel to family-forming benefits, Carrot also offers resources for menopause, a natural part of aging. Since menopause is not a disease, it’s under-researched, and only 25% of OBGYN programs provide menopause training. Still, menopause has a significant impact on health. Changes in estrogen and progesterone affect the brain, the reproductive system, and other organs. These symptoms can also negatively affect life score, decrease productivity, and impair daily activities. 7% of women experience early-onset menopause, which carries the additional risks of osteoporosis, heart disease, and more. 

Take the case of Rebecca, the VP of finance at her company. At 49, she starts having hot flashes and trouble sleeping. One year later, symptoms worsen: she becomes fatigued during the work day and can’t sleep at night. Her GP says the symptoms are just a part of life. But during a work meeting that offers an overview of benefits, she learns she can find a doctor who specializes in menopause, as well as join a support group addressing the pros and cons of HRT. She starts treatment and finds that her support group is invaluable. “We estimate $10,000 in retention savings,” said Niemynski. “But for a senior leader like her, savings might be much higher.” 

There is no one-size-fits-all solution when it comes to creating a suite of family-forming benefits, but Carrot does have one rule when it comes to connecting patients with resources: “No Google,” Niemynski said. “There’s a lot of terrible information that can lead you down a dangerous rabbit hole, and that will make people invest money in places that will not help them achieve their goals.”

Editor's note: From Day One thanks our partner, Carrot Fertility, for sponsoring this webinar.