ASRM Guidelines on Fertility Care During COVID-19 Pandemic

ASRM Guidelines on Fertility Care During COVID-19 Pandemic: Calls for Suspension of Most Treatments

ASRM Guidelines on COVID-19: The American Society for Reproductive Medicine (ASRM), the global leader in reproductive medicine, today issues new guidance for its members as they manage patients in the midst of the COVID-19 pandemic.  Developed by an expert Task Force, of physicians, embryologists, and mental health professionals, the new document recommends suspension of new, non-urgent treatments.ASRM guidelines COVID -19

Specifically, the recommendations include:

  1. Suspension of initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
  2. Strongly consider cancellation of all embryo transfers, whether fresh or frozen. 
  3. Continue to care for patients who are currently ‘in-cycle’ or who require urgent stimulation and cryopreservation.
  4. Suspend elective surgeries and non-urgent diagnostic procedures.
  5. Minimize in-person interactions and increase utilization of telehealth.

The above recommendations will be revisited periodically as the pandemic evolves, but no later than March 30, 2020, with the aim of resuming usual patient care as soon and as safely as possible.  ASRM has been closely monitoring developments around COVID-19 since its emergence. Data on its impact on pregnancy and reproduction remains limited. However, the task force used best available data, and the expertise and experience of the members to develop the recommendations. Until more is known about the virus, and while we remain in the midst of a public health emergency, it is best to avoid initiation of new treatment cycles for infertility patients. Similarly, non-medically urgent gamete preservation treatments, such as egg freezing, should be suspended for the time being as well. Clinics who have patients under treatment mid-cycle should ensure they have adequate staff to complete the patient’s treatment and should strongly encourage postponing, the embryo transfer.

Ricardo Azziz, CEO of the ASRM stated, “This is not going to be easy for infertility patients and reproductive care practices. We know the sacrifices patients have to make under the best of circumstances, and we are loath to in add, in any way. to that burden. And it will not be easy for our members. The disruption to routines, the stress on staff members and the very real prospect of economic hardship loom large for ASRM members all over the world.  But the fact is that given what we know, as well as what we don’t, suspending non-urgent fertility care is really the most prudent course of action at this time.”

Dr. Racowsky added, “We should recognize that the situation on the ground is fluid, and as such we will continue to revisit and review our recommendations at least every two weeks, to provide providers and their patients with the best information and support we possibly can.”

ASRM Press Release – May 17, 2020

Click here to read the entire release

The Latest Study on Regulation of Compensated Gestational Surrogacy in New York

The Latest Study on Regulation of Compensated Gestational Surrogacy in New York

The Latest Study on Regulation of Compensated Gestational Surrogacy in New York underscores the need to pass this legislation and shows that it would provide the most comprehensive protections for gestational carriers in the US.compensated gestational surrogacy

This report on the regulation of compensated gestational surrogacy in New York, issued in March 2020 to the New York State Legislature by Weill Cornell Medicine and the Cornell Law School is one of the most comprehensive reports of its kind and leads the reader to now other conclusion but that New York’s pending legislation, The Child Parent Security Act, would be the most protective of gestational carriers, or surrogate mothers, of any piece of legislation in existence in the US.  Surrogacy legislation  can be ethical and comprehensive.

To quote from the article, “The trend among state legislatures in the United States is to permit rather than prohibit compensated gestational surrogacy. Since 2000, fifteen states and the District of Columbia have acted to explicitly permit compensated gestational surrogacy. On the other hand, only four states have taken a prohibitive approach since 2000 and two of those states permit uncompensated gestational surrogacy.”

“In forty-four states there is no prohibition on surrogacy by statute or there is explicit or implicit permission. Even in the six states that have statutes that appear to prohibit surrogacy, courts have granted pre-birth orders to intended parents and have issued other pro-surrogacy decisions. Consequently, surrogacy in varying ways, including by approving pre-birth orders.”

“In sum, the health and medical literature does not weigh in favor of continuing to prohibit gestational surrogacy in New York. There are generally no disparate health outcomes for gestational carriers as compared to non-gestational carriers using assisted reproductive technology (ART) nor are their disparate health impacts on children. Additionally, there are no disparate psychological impacts on gestational carriers as compared to women who have had spontaneously conceived pregnancies. States across the country are moving to legalize and regulate gestational surrogacy in the last decade.”

March 20, 2020 by Cornell Weill Medical Center and Law School 

Click here to read the entire article.

