Do fertility clinics have a role in improving patients' work-treatment balance?

I recently had the pleasure of chairing at the first 'Fertility in the Workplace' Summit, organised by Fertility Network UK. This initiative was launched after a recent Fertility Network UK survey revealed the true challenges in the workplace for employees experiencing infertility; approximately 55 percent of those surveyed did not feel supported enough by their employer and 36 percent felt that their career was damaged due to fertility treatment.

A fundamental issue is that, under employment law, infertility is not a 'protected' medical condition and, therefore, employers do not have to make reasonable adjustments in the workplace, unlike for mental health or pregnancy. There is an ongoing Parliamentary debate about this, with two MPs – Alex Davies-Jones and Nicki Aitken – campaigning for the rights of infertile patients, with focus on employment rights.

Despite the absence of a favourable employment legal landscape for infertile people, many large-scale UK employers present at the summit – such as Co-op and Autotrader UK - have already introduced fertility-friendly policies in their workplace. These policies cover a range of benefits, which includes raising awareness in the workplace about infertility, creating an open environment to speak about it, allowing leave to their employees who are in the midst of fertility treatment and even providing financial health benefits that cover at least some of the cost of fertility treatment.

As part of demonstrating their commitment to this initiative, many employers have already signed the 'fertility in the workplace' pledge, which commits them to a minimum set of supportive recommendations that they need to implement within the workplace.

This invigorating event got me thinking about the role of the fertility clinics in this and what more we can do to support patients who are also hard-working employees and an active part of the workforce.

How can fertility clinics help their patients undergo their treatment around their work commitments?

The truth is that many clinics already try to accommodate patient requests around appointment times or procedure dates. This approach, albeit helpful to some extent, tends to be ad hoc and primarily reactive in response to a patients' cycle – it is the patient who finds it difficult to attend certain appointments due to work commitments and who, therefore, asks for different time slots.

I strongly believe that there is more that clinics can do to support patients in this respect.

To enable this extra support, there are certain actions that clinics can consider:

• Be proactive in asking every new patient how flexible or restricted they may be around their work commitments. This will facilitate a more personalised treatment plan, including timings of egg collection and embryo transfer, and demonstrate engagement around managing the journey in a more patient-centred way.
• Develop fully functional dual clinical pathways (face-to-face and remote), to enable both partners to participate and to reduce patient travel and, consequently, absence from work.
• Develop pathways that allow options around appointments, including out-of-office times.
• Offer options for home testing, where this technology is available and supported by a strong evidence-base.
• Adopt communication platforms that provide the support that patients need around the clock (even when the clinic is not open) to reduce anxiety. Artificial intelligence has already started to play a role in this, with the first communication apps specific to infertile patients already becoming available.
• Provide clear documentation about procedures and their implications for timelines and appointment dates that the patient can share with their line manager if required.

The benefits of this approach for our working patients are obvious. Having said that, clinics who commit to such initiatives are also destined to benefit.

Considering that most of our patients are also part of a workforce, these initiatives will clearly promote a more personalised, patient-driven delivery of care. It is well known that, apart from clinic success rates, the level of support that a clinic offers, ranks highly in the minds of prospective patients. Inevitably, more patient-friendly clinics are likely to attract more loyal patients. It is also clear that there is significant dropout of patients during the fertility journey which cannot be attributed simply to financial reasons. Therefore, personalised care is also likely to help clinics retain their patients and reduce dropouts.

One could argue that 'workplace-friendly' changes to the clinic practices could weigh heavily on resources and also be costly. While this may hold true for introducing certain innovations, not all proposed changes require more resources, just willingness to amend practice in a creative way. Moreover, any such short-term investment has a good chance of paying off in the longer term; for example, the adapted technologies may well help reduce the future burden on staff resources.

Is it, perhaps, also time for fertility clinics to sign a 'workplace-friendly' pledge?