Your Practical Guide to Fertility and Workplace Support
“Fertility treatment felt like a secret second job that I was doing alone,” says Clare*, a 35-year-old marketing manager. She and her partner, Shaun*, were trying for their second child through in vitro fertilization (IVF).
Managing early-morning ultrasounds that can get booked with little notice, plus intense medication protocols, can derail a workday. The average cost of fertility treatments can also cause a huge amount of stress, ringing in at $20,000 for one cycle of IVF. (There are less expensive methods, such as intrauterine insemination, which typically costs $1,000, but experts say it is less effective than IVF.)
And then there’s the emotional toll. “I remember getting a phone call that our latest cycle had failed and immediately wiping my tears to hop on a video call for work,” says Clare.
Clare and Shaun’s story is far from rare. One in six Canadian couples will experience infertility, a number that has doubled since 1980. While every journey is unique, most involve a steep learning curve: navigating clinics, tests, paperwork, and costs — and for working parents, this is all while keeping up with the demands of a job.
For Clare, that also meant trying to keep her “second job” a secret: “I had a calendar full of appointments and medication reminders that I felt like I had to hide from some of my clients,” she says. According to data from Maven Clinic, a virtual platform dedicated to women’s and family health, around 50 per cent of women choose not to disclose their fertility journeys to their employers, fearing they’ll be taken less seriously, or face negative impacts to their career advancement.
While there’s no crystal ball that will let you know how easy or hard trying to conceive will be, knowing what resources are available to you is a critical first step. That includes understanding what supports you can expect from your workplace. “Women make up nearly half the workforce,” says Jennifer Foubert, assistant vice president and head of product and growth for group benefits at Manulife Canada. “Workplace supports, including benefits plans, need to evolve to meet their needs.”
It helps to take stock of what questions to ask — of yourself, your doctor, and your employer — so you can feel more informed, more supported, and more resilient throughout your fertility journey. Here are expert recommendations for where to start.
What to ask yourself
“Fertility is especially difficult to navigate because you don’t always know you’re going to struggle until you get started,” says Dr. Titilayo Olupona, physician lead of the executive health program at Cleveland Clinic Canada, the medical director for Manulife Canada’s Group Benefits.
Before you even set foot in a clinic, it helps to intentionally reflect on your readiness to tackle the inevitable pressures of fertility treatments — on your body, your relationship, your mental and emotional wellbeing, and your finances.
- History: Have you tracked your cycle – both length and signs of ovulation – for six months? Tracking your periods in a journal or app can help identify cycle irregularities that may be a sign of underlying issues.
- Prior tests: Have you and your partner both had proper fertility assessments? When a male-female couple are on the fertility journey, male factor infertility accounts for about 30 per cent of cases. Forty per cent of the time it’s due to female factors. (The remaining 30 per cent is a mix of male and female, or entirely unknown factors.)
- Emotional readiness: Do you have support systems in place to help manage the stress and unpredictability of treatment? Being able to lean on friends, family, a therapist or a coach can be invaluable during the journey to conceive.
- Managing work: Do you have a plan for how to navigate this journey while balancing work? It can be a lot to juggle the mental load of fertility treatments alongside a busy career.
- Financial preparedness: Can you afford treatment, and if yes, how many rounds? In 2024, 14.6 per cent more people claimed fertility drugs under their benefits plan than the year before, according to Manulife Canada aggregate claims data. Some provinces and territories offer coverage or other savings opportunities for certain fertility-related medical procedures, but there is currently no federal coverage.
"Starting the fertility journey often requires taking the time to pause, reflect, and advocate for your own needs, something that is vital for self-care,” says Dr. Olupona.
What to ask your doctor
If you’re in the early stages of trying to conceive, and unsure when to contact a clinic, Shyna Asaria, a registered nurse and fertility awareness educator for Maven, has a simple piece of advice: “If you're under 35 and you've been trying for a year, then it's time to see somebody. If you are 35 and older and you've been trying to conceive for six months, it's time to see somebody.”
Even before seeking specialized treatment, there are questions you can ask your family doctor that may help your chances of getting pregnant. And Asaria recommends doing this as soon as family planning is on the horizon. “Even if you know you're not planning to have a child until later on, it's still very important to know how your own body works, for when you are ready to try and conceive,” she says.
Here are some key questions she recommends bringing up with your family doctor:
- Pre-conception health: Are there any dietary regimens, supplements, or therapeutic treatments they'd recommend to help with conceiving? It takes anywhere from several months to a year for an ovarian follicle to mature into an ovulation-ready egg, so long-term lifestyle habits that can impact egg quality can matter, especially in the months leading up to conception or fertility interventions.
- Other health factors: If you’re having trouble conceiving, could conditions that complicate fertility like PCOS, endometriosis, irregular ovulation, or thyroid issues be at play? PCOS and endometriosis both affect about 10 per cent of women.
- Treatment options: Ask for a clear picture of success rates, costs, and side effects of IUI versus IVF, specific to your health profile.
- Mental health: Ask what you can do to protect your mental health against stress, anxiety and depression, and whether a referral is needed to access specific experts.
Asaria emphasizes the need to equip yourself with mental health support. “I usually recommend something like cognitive behavioural therapy (CBT),” she says. “This is a huge journey that you're taking, and it's really important to find a therapist, or mindfulness practices like journalling or yoga, to help deal with the stress and emotional challenges.”
What to ask at work
Fertility treatment doesn’t follow a neat nine-to-five schedule. Early-morning appointments, strict medication protocols, and last-minute procedures can be hard to reconcile with a rigid schedule. Workplace supports can make a world of difference.
“We’ve heard that Canadians generally don’t feel adequately supported by their employers when it comes to family growth,” says Foubert. That gap makes it essential to understand what’s available — and advocate for what you need. Openly talking about the challenges can also help reduce the stigma around infertility and unlock much-needed support.
With that in mind, topics to raise with HR or your manager include:
- Flexibility: Ask about increased flexibility to accommodate appointment schedules and managing off-days to support your wellbeing.
- Confidentiality: If I disclose my fertility journey, are there protections in place to ensure I won't be penalized unfairly?
- Coverage: Ask what kind of support is covered by your benefits plan. That includes asking about coverage for the cost of fertility treatments, as well as coverage for mental health counselling, which can help manage the emotional impact of fertility treatments. Your employer may also offer access to health-care practitioners who can help navigate this life stage.
Access to experts is a huge piece of the puzzle, Foubert says. It’s why Manulife Canada is now offering access to Maven Clinic as an optional program in its group benefits plans. Eligible members are able to virtually contact fertility specialists and receive guidance and advice, 24 hours a day. Foubert notes that approximately 30 per cent of people struggling to conceive, become pregnant naturally after engaging with Maven’s program.
There’s no way to take the uncertainty out of infertility, but the right questions and the right support can help you feel more in control. As Clare puts it: “Fertility treatment ties into every aspect of your life. Looking back, I can see that any way you can lighten that load — whether through workplace support, counselling, or clear medical advice — is worth exploring.”
*Names have been changed for anonymity.
The information in this article is not to be relied on for medical advice for specific situations. Individual circumstances may vary. Always speak to a medical professional for medical advice.