Finally, the 2020 US Census is counting LGBTQ families

The 2020 US Census is underway, and new changes should result in a better understanding and representation of gay and lesbian families.

This year, the 2020 US Census is substantially changing its “relationship” question for households with more than one occupant. There are now four options: In addition to opposite-sex husband/spouse or unmarried partner, forms also include same-sex husband/spouse or unmarried partner.2020 US census

That should result in a more accurate count of LGBTQ families, which is important not only for scholars but also to better deliver services and make policy decisions.

But the community likely will remain underrepresented because the Census has not altered its gender question since it began in 1790.

Respondents can still select only “female” or “male.” Despite society’s awakening about the transgender demographic and a flourishing of pronouns, members of the community will have no way to identify itself unless they leave the question blank.

I predict, though, the Census will likely alter its gender question by 2030 or earlier for more detailed American Community Survey counts. 

That’s because the Census Bureau, albeit slowly sometimes, usually changes to reflect evolutions in society.

Take married couples. Up until 1970, the Census Bureau considered the husband to be the “head of household” and his spouse to mark the category of “wife of head,” no matter who was the breadwinner.

After the social upheaval of the 1970s, the Census substituted a “husband/wife” category for “wife of head,” allowing wives to be identified as the “head of household.” 

While the percentage of households that chose this option was relatively small, it did herald the increased movement of women into higher education and the fact that many wives were the primary breadwinner.  

That same year, the Census also replaced “roommate, boarder, lodger” with “partner,” though it was combined with “roommate” as the option.  

The Census, though, has been slower to adopt to the modern LGBTQ rights movement, which started with the 1969 Stonewall riots in New York City’s Greenwich Village.

bridgemi.com, by Kurt Metzger, March 5 2020

Click here to read the entire article.

Why a lack of oversight of surrogacy in Canada leaves some parents feeling taken advantage of

Surrogacy in Canada: Legal experts say Health Canada’s new rules won’t solve industry’s transparency problems of 

Surrogacy in Canada – Cuddling a child of her own was something cancer survivor Anna Camille Tucci feared might never be possible.surrogacy in Canada

In 2017, the Toronto woman had a full hysterectomy as part of treatment for ovarian cancer — but not before doctors harvested her eggs and created embryos with her husband’s sperm.

“Since I can remember, I wanted kids….That’s just something that was in my heart since I was tiny,” she said. “Even the thought of not being able to carry [a baby] — that was really difficult.”

But in December 2019, the 30-year-old’s dream of being a mom came true. A surrogate gave birth to Tucci’s healthy baby boy.

Motherhood has been “bliss,” Tucci says, yet she can’t shake lingering questions she has about the thousands of dollars she and her husband paid through the surrogacy agency they’d hired to help them navigate the delicate process.

With surrogacy in Canada, it is illegal to pay a surrogate, but it is legal to reimburse her for pregnancy-related expenses such as additional food, clothing, vitamins and any transportation costs she incurs traveling to her medical appointments. In some cases, the transactions are handled using a trust that is set up and managed by a surrogacy agency.

Over the course of a three-month investigation, CBC News spoke with dozens of people involved in surrogacy in Canada, including parents, surrogates and lawyers; their experiences reveal a burgeoning industry in which agencies lack oversight and mandatory transparency.

Five different families raised concerns about money that was paid to surrogates through their trust accounts.

Tucci wanted to know how nearly $2,000 a month was being spent, but the agency’s policy was that receipts aren’t released until after the birth.

In another case, an Ontario father demanded his agency send him his surrogate’s receipts. He found many didn’t have dates, some were duplicates, others were from before he’d met his surrogate, and one had a lottery ticket listed.

“I think people have found a way to pull the parents’ heartstrings,” Tucci said. “I think the industry as a whole — everyone that’s involved in it — I think they’re all there to make money in the end.”

Growing demand for surrogates

The most up-to-date data from Statistics Canada shows roughly one in six couples in Canada experience infertility — a figure that has doubled since the 1980s. Infertility combined with an increase in same-sex couples starting families means the demand for surrogates has boomed.

No public health agency tracks surrogate pregnancies, but data voluntarily provided by Canadian fertility clinics shows at least 816 surrogate births were reported between 2013 and 2017.

Once couples factor in fees for agencies, lawyers and fertility clinics, the cost can quickly reach $100,000 per pregnancy.

Introduced in 2004, Canada’s reproductive legislation was meant to prevent the exploitation of women and the commercialization of surrogacy.

