The hidden workforce health issue employers aren’t measuring

Fertility may appear more frequently on employee benefits agendas, but treating it primarily as a benefit risks overlooking a much bigger workforce health issue.

That is the warning from Fertility Matters at Work, which argues that reproductive health remains largely invisible within many organisations despite its potential impact on absence, retention, engagement and employee wellbeing.

The problem is not necessarily that employers are failing to collect workforce health data. It is that the underlying cause can disappear within the measures they already track.

An employee undergoing fertility treatment may record an absence as sick leave. Someone struggling with the emotional impact may appear within mental wellbeing or engagement data. Others may leave an organisation without disclosing that a lack of fertility support influenced their decision.

For employers trying to understand the health of their workforce, that creates a potentially significant blind spot.

Jennifer Elworthy, co-founder of Fertility Matters at Work, said: “Absence, engagement and mental wellbeing may get tracked, yet only 33% of organisations include fertility in their overall wellbeing strategy. It has stayed invisible partly because it sits behind closed doors. Sick leave gets logged simply as sick leave; 63% of people take time off during treatment, anecdotally to conceal it, so the data never tells the real story underneath.

“Employers end up measuring the symptom, unplanned absence, staff turnover, dips in engagement, without ever connecting it back to the cause. You cannot manage what you’re not measuring, and right now, most organisations aren’t even asking the question.”

The growth of employer-funded fertility benefits has helped bring reproductive health further into workplace conversations. But financial provision for treatment is only one part of the picture.

A benefit can exist on paper, but employees still need to feel able to use it. That brings fertility into wider questions around workplace culture, psychological safety, management capability and whether employees trust their organisation enough to disclose what they are experiencing.

Elworthy said: “Fertility benefits are important. A single round of treatment can cost thousands of pounds so financial support is always welcome. The problem is treating the benefit as the whole answer. Our research shows that 38% have left or considered leaving a job due to lack of support. If benefits and policy exist without the culture around them, they go unused. 87% of managers have not been trained on fertility at all, which means the people meant to signpost that support often don’t know it exists either. What needs to change is not the benefit itself, but what surrounds it: trained line managers, leaders who model that this is safe to raise.”

For employers, this raises a broader question about how workplace wellbeing investment is implemented.

Providing a health or wellbeing benefit does not automatically mean employees will feel comfortable accessing it. Manager knowledge, communication and organisational culture can determine whether provision translates into meaningful support.

Fertility can also challenge employers’ assumptions about who workplace reproductive health support is for.

It is not solely an issue affecting women undergoing IVF, nor does every fertility journey result in parenthood.

Elworthy believes these misconceptions are contributing to fertility remaining outside mainstream workforce health strategies.

She said: “The first is that fertility treatment is elective, something closer to a lifestyle choice than a medical need. The second is that it is rare, or only relevant to women trying for a first child. It affects all genders, all relationship structures and every path to parenthood, including those that do not end in a baby.

“The third, and perhaps most damaging, is that silence means the problem does not exist. 61% of employees fear telling their employer, and 64% cite stigma as the reason. No one raising it is evidence that people don’t feel safe, not evidence that support isn’t needed.”

That distinction is important for organisations increasingly using employee feedback, utilisation data and workforce analytics to determine where wellbeing resources should be directed.

Low disclosure cannot necessarily be interpreted as low need. Instead, employers may need to consider whether the working environment itself makes disclosure difficult and whether managers are equipped to respond appropriately when an employee does choose to talk about fertility.

The next stage of workplace fertility support could therefore be less about adding another standalone benefit and more about integrating reproductive health into existing health and wellbeing strategies.

That means considering fertility alongside mental health, menopause and other areas of workforce health, while recognising the connections with absence, retention, inclusion and management practice.

It also means ensuring policies reflect a wider range of experiences rather than focusing solely on treatment and successful routes to parenthood.

Elworthy expects that distinction to become increasingly important over the next five years.

She said: “They will treat fertility as core workforce health, sitting alongside menopause and mental health in strategy documents, not appended as an afterthought. Line managers will receive fertility-specific training as standard, the same way many now receive mental health first aid training. Policies will be genuinely inclusive of all genders, relationship structures and outcomes, including childlessness not by choice, rather than defaulting to IVF for a heterosexual couple.

“Data on fertility and reproductive health will appear in engagement and wellbeing reporting, because employers will have realised that what gets measured gets resourced. Most significantly, disclosure will stop being an act of courage and start being an unremarkable part of talking about health at work, because the conditions for it will finally exist.”

For UK employers, the issue ultimately goes beyond whether fertility support appears on a benefits menu.

If reproductive health can influence whether people take time away from work, disclose a health issue, remain with an organisation or feel supported by their manager, it belongs within the wider conversation about workforce health.

The challenge is ensuring employers can see it.