Fertility isn’t a private issue. Here’s what needs to change.
How the UK’s outdated workplace fertility policies and lack of inclusivity are contributing to fertility challenges and inequity.
Fertility is often framed as a personal issue but the reality is shaped by far wider structural and societal factors.
Whether it’s trying to be present at work alongside medical treatment, facing financial barriers, or navigating a complex system as an LGBTQIA+ person, our landmark new fertility report explores what needs to change in terms of workplace fertility support and inclusivity.
Navigating a fertility journey encompasses far more than medical appointments and procedures. It is often an emotional marathon, one that can place a significant strain on mental wellbeing and relationships. For some, the impact is profound. Around 15% of couples going through fertility treatment say their relationship has been damaged beyond repair.
The barriers beyond biology
While fertility is often framed as a medical issue, access to care tells a different story, and structural barriers play a significant role in shaping fertility outcomes, particularly here in the UK.
In her November 2025 Parliamentary Bill, Alice Macdonald highlighted that fewer than 10% of Integrated Care Boards currently provide the three full rounds of IVF recommended by National Institute for Health and Care Excellence, which has created what is often described as a ‘postcode lottery’, with access to treatment heavily dependent on where you live.
For many, this gap translates into significant financial pressure. In some areas, eligibility for NHS-funded treatment is restricted if either partner already has a child, regardless of whether that child lives with them. For LGBTQIA+ people and those pursuing solo parenthood, the barriers can be even higher. Only female same-sex couples can access funding in a small number of regions, leaving much of the LGBTQIA+ community without support.
The result is a system where the ability to build a family is not only shaped by biology, but by geography, policy and affordability.
“Miscarriage, infertility, diagnosis or loss can each bring a seismic sense of shock, what we call ‘reproductive trauma’. What compounds this trauma is when it’s met with silence or minimisation. People are often grieving privately while being expected to function publicly.”
Julianne Boutaleb, Perinatal Psychologist
When workplace fertility support isn’t working
Huge strides have been made in talking about and supporting mental health and menopause in the workplace. Fertility is the natural, next place to make a change.
Fertility is an everyday reality, and can’t be simply brushed off as a private issue that only exists outside of working hours. Uncertainty, hope, disappointment, grief – as well as appointments and physical side effects – are often being juggled around a demanding worklife. What’s more, in a culture that rewards resilience, it’s little wonder that it’s rare for fertility to be discussed at work.
Our survey highlights just how rarely fertility is discussed at work. Only 6% of respondents said they would feel comfortable sharing difficulties conceiving with their manager. That silence can be isolating, particularly during an already challenging time.
“This is a workforce crisis hiding in plain sight and, with the reality of a global fertility decline, it’s time for employers and policymakers to step up.”
Natalie Silverman, Fertility Matters at Work
There are also gaps in legal protection. In the UK, there is currently no statutory right to paid time off for fertility treatment, egg freezing or related appointments. Guidance from the Equality and Human Rights Commission encourages employers to respond with understanding, but this is not consistently applied.
Legal protections are also limited in the early stages of treatment, often only coming into effect after embryo transfer. This leaves many people navigating the most uncertain parts of their fertility journey without clear support. For same-sex couples, solo parents and those facing medical infertility, this can create an even more unequal experience, as treatment is often required simply for the chance to conceive.
Fertility and inclusivity: a story of inequity
Fertility journeys are deeply personal and shaped by individual circumstances, relationships and identities. Increasingly, they reflect a wider range of family structures, including LGBTQIA+ parenting, solo parenthood and donor conception.
Yet much of the current system, its education and funding is still built on the idea of a cisgender, heterosexual couple who begin trying to conceive through intercourse and only seek support when challenges arise. For those whose journeys begin differently, the path can be more complex, more costly and less clearly supported from the very beginning.
Barriers including delayed timing, lack of accessible information and uneven healthcare provision are often felt more acutely by LGBTQIA+ people and solo parents. But while fertility does not begin later for these groups, access to support often does.
In practical terms, this can mean additional financial hurdles for LGBTQIA+ people. For many, access to NHS support is unavailable or very difficult to access*. Many LGBTQIA+ people in the UK are required to self-fund treatment before becoming eligible for NHS support, sometimes covering up to twelve cycles of IUI. And that’s before the additional costs of donor gametes, storage and legal processes are factored in. These realities raise an important question about access and equity. Who is able to afford the journey to parenthood, and who is left navigating it with fewer options?
A call for cultural change
Fertility is still surrounded by silence and stigma, leaving many people to navigate fertility challenges on their own. By opening up conversations and sharing real fertility journeys, we can begin to shift that culture and create workplaces where people feel supported through the emotional realities of fertility treatment.
Fertility should not be a journey endured privately, but a shared societal issue that shapes how and when people are able to build families. It’s time for the systems shaping fertility to respond to the realities of modern life.
*Stonewall UK (2024) Access to IVF is still a postcode lottery. https://www.stonewall.org.uk/news/access-ivf-still-postcode-lottery.
To find out more about the fertility landscape in the UK today, including more about workplace fertility policies, read The Fertility Disconnect report here.