The maximum penalty for paying a surrogate for things that aren’t pregnancy-related is a $500,000 fine and up to 10 years in prison.

Parents shocked by cost of reimbursements

Tucci and her husband selected a surrogate through an agency and paid the company nearly $10,000 in fees for consultation and to manage their surrogate’s monthly reimbursements through a trust fund. They negotiated a legal contract with their surrogate that allowed her to claim expenses up to a maximum of nearly $2,000 a month during the pregnancy.

“We thought she would never actually meet that max that we had in the contract. But we found out that that’s not true,” Tucci said.

The surrogate would submit her receipts to the agency every month. The agency would then review them and reimburse her through the trust fund.

Agency says it is ‘extremely diligent’

The five families who shared their stories with CBC News were clients of the same agency — Canadian Fertility Consulting (CFC).

CFC says it is the largest agency in the country. It has roughly 400 ongoing surrogate-couple relationships and oversees some 300 surrogacy births every year.

Owner Leia Swanberg is the only person who’s ever been charged for paying surrogates in Canada.

RCMP raided Swanberg’s Cobourg, Ont., offices and she was charged in February 2013. Later that year, she pleaded guilty to regulatory offences for paying surrogates without receipts and was fined $60,000.

by CBC.ca, Chris Glover, Chelsea Gomez, Laura Clementson March 2, 2019

Click here to read the entire article.

Supreme Court to Hear Case on Foster Care and Gay Rights

The justices will consider whether a city may exclude a Catholic adoption agency from its foster care system because it refuses to work with gay couples.

The Supreme Court on Monday agreed to decide whether Philadelphia may exclude a Catholic agency that does not work with same-sex couples from the city’s foster-care system.Foster Care Gay

The city stopped placements with the agency, Catholic Social Services, after a 2018 article in The Philadelphia Inquirer described its policy against placing children with same-sex couples. The agency and several foster parents sued the city, saying the decision violated their First Amendment rights to religious freedom and free speech.

A unanimous three-judge panel of the United States Court of Appeals for the Third Circuit, in Philadelphia, ruled against the agency. The city was entitled to require compliance with its nondiscrimination policies, the count said.

Leslie Cooper, a lawyer with the American Civil Liberties Union, said the Supreme Court’s decision in the case would affect many families.

“This case could have profound consequences for the more than 400,000 children in foster care across the country,” she said. “We already have a severe shortage of foster families willing and able to open their hearts and homes to these children. Allowing foster care agencies to exclude qualified families based on religious requirements that have nothing to do with the ability to care for a child such as their sexual orientation or faith would make it even worse.”

In a Supreme Court brief, the agency agreed that the legal questions before the justices were enormously consequential.

“Here and in cities across the country, religious foster and adoption agencies have repeatedly been forced to close their doors, and many more are under threat,” the brief said. “These questions are unavoidable, they raise issues of great consequence for children and families nationwide, and the problem will only continue to grow until these questions are resolved by this court.”

The case, Fulton v. City of Philadelphia, No. 19-123, is the latest clash between anti-discrimination principles and claims of conscience. It is broadly similar to that of a Colorado baker who refused to create a wedding cake for a same-sex couple.

In 2018, the Supreme Court refused to decide the central issue in that case: whether businesses may claim exemptions from anti-discrimination laws on religious grounds. It ruled instead that the baker had been mistreated by members of the state’s civil rights commission who had expressed hostility toward religion.

The foster care agency relied on the decision, Masterpiece Cakeshop v. Colorado Civil Rights Commission, in arguing that it too had been subjected to hostility based on anti-religious prejudice. It added that its free-speech rights would be violated were it forced to certify that same-sex couples are fit to be foster parents.

The city responded that the agency was not entitled to rewrite government contracts to eliminate anti-discrimination clauses.

“It has never been the case that religious entities, or entities with deeply held secular views, are constitutionally entitled to enter into government contracts and then defy any terms to which they object,” the city’s brief said. If the agency’s “sweeping constitutional claims were accepted,” the brief said, “they would cause mayhem in government contracting.”

NYTimes.com, By Adam Liptak, February 24, 2020

Click here to read the entire article.

War Of The New York Surrogacy Bills Erupts

New York is lagging behind the rest of the country as one of the few remaining jurisdictions in the United States that does not permit compensated surrogacy.

