Understanding the implications of fertility benefit design

Clinical evidence, financial impact

Employers are increasingly recognizing that the way fertility benefits are designed directly impacts both clinical outcomes and total healthcare costs. Models often rely on rigid step-therapy requirements, such as multiple IUI attempts before IVF, regardless of patient age, diagnosis, or medical need. Yet clinical data show these approaches can delay pregnancy, increase treatment costs, and raise the risk of multiple births and NICU stays.

This whitepaper explores the clinical and financial case for personalized fertility care, demonstrating how individualized treatment pathways—guided by patient need and clinical evidence—lead to healthier births, shorter time to pregnancy, and lower overall costs. For employers evaluating fertility benefits, the findings highlight why modern, evidence-based benefit design delivers better outcomes for employees and stronger value for organizations.

Download the whitepaper to learn:

• What the data shows about IUI success rates by age. Overall, 11% of IUI cycles were successful for all ages, with just 8% successful for those 35 and older—and success declines progressively with age and with repeated attempts 
• How benefit designs that mandate step therapy affect time to pregnancy and total cost. Members who attempted three IUIs before switching to IVF required 356 days on average to achieve pregnancy—73% longer than members who initiated treatment with IVF (206 days). 
• Why cost per cycle is an incomplete measure of fertility benefit value. IUI pregnancies carry 3.6x greater risk of multiples than IVF pregnancies, and multiples carry 4.8x higher NICU and delivery costs than single births.