Harvard Business review

Navigating Work While Undergoing Fertility Treatments

In this follow-up to their previous HBR article, “Employers, It’s Time to Talk About Infertility,” authors Serena G. Sohrab and Nada Basir offer research-based advice for women navigating their fertility issues and their careers simultaneously. In their forthcoming research, they interviewed 40 professional women who had recently gone through fertility treatments while they worked full time. Drawing on their experiences of what made things harder as well as what helped them, they offer guidance for handling three major challenges: managing appointments, deciding whether or not to disclose (and how), and managing career moves.

One in eight women of reproductive age face difficulty in conceiving or carrying a pregnancy to full term, which makes infertility as common as breast cancer and more common than type 2 diabetes. Women — and their employers — have historically had limited resources for dealing with the countless challenges that infertility creates for them at work. We seek to change that by supporting women’s ability to navigate their fertility issues and their careers simultaneously.

In a previous HBR article, we shared resources for managers who wish to better support their employees through this phase of their lives. Here, we focus on women going through fertility treatments and offer research-based advice on how to better cope.

In our forthcoming research, we interviewed 40 professional women — some of whom are quoted here — who had recently gone through fertility treatments while they worked full time. Drawing on their experiences of what made things harder as well as what helped them, we offer guidance for handling three major challenges that anyone experiencing fertility issues may face.

Managing Appointments

Fertility treatments require you to go into the clinic every other day, if not every day…So when the workday was expected to start at 7 a.m. and I had to be at the clinic at 7 a.m., I had to juggle my team and three or four meetings. It meant reorganizing my whole day. It meant coming in around 10:00. And it truly felt like the walk of shame.

Beyond the physical and emotional toll of fertility treatments, the time commitment and inflexible nature of appointments can present significant challenges for patients. Fertility treatment involves frequent and unpredictable visits to the clinic, including (but not limited to) early-morning monitoring sessions that involve bloodwork, ultrasounds, and consultations with a nurse. A patient usually gets a call a few hours after with instructions for medication and when they need to come in again, which could be as soon as the next morning.

Our research showed that the following steps can help you navigate these appointments while working:

  • Block off early mornings. If you have flexibility around the scheduling of your meetings, try to schedule them after 10 AM, particularly on days when you anticipate going in for morning monitoring.
  • Choose the right clinic. If possible, choose a clinic that’s not too far from your office or home office. A long commute to the clinic is the last thing you need during this process. Also, many people look for clinics that start early in the morning and are willing to accommodate their work schedules. While it may be difficult to ask around for recommendations, quick calls to the clinics to get a feel for how they operate before deciding on one can be helpful.
  • Work from home if you can. Many women we talked to shared that the switch to working from home during the pandemic made it easier to manage treatments while working, as it reduced the visibility of their absences. Some women said they were able to get work done, or even join meetings, while at the clinic.
  • Find an ally. A supportive manager or teammate you can confide in can be an invaluable asset. For example, after months of struggling with managing her treatments, Anita,* a senior consultant at a technology company, disclosed to her manager, who turned out to be extremely supportive. One month, a business trip overlapped with her IVF cycle. Once her manager learned about the conflict, he quickly found someone to take Anita’s place. Similarly, Samantha,* an occupational health and safety specialist who had told a teammate about her treatment, was able to ask him to cover a training workshop that was scheduled on her egg retrieval day.

Reach out to people in your organization whom you know will support you and seek their guidance and help. They may share strategies for dealing with challenges or advocate for you if needed.

To Disclose or Not to Disclose

I felt like I had to say something to say that this wasn’t me taking advantage of a system. This is me actually going through like a medical thing…So there was a point, a tipping point where I felt like I had to speak up and say that I’m going through something.

Whether to share with your manager or coworkers that you’re going through fertility treatments is an important decision to make, as there are benefits and drawbacks to disclosure. Some women don’t disclose out of fear of negative career repercussions, such as being judged as less committed to their job or being left out of promotion or growth opportunities. Others view it as a private matter and prefer not to bring their personal struggles into the workplace.