Things just took a bizarre turn in the New York legislature when it comes to surrogacy. Last week, New York State Senator Liz Kruger (SD-28) introduced S7717. That’s a new bill to legalize compensated surrogacy in New York. Great, right? Well, there’s already a different bill that’s both much further along and also, like, way better than S7717. So what gives?New York surrogacy

As astute readers know, New York is lagging behind the rest of the country as one of the few remaining jurisdictions in the United States that does not permit compensated surrogacy. And while a handful of jurisdictions once also had this legal prohibition, most have reversed course. Fortunately, New York has been looking poised to do the same with the smart, well-drafted Child-Parent Security Act. However, that’s a separate bill — and quite different from S7717.

What’s going on?

Last year, the Child Parent Security Act (CPSA) came very close to passing. But then it didn’t. Instead, it fell victim to the legislative sausage-making process.

After passing the Senate, and having the full and vocal support of Gov. Andrew Cuomo, it was never brought up for a vote on the Assembly floor. So eventually, it died at the end of the 2019 legislative session. It didn’t help that at the last minute, noted feminist icon Gloria Steinem, published an incendiary op-ed against surrogacy.

 

gestational carriersSo incendiary that some people had to do some real soul searching as to whether we were still, in fact, feminists, while Steinem argued that permitting compensated surrogacy was exploitative of women. It was sort of surreal to hear Steinem on the side of having the government tell women what they can and can’t do with their bodies.

However, after all that, this should be the CPSA’s year. Except now comes along S7717, which looks like an attempt to muddy the waters.

The CPSA takes the approach of following the generally accepted standards and best practices concerning surrogacy arrangements, including those recommended by the American Society for Reproductive Medicine (ASRM); S7717, in contrast, takes a very different approach.

To give it some credit, it does seem to provide a clearer path for compensation for “genetic surrogacy” –- where the surrogate is genetically related to the child. However, most surrogacy in the United States is “gestational surrogacy” –- where the surrogate is not genetically related to the child. She is, instead, providing a way to help intended parents, who could not have a genetic child otherwise, bring their child to birth. Here especially, S7717 takes a new and strange direction.

  • Everyone Must Live In New York. S7717 requires all parties to be either a United States citizen or a legal permanent resident and to be residents of New York for the past 12 months. There is an exception if the parties are “immediate” family and there is no compensation. But that’s a very narrow band. Penalizing and disqualifying someone for living across state lines or being a second cousin versus an “immediate” family member is a harsh line to draw. 
  • Random Restrictive Medical Requirements. If that weren’t enough, S7717 requires that a woman wishing to be a surrogate under the proposed law *must* be under 35 years old, and cannot have more than three births. It’s not exactly clear where these numbers came from though, since the ASRM guidelines provide that a woman can be a surrogate up to the age of 45 (ten more years!) and can have five prior births.
  • Impossible(?) Financial Requirements. The bill also requires what would often be impossible requirements. The intended parents would be required to have a life insurance policy in place for the surrogate for a minimum of $750,000, as well as a short-term and long-term disability policy. While maybe obtainable in some cases, and definitely good things to have in place in a perfect world, sometimes it can be very difficult to find such policies. For instance, some disability policies are not readily available to anyone if not provided by an employer, or require at least a year of being in place prior to eligibility for the benefits. So if no policy is available, it’s another no go.
  • Surrogate Can Keep The Child?! OK, the restrictions described above aren’t great. But probably way worse is the bill language providing that the surrogate is permitted to terminate the agreement at *any* time. And that specifically includes any time during the pregnancy. Even though the intended parents would be required to be financially responsible for the child at all times, a surrogate could decide to be a parent to the child.

Consistent with that madness, S7717 provides that hopeful intended parents can only be judicially recognized as the sole legal parents of the child after the surrogate submits a written declaration — no sooner than eight days following the birth of the child — stating that she is voluntarily consenting to disclaim and renounce her parental rights. But until such a waiver is submitted, the surrogate retains decision-making responsibility for the child (but still not financial responsibility). Whoa. That does not sound right.

AboveTheLaw.com by Ellen Trachman, February 19, 2020

Click here to read the entire article.

Commercial Surrogacy – a Complicated Legal Picture

Commercial Surrogacy’s Complicated Legal Picture

After trying to conceive through nine cycles of IVF, unsuccessfully, Alexis Cirel’s doctor suggested she and her husband take a different route: a gestational surrogate and commercial surrogacy.commercial surrogacy

“It was a hard decision and it took months of introspection,” says Cirel, an attorney in New York City. Ultimately, she agreed with her doctor. But surrogacy wasn’t legal in her home state, and she worried about the risk that her “biological child would not be my legal child” under state law.

