This is not a fertility story with a happy ending, but it ends with hope for others.
We’ll start with what we have in common. Both of us worked in the higher education sector while undergoing fertility treatment. We both went through numerous cycles over a number of years, and they all failed.
Both of our fertility issues arose after giving birth. We were already familiar with the professional stigma, readjustment and stressors that came with being parents. Neither of us wanted to compound the damage to our reputations or career prospects, especially if we were not going to have another child.
We suppressed our frustration and grief, while we carried on with the job. When we were open, our colleagues’ compassion sustained us, but it was all still exceedingly hard.
Our stories do diverge in some ways, and for one of us, treatment carries on. We do, however, share a sense that better awareness of the challenges of juggling fertility treatment and work and guidance for workplace support are needed.
We know we are not the first to surface this issue, but our hope is that our stories will give rise to the clarity and compassion needed to support those who struggle to conceive.
Understanding the scope
According to the NHS, about 1 in 7 couples will have trouble conceiving. About the same percentage will struggle to fall pregnant for a second time. As mentioned before, both are forms of infertility. It is therefore likely that you will encounter someone seeking treatment – or someone partnered to this person.
The most recent HESA data tells us that in higher education settings, there are just over 104,000 female academic staff and at minimum 120,000 non-academic staff. Fertility can also affect men, and of course, can affect students as well as staff.
Understanding fertility treatment
Fertility treatment is not the same as IVF. It can span everything from diagnostic testing, hormone-based therapies, medically inducing ovulation, withdrawing and implanting sperm and eggs and far more. The cost for those self-funding is typically £800 to £5,000 per cycle, but it can run upwards to £15,000.
Fertility treatment is an embodied and emotional experience. The migraines; the bruised abdomen from injections; intense swelling and bloating. The hormones playing havoc with your emotional state; the trauma when it fails. For all of this, normal employment laws relating to medical and sickness leave apply. Pregnancy protections begin only once a woman is pregnant. Compassionate leave for failed cycles is discretionary.
How fertility treatment can impact work or study
In terms of availability, fertility treatment is usually minimally disruptive, unless the person receiving treatment has to travel to seek care. One of us was able to fit most appointments into lunch or at the start of the day, but the other had to undertake eight hour round trips to attend a specialist clinic for patients with immune-system issues. This required short-term cover, but it could be planned.
The issue, however, is that you often don’t know when your treatment will start, particularly if it is IVF. You wait three months, you get an appointment for the following week, and if you don’t say yes, you wait a further six months – or two years if a pandemic comes along.
Fate will, of course, make this happen at the worst possible time. After a divisional restructure, one of us had to renegotiate a fixed-term employment contract in the run-up to a cycle of IVF. Eight months later and at another organisation, the same thing happened again. Imagine starting a role with that level of stress, pumped full of hormones.
That is what has an impact.
Issues relating specifically to higher education
Higher education is paradoxically static, in that classes are scheduled, the same sort of things repeat at the same time each year – and also dynamic, in that it can be hard to predict when certain external decisions, such as publication or funding, will be made.
Building upon the issues highlighted above, one of us found out they secured a major grant between cycles. The subsequent cycle failed just as the funded project, which involved a large number of institutional partners, was just beginning to get off the ground – but they were reliant on the success of the project to part-fund their own role.
The other was invited to go to Florence for an ERASMUS + funded project transnational meeting. The timing was bad for follicle development monitoring, which involves scans at a particular point in a cycle, and it would be difficult to travel with needles and medicine that needed to be refrigerated to a certain temperature. So, for one of us, that CV-defining opportunity was lost.
Another issue is the interface with the public on politically contentious issues. One of us was trolled by an academic activist. It impacted a cycle. Even when the issues are less contentious – in one case, teaching on topics relating to babies and children – it can be exceedingly difficult to retain academic detachment for an issue so close to raw emotion.
But in the dog-eat-dog race for permanent jobs, or even just hard-earned collegiate respect, you carry on, don’t you?
Where universities can provide leadership
If higher education providers were to act together, perhaps under the auspices of a membership body, to co-produce a framework for supporting those with fertility issues, that would significantly advance practice. There is scant guidance for managers and institutions, so it is unsurprising many feel at a loss on how to best support people. Casual and fixed-term employment complicates things further.
They can also support people through education. Murray Edwards College at Cambridge is doing this already, and others should consider following suit.
What you can do to help
If you find you need to support someone going through fertility treatment, here is what we suggest you do:
- Be supportive. Listen and ask open questions about how you can help. Think about the impact treatment can have on personal wellbeing as well as on one’s career.
- Be flexible. Make reasonable adjustments, just as you would with anyone with unexpected medical need.
- Be compassionate. This is the most important one. Fertility issues can erode one’s sense of self-worth. Infertility causes deep grief. Be responsive and kind. Regardless of the outcome, it matters deeply.
I think this is a really important article and my thoughts are with the authors. I think the way that fertility issues can interact with precarity is so important, and so sad. I didn’t have IVF but I did have three miscarriages while working as an academic on fixed-term contracts, and then went on to have a baby (and then left academia). I found the miscarriages had a terrible impact on my productivity and trajectory and, unlike when I had a baby, because it wasn’t visible, there was no support, no schemes. As the authors say, it’s so hard to know that you’re damaging your career for a baby you might never have. But I think the only solution is to make academia a less punishing profession for everyone – one where having personal issues for a couple of years out of a career isn’t fatal, where workloads allow people to be human. I don’t think a framework for fertility, however well intentioned, can do much otherwise.
Thank you for writing this article.
Wonderful article. I too have suffered two miscarriages in the last 6
six months, and we are still trying to conceive and not give up on our dream of becoming parents.
The personable, caring and genuinely supportive way in which I have been treated by colleagues, especially my senior (male) colleague/s eased my anxiety about returning to work (I was away for 4 days for my first loss and one day for the second). Being honest about what I was going through helped me, and I hope also helps break the stigma of silence around pregnancy loss.
We are all human beings with real, sometimes painful and messy lives. Just a little authentic compassion can do so much to relieve the sense of painful isolation for women and their partners in inevitably feel when they have to ‘put their work face on and return to the day job’. Seeing the person behind the worker matters, and can make all the difference.
I send my wishes of support to anyone else also on this journey, and my thanks to all have supported us along the way.
Related: https://onlinelibrary.wiley.com/doi/full/10.1111/gwao.12665
thank you for sharing this article. I agree with the writers that this is an extremely important work. I believe it’s crucial to consider how precarity and fertility concerns can combine.