It’s time for better access to family building benefits: a note from Chief Medical Officer, Dr. Janet Choi

closeup of hand signing the Access to Family Building Benefits letter

The last few years have marked an increase in employers enhancing their benefits to include fertility and family building options. The momentum is great. With more than two decades of experience in fertility and family building care, I can tell you with certainty that having coverage can change lives.

However, we’re seeing different fertility solutions are still inadvertently restricting access for some groups – meaning that an increase in access is not equating to equity in access.

Recently, a group of prominent attorneys, academics, and scholars across the U.S. highlighted this issue in “An Open Letter in Favor of Rational and Equitable Access to Fertility Care and Benefits.” The letter explains the state of fertility and family benefits today, examines how disparities are prohibiting people from accessing care, and calls for a better way to support growing families.

The problem is two-fold. First, common plan designs include dollar cap models that treat fertility issues differently than other types of medical care, for example, we don’t put a dollar cap on chronic pain or diabetes. Second, many traditional coverage models require a restrictive diagnosis of infertility or force patients to work their way through a battery of less-effective treatments before they can move on to full cycles of IVF or other appropriate care.

For instance, Progyny recently completed its LGBTQ+ Fertility and Family Building Survey. It found that 68% of LGBTQ+ individuals with employer-sponsored coverage can’t access their benefit because of restrictive policies that require a period of unsuccessful heterosexual intercourse.

It doesn’t have to be that way.

Even as fertility coverage is growing in the American workforce, this coverage is often hampered by arbitrary caps and discriminatory policies that we simply don’t see in other areas of health care. These outdated plan designs only serve to hurt families, make care difficult for employers to provide, and create inequities in the health care system.

If you’re of a mind – like we are here at Progyny – that the right to build a family is universal, I encourage you to dig deep in your search and examination of fertility and family building benefits. Focus on equity in care. Focus on the people you care for. And as the open letter states: “Caps should be rejected in favor of parity: just as mental health must be afforded coverage equal to physical conditions, benefits that help families overcome infertility should be available on no less favorable terms than for other medical conditions.”

To continue the momentum and conversation, I encourage you to sign the open letter.

If you’re a benefit leader looking to understand how this impacts you and your employees, I’ll be doing a virtual fireside chat on Wednesday, August 2 at 2pm ET with Kendyl Hanks, lead signer of the letter, to discuss what a better, truly inclusive benefit landscape can look like. Be sure to save your seat and submit your questions here.

For additional resources, we also have an Equitable Fertility and Family Building Checklist that can help you identify a truly equitable benefit.

Lastly, talk to your workforce. Ask them about their access, explore their many paths to parenthood, and find out what they need to feel safe and secure in their fertility and family building journey.

In doing so, you can play a key role in making your organization a champion for equitable family building.


Dr. Janet Choi is a highly ranked board-certified REI, bringing over two decades of clinical expertise in fertility and family building. Dr. Choi has published and lectured extensively on infertility, onco-fertility, and fertility preservation. She is a member of ASRM, ACOG, and the NY Obstetrical Society. She earned her medical degree and completed her residency at Columbia University and completed her REI fellowship at Weill Cornell Medical College.

Ready to learn more about how your company can implement an inclusive fertility and family building solution?