New York is currently one of three states (along with Louisiana and Michigan) that don’t allow surrogacy contracts (though the remaining states vary greatly in their regulation of surrogacy) but may soon join the majority, with legislation on the table to make paid (aka commercial) surrogacy legal.

In the absence of a national policy, state legality issues date back to 1984, when a couple put an ad in the newspaper seeking a surrogate. Mary Beth Whitehead, of New Jersey, responded, and gave birth to Baby M. But everything soured when she wanted to keep the baby, which was conceived with her own egg. The New Jersey Supreme Court found that the payment to Whitehead was illegal, but ruled against her on the issue of custody: Baby M. went to the intended parents, though Whitehead received parental rights.

After the debacle, New York criminalized gestational surrogacy by fining parents and anyone who assists them, says Anthony Brown, New York-based founder of Time For Families Law, and the founding chairman of Men Having Babies, a nonprofit organization that educates gay men about surrogacy. The law was created to address traditional surrogacy (fertilizing the surrogate’s egg), but was extended to prohibit gestational surrogacy, where the child has no genetic relationship with the surrogate, rendering any contracts for “altruistic” surrogacy void and all commercial surrogacy contracts illegal.

Many people think it’s time to revisit the issue.

New York Gov. Andrew Cuomo recently launched a campaign to legalize gestational surrogacy, after a 2019 effort failed, and he has support from families, attorneys, LGBTQ rights groups, and even celebrities (Bravo’s Andy Cohen was present for the campaign announcement).

“This antiquated law is repugnant to our values, and we must repeal it once and for all and enact the nation’s strongest protections for surrogates and parents choosing to take part in the surrogacy process,” Cuomo said in a statement.

The new legislation would create protections for surrogates so they could make their own health care decisions, including whether to terminate a pregnancy; would create legal protections for parents of children conceived by reproductive technologies such as artificial insemination and egg donation; and would eliminate barriers to second-parent adoption (a single visit to court to recognize legal parenthood while the child is in utero would suffice).

Many New Yorkers use surrogates but travel to other states to use them. Repealing the bill would simply make it easier and safer for everyone involved, Cirel says. She switched from her corporate law role to become a family law and matrimonial attorney after going through the surrogacy process, and she is a member of New York’s Love Makes a Family Council, created in conjunction with the proposed law.

Romper.com, February 19, 2020 by Danielle Braff

Click here to read the entire article.

Paying gestational carriers should be legal in all states

Every year, hundreds of thousands of babies are born in the U.S. using assisted reproductive technologies, including the use of gestational carriers, a multibillion-dollar industry that is controversial and largely unregulated.

One of the controversies involves the use of paid gestational carriers, women who agree to carry a fertilized embryo, created from another woman’s egg, give birth, and give the baby to its parents. This is different from tradition (or genetic) surrogates, who provide both their own eggs and their own wombs. Gestational surrogacy now constitutes 95% of all surrogacy in the U.S.gestational carriers

State laws about arrangements for gestational carriers vary widely and are in flux. This kind of surrogacy is currently allowed in 10 states; prohibited but with various caveats and additional legal proceedings in 30; practiced with potential legal obstacles and inconsistent outcomes in five; practiced but with legally unenforceable contracts in two and prohibited in three. Several of the 40 states with real or potential legal hurtles require that couples be married and heterosexual, or allow surrogates to choose at any point to keep the baby.

Commercial surrogacy first gained wide attention in the 1980s through the Baby M case. Elizabeth Stern had multiple sclerosis and feared that pregnancy would worsen it. Through a newspaper ad, she and her husband connected with Mary Beth Whitehead, who agreed to carry a fetus for them as a traditional surrogate, providing both an egg and a womb. But after giving birth, Whitehead decided to keep the child. A New Jersey court awarded the Sterns custody of Baby M, but banned all such future surrogacy contracts.

Since then, practices have changed and the use of gestational carriers has grown dramatically. In many states, however, prospective parents need to travel to other states, like California, to avoid legal obstacles. Some seek surrogates in the developing world, which has its own set of problems.

Competing proposed bills in New York state highlight the conflicts involved in gestational surrogacy.