These concerns vary from person to person, as do the potential benefits of disclosing. The decision is very personal, and you need to assess its overall benefit in the context of your unique life and work setting. The important thing to remember is that you are in charge of the disclosure decision, and you can decide who needs to know about your situation and how much they need to know. When thinking about disclosing your fertility treatment at work, consider the following questions:

  • What do you wish to gain from disclosing your treatments? Are you looking for support in managing the appointments and missed work? Or are you worried that your manager may think you’ve become disengaged or are looking for another job and feel the need to offer an explanation?
  • What are the potential impacts of disclosure on your career? Do you anticipate that knowledge of your parenthood intentions will influence your inclusion in growth opportunities, such as promotions or involvement in high-visibility projects? Do you expect that management would consciously or unconsciously exclude you from growth-accelerating projects if they knew?
  • How supportive do you expect your manager or coworkers to be? Do you think they’ll understand your situation and offer accommodation? Or are you unsure of how they’ll react? How family-friendly is your organization and your manager?

Considering those questions can help inform your disclosure strategy. For example, if you need support with managing appointments but have reason to believe that knowledge of your parenthood intention could negatively impact your career and you don’t anticipate that your manager would be supportive, we recommend keeping the disclosure vague. Explain that you’re dealing with a medical situation that creates some uncertainty in your schedule, and work with your manager to find a proper arrangement.

If you do decide to disclose your fertility treatments, here’s how to lead the conversation with your manager:

  • State your objective. You may simply want to share because you want to lighten the burden of the secrecy or explain the frequent absences. In that case, you can simply clarify that you mostly want the manager to be aware of your situation. If you need support with scheduling flexibility, travel plans, or other aspects of your job, discuss that with your manager and work with them to come up with a plan that works best for you and the team.
  • Clarify the uncertainty of the treatment. Many managers may not be aware of the uncertainty when it comes to the outcome of fertility treatments and how long the process can take. Hence, a manager may assume that an employee going through fertility treatment will shortly go on parental leave and plan according to that optimistic scenario. They may assume you’re not interested in getting involved in long-term projects or high-demand positions. It’s essential that you take this opportunity to inform your manager about the long-term uncertainty around fertility treatments and clarify that the treatment is an unpredictable, and potentially lengthy, process. If you do not intend to take a backseat, be explicit about that.
  • Be ready to answer some questions. Keep in mind that most managers don’t receive any training around supporting employees who experience infertility. Yours may not be familiar with the process and might have questions about the implications for them and the rest of your team. As much as possible, create room for a two-way conversation.

Managing Career Moves

I have a lot of friends who have left and gone to other companies who have said, ‘We would love for you to come here; this is a perfect role for you.’ And I’m just like, it’s not the right time. In my head, I’m thinking I do not feel comfortable leaving right now and going somewhere new. So, I have this weird battle where it’s like, a) I don’t want to go somewhere new and have to earn credibility so that I can be flexible for fertility treatments, or b) I don’t want to start somewhere then instantly be pregnant and need maternity leave. Because that also doesn’t feel like an appropriate thing to do to a new company.

In addition to the day-to-day hardship of balancing fertility treatments and work, the treatments may pose long-term challenges in terms of career moves. While pregnancy has a relatively clear timeline — a nine-month pregnancy and a set period of parental leave — one of the biggest challenges with fertility treatment is the uncertainty about the duration. This can make career planning very difficult, leaving many women at a standstill as they hesitate to pursue growth opportunities. Many women we spoke to stayed in their same roles for various reasons, including wanting to stay with a supportive manager, the additional stress of taking on a new position or joining a new company, or feeling guilty about committing to something new only to have to step away if they were to conceive.

While there’s no magic solution to this problem, it’s important to be mindful of the impact the process may have on your career. Similar to the decision around disclosure, assess your thinking around career decisions and why you may be holding back on opportunities that come up at work. For example, if you’re worried that a particular career move may add additional stress, then it may not be the right time to take on the new position or project.

However, holding back on career opportunities in anticipation of potentially getting pregnant can be suboptimal given the uncertainty around treatment length and outcome. While many of the women we spoke to stayed with their current organizations throughout their treatment, even when they didn’t feel they were supported, there were others who did not hold back from pursuing career opportunities with their current employer or other organizations. Some of these women specifically asked about benefits and flexibility around treatments when searching for a new role, ensuring that they were joining a supportive environment.

* * *

The journey to conceive looks different for everyone. What has worked for one person won’t necessarily work for another. Navigating fertility treatments and work can be especially challenging. As one woman told us, it’s like “walking across coals” and “up a mountain.” But with the right kind of support, it doesn’t have to feel this way. Be gentle with yourself, recognize the immense impact of this treatment on your life and well-being, and reach out for support, whether that’s to a friend, a trusted coworker, or one of the many online support groups.

* Real names have been changed.

Editor’s Note: In this piece, we specifically refer to women experiencing fertility issues, as all of the individuals the authors spoke to identify as women. The guidance here could apply to any person experiencing fertility issues.

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