More <a href="https://www.thenationalnews.com/tags/uae/" target="_blank">UAE</a> companies are offering support to employees with <a href="https://www.thenationalnews.com/health/2022/10/21/doctor-sees-growing-numbers-of-gym-going-steroid-users-with-fertility-problems/" target="_blank">fertility issues</a>, but they are still a minority, experts have told <i>The National</i>. With infertility increasing globally and <a href="https://www.thenationalnews.com/uae/2023/10/26/change-in-law-allows-unmarried-non-muslim-couples-to-undergo-ivf-in-uae/" target="_blank">law changes in the UAE</a> allowing unmarried non-Muslim couples to undergo IVF treatment, more people than ever are seeking medical solutions for family planning. Toshita Chauhan, business head of health and motor insurance at Policybazaar.ae, said there is a growing demand for fertility treatments to be included in medical insurance packages across the UAE. “Fertility treatments, specifically <a href="https://www.thenationalnews.com/uae/2021/07/04/ivf-in-the-uae-why-the-fertility-treatment-is-so-popular/" target="_blank">IVF</a>, are not routinely included in most UAE health insurance plans, especially for expats,” she told <i>The National</i>. “Some insurance companies might be offering plans with optional add-ons for fertility treatments, but these are likely not the majority.” When it is included, it is within premium products worth more than Dh60,000 per year, she added. “The percentage of companies [with] fertility coverage in UAE health insurance packages would likely be a low single-digit percentage.” <a href="https://www.thenationalnews.com/health/2023/01/12/global-decline-in-male-fertility-sparks-need-for-action/" target="_blank">Infertility is</a> a disease of the male or female reproductive system defined by the World Health Organisation (WHO) as a failure to achieve a pregnancy after a year or more of trying. The UAE has one of the <a href="https://www.thenationalnews.com/uae/health/uae-has-one-of-the-lowest-fertility-rates-in-the-world-study-finds-1.970502" target="_blank">lowest fertility rates</a> in the world, with high living costs and a growing focus on building careers over starting families contributing to a decades-long decline, according to a 2020 study by US-based data resource organisation Knoema. One in six couples in the UAE have difficulties conceiving, and the total fertility rate has decreased from 2.7 births per woman in 2000 to 1.5 in 2021, according to statistics from the World Bank. Factors associated with infertility across the country include increased age at marriage, obesity, high tobacco use, consanguineous marriage, a lack of physical activity and a high prevalence of chronic comorbidities, especially diabetes, according to a 2023 report published in the<i> International Journal of Environmental Research and Public Health</i>. This is in line with global statistics, as the WHO reported last year that about 17.5 per cent of the adult population – about one in six worldwide – experience infertility. The report showed limited variation in data between regions, and rates were comparable for high, middle and low-income countries. “The report reveals an important truth: infertility does not discriminate,” said Dr Tedros Adhanom Ghebreyesus, WHO director general. “The sheer proportion of people affected shows the need to widen access to fertility care and ensure this issue is no longer sidelined in health research and policy, so that safe, effective and affordable ways to attain parenthood are available for those who seek it.” HSBC UAE, which falls under the subsidiary HSBC Bank Middle East, is the latest to announce the introduction of fertility treatment coverage within its health insurance packages. This includes in vitro fertilisation and intrauterine insemination, as well as fertility preservation support. It extends to all female and male employees, as well as their spouses. Engineering consultancy company WSP Middle East also introduced fertility provisions for workers in 2021. Its group insurance package provides up to $10,000 a cycle for anyone undergoing relevant treatments such as IVF, gamete intrafallopian transfer and zygote intrafallopian transfer, said the company’s human resources director, Richard Stilgoe. The company also has flexible working options in place to allow employees “the time and space required to focus on what matters most”, he added. “We recognise that parenthood is an essential part of forming a well-rounded life for many people,” Mr Stilgoe told <i>The National</i>. “In the case of starting a family, we are mindful that people oftentimes might delay their journeys into parenthood due to fear of negative career consequences, discrimination or lack of psychological safety in the workplace. “We want to dispel this stigma and instead empower our people to take on major life decisions stress-free with full confidence.” This year WSP will also introduce a programme offering employees more options when returning to work following any recent fertility struggles, maternity leave or long-term illnesses, he said. This could be an “accelerated pathway back into the professional environment or, if they prefer, a more gradual integration option”. Global technology company Snap Inc, which developed and runs Snapchat, has a similar return-to-work policy and offers its UAE staff insurance coverage for expenses associated with infertility diagnosis and surgical treatments, plus access to Carrot Fertility and Maven Clinic. “These programmes provide access to dedicated care support teams, educational resources, advisory services and generous financial support through employer-sponsored funding for eligible fertility services, such as IVF, sperm and egg freezing,” a representative told <i>The National</i>. Currently, there is no legal obligation for companies in the UAE to provide support to employees undergoing fertility treatment, said James Clarke, a lawyer with BSA Ahmad Bin Hezeem and Associates. “There are well-understood protections in labour law around taking sick leave, so where, for example, a certain treatment resulted in an individual worker unable to work for a period of time, then subject to any additional terms of the relevant employment contract, there would be some protection, depending on the detail of the individual’s circumstances,” he said. Mr Clarke said the company has noted an increasing number of employers in the UAE “beginning to take a positive initiative by offering specific support to employees undergoing fertility treatment”. This isn’t always related to health insurance, however, particularly among smaller companies that simply cannot afford the high premiums. Tappy Toes Nursery, for example, which has two locations in Dubai, has instead incorporated support within its HR policy, said managing director Foram Gohel. This allows staff members undergoing fertility treatment to use a portion of their maternity leave, which is 120 days. “Our HR policy is pro-employee, acknowledging the emotional and physical challenges that accompany fertility treatments,” said Ms Gohel. “Starting a family is a huge step forward and it comes with ample responsibilities. Supporting our staff through their journey eases their concerns, and they are able to be productive, and leads to high employee retention rates.” Cassie Destino, an American fertility doula in Dubai who founded IVF Support UAE, said she doesn’t often come across people who have provisions within their employment contracts. “In fact, I see a lot of people asking me how they should navigate going through this treatment without their boss or company knowing,” she said. Scheduling issues and emotional concerns are key subjects for full-time employees undergoing fertility treatment, added Ms Destino, who has herself undergone two rounds of IVF. “It often depends on your relationship with your boss … A lot of people don’t like to talk about it with friends and family. “They certainly don’t want to talk to their boss about it, so there are lots of psychosocial dynamics to it, as well as the practical financial aspects.” However, Ms Destino said she has noticed more acceptance of fertility issues, in the UAE compared to her home country. “<a href="https://www.thenationalnews.com/world/us-news/2024/03/06/alabama-legislation-to-protect-ivf-providers-moves-towards-final-approval/" target="_blank">In Alabama</a>, they’re overturning people’s right to have IVF … it’s very upsetting,” she said. “Nobody starts fertility treatment lightly. It is because they have a fundamental life goal in mind, which is to become a parent, which is the right of all human beings. And they are finding it difficult for whatever reason. “[Employers] helping to create their family is like the biggest gift you can ever give to someone and, if you value your employee, then what an extraordinary opportunity you have to make this huge difference in their life.”