In June 2019, the New York state Senate voted to legalize gestational surrogacy. The pushback was swift and strong. Noted feminist Gloria Steinem argued strongly against the proposal, raising concerns that poorer women of color would disproportionately serve as gestational carriers. She also pointed out that the bill would require surrogates to be state residents for only 90 days, which could prompt human traffickers to bring women to New York to serve as surrogates. The State Assembly then rejected the proposal. Lawmakers are now considering at least two different revised versions of the bill — one from Gov. Andrew Cuomo and one from the bill’s original sponsor — that address these criticisms.

I believe the state should legalize gestational surrogacy, providing it includes protections to avoid the problems Steinem highlighted.

In the debates in New York, as well as those in other states, both sides have been arguing in the relative absence of data, without acknowledging this deficit. In fact, the limited data available so far do not suggest that women become gestational carriers because of financial distress, nor do the demographics reflect racial disparities.

StatNews.com, by Robert Klitzman, February 12, 2020

Click here to read the entire article.

Fresh Eggs For IVF Offer Slightly Better Birth Outcomes

Using fresh donor eggs for in-vitro fertilization (IVF) provides a small but statistically significant advantage in birth outcomes compared to frozen donated eggs, research finds.

The national study in the journal Obstetrics & Gynecology was the largest head-to-head comparison of the two IVF approaches, measuring the likelihood of a good perinatal outcome, defined as a single baby without prematurity and with a healthy birth weight.fresh eggs

“Our study found that the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference,” says lead author Jennifer L. Eaton, medical director of assisted reproductive technology and director of the Oocyte Donation Program at the Duke Fertility Center.

“From a clinical standpoint, given that frozen eggs have many benefits such as ease, cost, and speed, the decision to use fresh or frozen donor eggs should be made on an individual basis after consultation with a physician,” Eaton says.

Eaton and colleagues, including senior author Alex Polotsky of the University of Colorado Advanced Reproductive Medicine, studied three years of data from the Society for Assisted Reproductive Technology. Nearly 37,000 IVF attempts were analyzed, including 8,381 (22.7%) that used frozen eggs and 28,544 (77.3%) using fresh.

Controlling for factors such as the quality of fertilized eggs and the age of both mother and donor, the researchers found that fresh eggs resulted in a good perinatal outcome in 24% of fertility attempts compared to 22% of the attempts with frozen eggs. Implantation, clinical pregnancy, and live birth rates were all significantly higher among the women using fresh eggs vs. frozen.

“As IVF with donor oocytes has become standard treatment for women with decreased egg supply or advanced reproductive age, there has been an increased demand for donor oocytes, making frozen eggs an attractive option,” Eaton says. “In general, IVF with frozen donor eggs is cheaper and faster than with fresh donor eggs.

Fututiry.org by Sarah Avery-Duke, February 7, 2020

Click here to read the entire article.

The Number of Employers Who Offer Fertility Benefits is on the Rise

Fertility benefits rank high on the list of valuable benefits that make recruiting top talent, retaining valuable employees, and reducing turnover easier. Providing coverage for family building options has been shown to increase employee retention and loyalty.

According to a recent FertilityIQ survey, 68 percent of millennials consider fertility benefits when choosing an employer, and 9 out of 10 employees with fertility issues will switch jobs for benefits.fertility benefits

This scenario was very true for millennial, Katie Goad and her husband Adam. They had an 8-year-old daughter and wanted to expand their family. After giving birth to her first child, Katie had surgery that meant she would have to undergo in vitro fertilization (IVF) in order to have another child.

Lacking insurance for IVF, Katie was determined to expand her family without going into debt in the process, so she explored her employment options and discovered that Starbucks offered benefits to cover IVF, even to hourly, frontline workers. Starbucks is revered for being among the first to provide fertility benefits to hourly and part-time employees.

“I was honest with them in my interview about what my goal was, and what my intentions were,” Goad said in a recent interview with Benefit News.

She landed the job and started working as a part-time barista.

In a recent survey, FertilityIQ, author of the extensive Family Builder Workplace Index, found that 73 percent of fertility patient respondents felt more gratitude toward their employer because of fertility benefits, 61 percent said it made them feel more loyal, and 53 percent said it influenced them to stay with a particular employer longer.

“In this tight labor market, millennials are entering the family building years and flooding the workforce. Companies eager to recruit top talent know that offering fertility benefits, paid parental leave, and flexible schedules fosters a great sense of loyalty,” said Patty Stull, Chief Marketing Officer of SGF.

Once Katie qualified for health benefits through Starbucks, she began fertility testing and treatment under the care of Dr. Mark Perloe at Shady Grove Fertility Atlanta.