Resources
Fertility and Occupational Health
Where fertility, occupational health and equity meet. White paper, supporting evidence, and signposts for OH practitioners receiving referrals.
Read the founding paper belowWhite Paper · April 2026
Hormonal Health Equity Initiative
Fertility treatment and work: the integrated picture
What the evidence says, what it means, and what can help.
Dr Divpreet Sacha · Dr Nadia Masood
Founding Directors, HHEI CIC
White paper · April 2026 · 11 pages
The paper
Most people undergoing fertility treatment keep going to work. This paper sets out what that means for employers, occupational health, and policy, and what the evidence suggests good support actually looks like.
- ·An accessible overview of what fertility treatment involves and where it intersects with working life.
- ·The psychological dimension, the workplace gap, and the case for inclusive support beyond the individual.
- ·What good support can look like in practice, drawn from the integrated lens HHEI works through.
Companion resources
Published with iOH
The white paper above sits alongside two companion resources, authored by Dr Divpreet Sacha and published in partnership with iOH for occupational health practitioners.
Produced in collaboration with iOH (the Association of Occupational Health and Wellbeing Professionals).
iOH toolkit · April 2026
Supporting Employees Through Fertility Treatment
The full toolkit on the iOH website. Clinical context, workplace impact, legal framework, and OH assessment guidance. Free for iOH members; lead article in OH Today, May 2026.
A live webinar accompanies the toolkit on Wednesday 27 May 2026, lunchtime, hosted by iOH for members.
Read on ioh.org.ukA4 infographic · iOH × HHEI
Fertility treatment and OH: a one-page summary
Co-branded one-page reference for OH practitioners. Headline statistics, the IVF cycle phases, common referral presentations, and what OH contributes at each stage.
Open access. Print-ready A4.
View infographicThe wider picture
How hormonal health impacts the workplace
HHEI is one paper into its work. The picture below is drawn from research by other organisations. We cite them here because the paper sits inside this wider landscape, and because attribution matters.
The economic cost of inaction
Hormonal health absenteeism is estimated to cost the UK economy around £11bn a year, with roughly 60,000 women out of work due to unmanaged menopause symptoms alone.
Source: NHS Confederation, 2024
The training gap
87% of managers report no training on fertility or hormonal health, and 39% of employees have used sick leave to conceal fertility treatment from their employer.
Source: Fertility Matters at Work and CIPD, 2025
The policy gap
Only 26% of UK employers offer any form of fertility support, and only 11% of organisations have a dedicated menstrual health policy.
Source: CIPD workplace health surveys, 2024 to 2025
The equity gap
Live birth odds after IVF are roughly half for Bangladeshi women compared with White British women. Black African women are around 80% less likely to receive HRT for equivalent symptoms.
Source: Maalouf et al., BJOG, 2017; BMJ Medicine, 2025
For OH practitioners
Receiving fertility referrals: what to consider
Signposts for occupational health practitioners. Not clinical guidance.
Fitness for work during treatment
IVF and other assisted reproductive technologies involve multiple clinic appointments, hormonal side-effects (bloating, fatigue, mood changes), and procedural recovery. For OH practitioners: a structured fitness-for-work assessment should account for the full cycle timeline, not just egg collection or transfer days.
Reasonable adjustments
Flexible start times, remote working, private space for injections, and temporary redeployment from physically demanding roles are all adjustments OH reports have supported. The Equality Act 2010 may engage where treatment-related symptoms constitute a disability in practice; OH opinion on whether the threshold is met is valuable for employer decision-making.
Psychological dimension
Failed cycles carry significant psychological weight. OH practitioners receiving referrals should ask about cycle history, not just current treatment status. Signposting to clinical psychology or peer support alongside occupational rehabilitation improves outcomes.
Return to work after treatment failure
Pregnancy loss following IVF is distinct from spontaneous miscarriage in several ways: the circumstances are known, the treatment investment is high, and the psychological impact may be compounded by repeated cycles. Structured OH review at this point, rather than relying on GP fit notes alone, supports sustainable return.
For employers
What employers need to know about mandatory requirements
Plain reading of the regulatory position as of April 2026. Not legal advice.
Gender Equality Action Plans (GEAPs)
Introduced under the Employment Rights Act 2025. Employers with 250 or more employees will be required to publish a GEAP, with a statutory duty to act on menopause and perimenopause. The voluntary phase opened in 2026; mandatory publication is currently expected from Spring 2027.
Equality Act 2010
Menopause, fertility treatment and conditions such as endometriosis can already engage the protected characteristics of sex, age and disability. Tribunals have upheld claims where employers failed to make reasonable adjustments.
Worker Protection (Amendment of Equality Act 2010) Act 2024
Introduces a positive duty on employers to take reasonable steps to prevent sexual harassment, including conduct connected to hormonal health and fertility. Failure can result in uplifted tribunal awards.
Fertility Treatment (Employment Rights) Bill, 2025
Currently at second reading. Would create a statutory right to time off for fertility treatment. Worth tracking for organisations updating fertility policies now.
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