Paid time off for fertility treatment is critical for success

Around 3.5 million people in the UK experience infertility, yet despite growing awareness, conversations about reproductive health remain too often awkward, whispered or ignored in the workplace. Many women are forced to use annual leave or sick days to hide their fertility treatment from employers, jeopardising their chances of success.

The reality is fertility treatment is a delicate balance of science, timing and biology. Every injection, scan and procedure is synchronised to the body’s precise reproductive rhythm. So, when timing is off, success rates can drop dramatically.

A woman’s egg is viable for only about 12-24 hours after ovulation, with sperm surviving for just a few days in the reproductive tract. Egg retrieval for IVF must therefore be perfectly timed to coincide with ovulation to maximise the chance of fertilisation.

Doctors closely monitor hormone levels such as oestrogen to determine the exact moment the eggs are mature enough for retrieval or insemination. A single mistimed injection or delayed appointment can mean missing the optimal window entirely.

Retrieving eggs too early may yield immature, nonviable eggs, and retrieving them too late risks spontaneous ovulation, losing the eggs before they can be collected. Similarly, transferring embryos at the wrong stage of the uterine cycle reduces the chances of successful implantation.

Timing is therefore everything in fertility treatment. One round of IVF typically involves around four to seven appointments, depending on hormone levels and follicle development, factors that can't be predicted in advance.

As a result, appointments are often arranged at the last minute, especially towards the end of the stimulation, leaving little room to book time off or simply “call in sick”. Missing even one session for monitoring or a procedure can derail the entire process, forcing patients to start again from scratch. Without the legal right to time off, an estimated 63 per cent of people resort to taking sick leave to attend appointments.

This also comes at a real cost; government research estimates UK employers are losing up to £85 billion in unpaid sick leave every year. A problem that could be significantly reduced if workplaces acknowledged the reality women face.

There is also a real emotional toll on women who are forced to navigate fertility treatment in secrecy. Macdonald claimed that some women have even faced disciplinary action as a result of taking annual leave or sick days to attend fertility appointments.

Needless to say, this added stress can undermine efforts, as women struggle to balance workplace policies with the emotional demands of fertility care.

During an already difficult emotional and physical journey, the pressure to conceal, justify, or defend their choices only compounds the strain, and elevated stress levels are known to affect the chances of conception negatively.

That’s not to say progress isn’t being made when it comes to improving workplace protections for those struggling with infertility.

The proposed Employment Rights Bill, for instance, would require employers to offer unpaid bereavement leave for miscarriages occurring before 24 weeks. Yet there is still no comparable provision for those undergoing fertility treatment, such as IVF.

Despite the significant emotional and physical toll IVF takes on many women, it continues to be legally classified as an elective procedure, in the same category as cosmetic surgery.

Of course, workplace benefits differ from company to company, but more businesses are now offering support packages that include egg-freezing and storage costs, financial support for IVF treatment, and paid leave for fertility appointments.

However, fertility care benefits should not come at the expense of robust parental leave or childcare policies. The two are not mutually exclusive; comprehensive support should cover women and couples before, during and after pregnancy.

Fertility rates in England and Wales fell to an all-time low of just 1.41 children per woman last year, marking the third consecutive annual decline. To maintain the current population, the rate needs to be upped to 2.1.

In light of this, Macdonald stressed to the government that workplace fertility support packages are also “in our own national interest”

In simple terms, Britain needs more people to have children and grow families to sustain the future workforce and the tax base that underpins the country’s economy.  Countries such as Greece, Japan, and Italy have already recognised this need and introduced laws granting leave for fertility treatment.

But without government backing, it’s unlikely Alice Macdonald’s Bill will ever become a reality in the UK.

The success of a woman’s fertility journey depends on time off, time that should no longer be hidden as annual leave or sick days. Fertility is not elective, and neither should be the right to support and time off at work.

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Dr Cesar Diaz is Chief Medical Officer at CREATE fertility.

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