Abstract Study question Is there a need for a fertility revolution to accommodate the modern workforce, and how canit be safely and effectively implemented? Summary answer Offering care to employees facing fertility issues is vital as access to reproductive healthcareis more needed and more of a challenge than ever before. What is known already The UK faces a fertility care crisis as NHS struggles and private insurance premiums soar,prompting employees to seek support from employers. Challenges include an ageing parent demographic, falling fertility rates, and a global decline in sperm quality. Employees demand healthcare support, with 55% wanting fertility assistance, and 1 in 3 considering job change due to inadequate fertility or baby loss support. Financial concerns further delay fertility journeys for 56% of employees, impacting mental well-being. While high-cost fertility benefits emerge, the call is for holistic, early-stage support to mitigate stress and improve overall fertility outcomes for employees. Study design, size, duration During September 2023, a survey was conducted to explore and make the link between the personal / human experience of infertility and the corporate impact / responsibility in supporting someone through it. The survey was disseminated to 1031 employees, 511 of which were struggling with fertility issues and 508 were trying to conceive or considering future fertility. Participants/materials, setting, methods An online survey anonymously gathered responses from UK employees across various sectors, posing 22 targeted multiple-choice questions on fertility, pregnancy loss, and miscarriage. The survey sought to understand the intricate connections between theseaspects and the provision of employer-based support and benefits, shedding light on the current landscape of fertility-related concerns within the workforce. Main results and the role of chance The survey shows that 28% reported personal fertility experiences, and 37% faced challenges themselves or through partners. 55% desire increased employer support during their fertility journey, peaking at 66% among BAME individuals. Importantly,30% prioritise fertility benefits over a condensed work week, with Gen Z (37%) emphasising this more than Gen X (28%). Attrition concerns are evident, with 21% contemplating job changes due to fertility struggles, higher among BAME (31.54%) and LGBTQ + (25.62%) individuals. Productivity is impacted for 30%, with LGBTQ+ individuals experiencing a higher impact (38%). workplace relationships suffer for 25%, while 24% believe their workplace poorly support those facing fertility challenges.Taking time off for fertility-related issues is prevalent, with 64% having done so, and 22% believe more employer support could have reduced their time off. Workplace policies appear lacking, as 39% find them non-inclusive, with BAME (44%) and LGBTQ + (49%) individuals expressing higher dissatisfaction. Attraction and retention are influenced by fertility support, as 47% of Gen Z and 47% of BAME respondents prioritise it when considering new roles. Limitations, reasons for caution No limitations identified. Male, female and gender neutral/ non-binary respondents were included in the survey, along with those who identified as single or were in heterosexual same sex relationships. People from BAME communities were also included in the survey. Wider implications of the findings The survey underscores a growing need for employer support in fertility challenges. Attrition concerns and productivity impacts reveal potential economic ramifications for organisations neglecting fertility support and inclusive strategies. Findings position comprehensive fertility support and emotional wellbeing support as a competitive advantage for talent attraction. Trial registration number not applicable
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