By Jenny Saft, General Manager, Global Markets, Progyny
When we started Apryl, we made a very specific bet: fertility benefits would not stay a US-only conversation.
At the time, the US market was already moving. Employers were starting to understand that fertility and family-forming support was not a niche perk, but a benefit that mattered deeply to employees and could become a real differentiator for companies competing for talent.
Outside the US, the conversation looked very different.
In Europe and Asia, many employers had a different starting point. They were not used to funding healthcare directly in the same way US employers are, because public healthcare systems already existed. Fertility support was therefore often seen as something the healthcare system should cover – or, at best, something nice for an employer to add.
But when we looked closer, the gaps were obvious. The WHO estimates that 1 in 6 people globally experience infertility in their lifetime, a rate that holds consistent across high-, middle-, and low-income countries alike. Yet public coverage was often partial, narrow, or tied to specific eligibility criteria. In some countries, access depends on age, diagnosis, marital status, sexual orientation, or the type of treatment. In others, the treatment might be legal but expensive, difficult to access, or culturally sensitive to talk about. The result was a patchwork of support that left many women and families with unmet needs and employers without a clear way to bridge the gap.
That is why we built Apryl in 2019. We believed that global employers would eventually need a better way to support fertility and family forming outside the US – not by copying the US model, but by building something that understands local healthcare systems, laws, costs, and cultural realities. We knew that meaningful support would require deep regional expertise, because what works in one country can be inaccessible, inappropriate, or ineffective in another.
At the time, that required a lot of market education. We were fundraising, building the product, speaking to customers, supporting members, fixing edge cases, writing decks, and doing whatever needed to be done that day. It was intense and scrappy, but the conviction was clear: global companies would eventually need global fertility benefits, and those benefits would have to work locally.
When the buyer conversation changed
When Apryl joined Progyny two years ago, in June of 2024, one of the biggest changes was the buyer conversation.
Suddenly, we were much closer to U.S. decision makers responsible for global workforces. These were benefits leaders who already understood the value of fertility benefits because they had seen the impact in the U.S. Their question was not, “Why should we pay for this?” It was, “How do we make this work for our employees outside the U.S. as well?”
That shift mattered because it moved the conversation from education to execution.
Apryl had built the global-first foundation: the technology, local market knowledge, speed, and willingness to work through complicated country-by-country realities. Progyny brought employer trust, clinical expertise, operational discipline, and experience supporting large, complex clients.
Together, we were able to take something we had believed in for years and build it at a meaningful level of scale.
Why local reality matters
The reason global fertility and women’s health benefits are hard is that the details change everywhere.
By 2024, 55 percent of countries had fertility rates below the replacement level, according to the UN’s World Fertility 2024 report. Demand for fertility support is not a niche or future concern. It is already widespread, and public systems were not built to meet it at scale.
What is covered through public healthcare? Which treatments are legal? Which family structures are recognized? What does access actually look like? How much does care cost locally? How do culture, stigma, language, and regulation influence whether someone even feels comfortable asking for help?
A global benefit cannot answer those questions with one policy and a translated landing page.
That has been one of the biggest lessons from building Progyny Global: care only works when it reflects local reality. What works in Germany may not work in India. What is accessible in the UK may not be available in Brazil. Public healthcare coverage can look strong from the outside and still leave employees with real gaps when they actually need care.
For employers, this means fairness is more complicated than offering the same amount or the same policy everywhere. A meaningful benefit must account for local costs, laws, access, and culture.
For employees, it means they should not have to become experts in healthcare systems, reimbursement rules, treatment pathways, or country-specific regulations just to understand their options.
What changed in two years
Joining Progyny changed the pace immediately. It gave the original Apryl platform access to a much larger client base, deeper operational expertise, and the ability to build for global employers at a level we could not have reached alone.
In a short amount of time, we expanded from a fertility-focused platform into a comprehensive global women’s health offering:
- Support in 120+ countries
Not as a theoretical global footprint, but as a benefit that works across different healthcare systems, legal frameworks, currencies, cost levels, and cultural expectations. - 14 languages – growing to 30 by the end of 2026
We built language support into every layer of the experience, from the platform to live PCA consultations, because understanding your options clearly should never be a barrier to care. - Three connected programs: fertility and family forming, pregnancy and postpartum, and menopause
This has been an important evolution. Women’s health does not happen in isolated moments, so the support should not be built that way either. - The Progyny Card
One of the biggest barriers in fertility care is the upfront cost. The Progyny Card helps reduce that burden by making it easier for members to access care without paying large amounts out of pocket first. - Country-specific customizations
This is probably the least visible work, but some of the most important. Local compliance, cultural sensitivities, benefit design, reimbursement flows, and healthcare realities often determine whether a benefit actually works in practice.
This is where the Apryl-Progyny combination has been most powerful: we were able to move faster and build at greater scale, while staying close to the local details that made the original platform valuable in the first place.
What this means now
What should be clear by now is that global women’s health benefits are no longer an edge case. They are becoming part of how serious employers think about supporting their workforce.
But the answer cannot be a U.S. benefit exported into other markets. And it also cannot be a loose collection of local exceptions that becomes impossible to manage. It has to be something more practical: one global framework, with enough local intelligence to actually work country by country.
That is the space Progyny Global is building in.
What I love is that the original bet behind Apryl still sits at the center of the work. The difference is that it now has the scale, experience, and employer trust of Progyny behind it.
That is what Progyny Global represents today: a new standard for global women’s health benefits. And in many ways, we are still at the beginning.