By Lauren A. Tetenbaum, LMSW, JD, PMH-C (Perinatal Mental Health Certified)
The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.
While struggling with infertility, is your work a welcome distraction? When your personal calendar is packed with fertility treatment appointments, reminders for your in vitro fertilization (IVF) injections, and support group gatherings, is your boss accommodating? If suffering from pregnancy loss, are you able to access a form of paid family leave? During your fertility journey, are your colleagues and/or Human Resources department providing the emotional support you need as you navigate stress, side effects, and scientific unknowns?
Hopefully your career can be a source of comfort and control when your life otherwise feels out of control and unpredictable. As a social worker specializing in supporting women through life transitions, including the perinatal and preconception periods, I work with many women whose mental health is impacted by their fertility challenges, which are unequivocally expensive and emotionally draining.
Managing your fertility journey can feel like another full-time job. And, with fertility treatments costing thousands of dollars, your income and earning potential can feel even more important to maintain to cover the expenses. Since family planning generally occurs during career-building years, how can you make your job work for you while seeking healthcare for fertility issues?
Know your needs: calendar, costs, and communication
When you’re trying to conceive (TTC) and in need of fertility care like IVF treatments, embryo transfers, or other healthcare related to medical conditions, you’re most likely going to need to attend several doctor appointments during the workday.
Dr. Taraneh Nazem, a double board-certified reproductive endocrinologist and infertility specialist and an obstetrician-gynecologist, explains: “We usually see a patient for seven visits for the stimulation and egg freezing process over a period of two weeks; if we are proceeding with embryo transfer, we’ll do an additional three. Then we’ll monitor them for about six to seven more visits if pregnant.”
The clinic appointments typically range from 30 minutes to 2 hours, according to Missy Modell, the Founder and CEO of YES MAM, who recently froze her eggs at a clinic in Manhattan. She spent thousands of dollars on clinic appointments (including monitoring, bloodwork, and ultrasounds), which she attended every or every other day for about 2 weeks. “The egg freezing process is really about a month long,” she describes, “because of the hormonal side effects and physical limitations and their impact on your schedule. You’re supposed to take off work the days of and after the retrieval, and then, if you’re like me, you can feel emotionally, physically, and mentally off your A-game for another week or so.”
While Modell manages her own schedule, she is still beholden to her clients and their deadlines. She felt the need to explain what she was going through so she could maintain expectations, as she needed to uphold her business to pay for her treatment expenses–none of which were covered by her health insurance plan.
Working with a fertility specialist or clinic that can be flexible in meeting your scheduling needs is key to your overall health, including your mental health, during this process. Many recognize that fertility treatment appointments are time-consuming during a business day in the midst of an already anxiety-provoking period.
At the clinic, Dr. Nazem and her team try their best to accommodate patients’ work schedules: “We have lots of ways to schedule in order to best support our patients and help make it possible for them to juggle work and appointments. For example, we start at 7 AM!” You may want to consider also working with a fertility coach for support, or even find a nurse who can help with virtual or at-home injections, to alleviate some of the overwhelming feelings.
When it comes to costs, consider payment plans, loans, or other financing programs as resources. It’s important to understand the full fees of the treatment and how you can afford them through your job or otherwise, so that those costs do not cause additional stress. And of course, communicate with your colleagues and clients about what you’re going through to the extent you feel comfortable.
Many of my own clients prefer not to disclose the details of their fertility issues to their employers and coworkers, and that’s okay; we work together to craft communication strategies that feel aligned with their needs and boundaries.
Prioritize your principles (and if needed, consider a change)
Fortunately, it has become increasingly common for fertility and family planning to be more openly discussed in general—and in the workplace. Many companies provide fertility-related benefits to their employees to help subsidize (if not fully cover) the cost of fertility treatments.
Fertility concierge services or programs may be available as an employee benefit. For example, programs like Stork Club are offered at a wide range of self-funded employers (with 2,500 employees or greater) in many industries, including technology, law, finance, healthcare, manufacturing, transportation, and education.
It is certainly in the best interest of both the employer and the employee to offer access to fertility treatments: research by RESOLVE: The National Infertility Association and Carrot, an evidence-based fertility care platform, reflects that 77% of millennials and Generation-Z employees would stay at their company longer if their employer offered fertility benefits, and 88% would even consider changing jobs for access to fertility benefits.
“I so appreciate how my employer supported me through coverage (three cycles via Progyny plus a $20,000 surrogacy benefit) and management understanding (including flexibility and the ability to work from home before it became mainstream),” reflects Ashley Gildin Spitzer, a Senior Enterprise Client Solutions Manager at LinkedIn and a Fertility and Surrogacy Consultant.
Financial support is not the only form of fertility-related support workplaces can provide. I once worked with a woman who experienced a miscarriage while at work. She was able to get logistical and emotional help from her colleagues, both in the moment and during the weeks and months after, making her feel less alone personally and more loyal professionally.
On the other hand, when a work environment is not supportive, it’s necessary to assert your values regarding work/life balance—for now and for when you hopefully have the child(ren) you want. “I felt like I was drowning, between attending appointments with specialists, recovering from procedures, and exploring additional options, all while responding to work demands and billable hours requirements,” recalls Alexis Cirel, a matrimonial and family attorney who experienced infertility struggles for many years as an associate. “I chose to carve out my own career path and focus on the emerging field of reproductive family law while I navigated my own reproductive healthcare needs.” She is now a mom of 2, a law partner in her group, and a recognized leader in her field, having been instrumental in the passage of the legislation legalizing gestational surrogacy in New York State.
Seek support: professional & peer
My clients, peers, and I firmly believe that a supportive workplace is imperative during this time. As Ms. Gildin Spitzer has eloquently explained: “It is essential that managers educate themselves on the prevalence of infertility and that they understand infertility is not a choice.”
Nobody chooses to struggle to get pregnant or start a family. Compassionate and empathetic managers can help to make a difficult journey just a little bit easier. And, as Leyla Bilali, Registered Nurse and founder of Fertility Together, points out, “The less stressed an employee is, the better off she will be at work. Ideally, for many reasons, a job or a boss should not be adding to the heavy mental load during this time.”
It can feel incredibly overwhelming to go through fertility challenges, so I encourage you to take care of yourself while you do so. That can mean giving yourself time and space to let the feelings flow, taking PTO or some kind of leave to process and regroup, collaborating with others on advocating for change in company policies, seeking out a support group, and/or talking to a mental health specialist. “Please don’t be afraid to ask for help and lean on people, including people you know and trust from work,” advises Modell. She has discussed her journey on her social media and podcast, Sorry for Apologizing, and says: “I think it’s important to be open.”
Indeed, the more conversations, education, and collaboration we have as a culture regarding fertility issues, the less isolated those experiencing them will feel. Therapeutic tools that can be used to overcome the anxiety often felt by those experiencing infertility or undergoing treatment include self-compassion (being kind to yourself and trying to put less pressure on yourself) and short-term strategizing (reminding yourself that this is a temporary period in the midst of a long career and focusing on getting through each day as it comes). Your career matters and your family goals matter—and so do you and your mental health.
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