We’re heading into a Canadian fertility crisis… And it’s not just a women’s problem.
The state of the Canadian fertility market and case for employer-sponsored benefits
I’d like to start by heavily emphasizing what should be obvious but oftentimes isn’t; reproductive health and fertility is not niche nor is it a women’s problem. It’s everyone’s problem.
This is important to understand to properly assess the gap in benefits coverage and the lens through which we should look at better supporting our population of people who are struggling to get access to treatment. But let's start with where we stand as a population.
Are we witnessing a decline in childbirth?
We are having fewer children, and some of us are having none at all. In 2022, Statistics Canada reported that Canada registered its lowest fertility rate, 1.33 children per woman down from 1.4 in 2021 and 1.6 in 2015.
The factors contributing to this decline are multi-faceted. Some attribute it to a desire to have fewer children, coupled with the pursuit of various personal goals such as financial stability, finding a life partner, or ensuring strong mental health. To make things more difficult, we are living in a world filled with economic and inflationary pressures and escalating living costs, forcing individuals into dual-income scenarios just to make ends meet.
The consequence often results in delayed family-building, a price paid to secure education, climb the corporate ladder, establish stable relationships, and achieve financial security. Individuals and couples are therefore older when they ultimately decide to grow their families.
While you can’t turn a blind eye to the world we live in today and the financial pressure that exists, another issue is emerging - the rapid increase of infertility rates.
Why is infertility on the rise?
In April of 2023, the World Health Organization (WHO) dropped a startling statistic that 1 in 6 people are affected by infertility at some point in their lives. While this might be surprising to some, those in their childbearing years, whether currently struggling or having experienced fertility treatments, are intimately acquainted with this challenging journey or have friends or family members going through it. However, this statistic tends to overlook the struggles faced by LGBTQ2S+ individuals and couples, and single parents by choice, who often encounter systemic challenges in accessing medical support for family-building.
There is no one reason driving increased infertility rates, but would attribute factors such as:
As a population, we’re having children later in life and running up against the biological clock.
Lifestyle factors such as obesity rates, higher intake of processed foods, more sedentary lifestyles.
Environmental factors such as air pollution, microplastics, industrial chemicals, etc.
What we know is that women are born with a finite amount of eggs - and this number depletes as we age. This reality becomes especially evident as one navigates the typical career trajectory - the biological and career clock work in completely opposite directions. We find ourselves in demanding careers in our mid-30s, which directly intersects with our optimal fertility window. While women are born with a finite number of eggs, men continually regenerate sperm every three months. Simple lifestyle changes can significantly impact one's fertility prospects, yet a notable obstacle remains - a lack of basic education surrounding fertility.
And we’re now learning that nearly 50% of infertility cases are male factor related. One-third of the time infertility is attributed to the woman, one-third to the male and one-third its ‘unexplained’, so it nets out to be a 50/50 split male to female. Despite the even split, women tend to bear the disproportionate burden of treatment. In some cases that means undergoing invasive procedures.
There are a lot of opportunities in both women’s and men’s health to address these gaps. At Sprout Family we’re focused on two things first: education and financial access.
Family-building treatments are financially out of reach for many
First, fertility treatments like preservation (egg, sperm, embryo freezing), in vitro fertilization (IVF), and intrauterine insemination (IUI) provide hope to individuals and couples struggling with infertility. But, despite the promising outcomes, they come with a hefty price tag that some simply can’t afford. In other cases, individuals make difficult financial decisions such as redirecting down payment savings towards fertility treatment, forgoing vacations for extended periods to accumulate funds, considering personal lines of credit or even taking on a second job to cover the cost of treatment. Under all of these scenarios, the outcomes are not certain which further exacerbates stress and anxiety during the process.
Second, surrogacy is oftentimes misunderstood particularly in the Canadian context. Despite domestic surrogacy being altruistic - there are significant costs associated with the journey. Expenses range from agency fees ($5-$20k), legal fees ($5-$8k), and surrogate mother reimbursable expenses such as travel, food, accommodations, daycare, etc. ($13k-$25k). On top of this, individuals need to pay for IVF, associated medications, and potentially donor sperm, eggs, or embryos. The entire journey puts you anywhere between $35k and $75k.
And finally, adoption. There are choices to be made whether you want to adopt through the private or public system within Canada or go internationally. While costs vary across these options, individuals can anticipate being out of pocket by $10k+ once they bring their adopted child home.
There is a significant opportunity to improve family-building in the workplace
Mapol Inc. and Organon Canada collaborated on a report examining the state of fertility benefits in Canada. 1,000 benefit plans were reviewed, revealing a significant gap in coverage - a staggering 53% of employers provided no fertility coverage whatsoever.
Among the 47% of employers that did offer fertility benefits, less than 2% of these plans covered both essential components - drugs and treatment costs including procedures like IVF, sperm and egg freezing, diagnostic testing, surrogacy, or adoption support. This prevalent misunderstanding leads both employers and employees to believe they have comprehensive fertility coverage, only to realize its limitations when utilized.
While drug coverage is undoubtedly beneficial, it falls significantly short of addressing the total cost of care when, for example, you are going through a round of IVF which could cost $20,000+, or surrogacy which could exceed $30,000. These costs end up being financially unattainable for considerable portions of employee populations.
Considerations as you start to explore family-building solutions for the workplace
Access to comprehensive family-building care, covering all pathways to parenthood (fertility preservation like egg freezing, IVF, adoption, surrogacy), is no longer considered a nice-to-have insurance option - but a critical necessity for companies to support their teams.
To individuals - I encourage you to be vocal advocates for yourselves and your colleagues. It's essential to engage with your leaders and HR teams responsible for shaping a workplace culture. Everyone deserves the chance at parenthood, and accessing the necessary resources should not be reserved for a privileged few.
And to HR leaders, it's crucial to recognize that some team members may be grappling with family-building issues silently. Collectively, let’s work together to create a world where everyone has timely access to resources, knowledge, and financial support when they need it.