Meaghan Ferneau was 29 when she discovered she was infertile. She had undiagnosed endometriosis for years and she described doctors saying her condition was all in her head until a specialist told her she needed “surgery yesterday.”
It was the beginning of a seven-year series of failed embryo transfers, surgeries, medical hormone treatments and a miscarriage. She has spent the last three years pursuing IVF treatment, and all for one goal: “I wanted to hear my baby cry.”
Now age 35, Ferneau gave birth to her daughter nine months ago. The Arkansas-based senior marketing manager has performed three embryo transfers for which she had to travel to her hometown of St. Louis. Her saving grace, she said, were the employee benefits she could access through her employer while she was neck-deep in nearly $25,000 in infertility-related bills.
Ferneau had a difficult pregnancy. She was hospitalized twice and her baby spent five days in the neonatal intensive care unit when she was finally born.
Previously, she had undergone two laparoscopic surgeries in two years to treat her endometriosis. Neither worked.
Ferneau felt the few clinics in her state weren’t right for her. “I see my personal health as something I need to advocate for and research,” she said Fortune, adding that she knew “very well that some technologies, such as intrauterine insemination, would not work for me, a patient with a very intense level of endometriosis.”
That’s what drove her to the fertility clinic she visited in Arkansas, and it wasn’t the first red flag she noticed. “They requested a marriage certificate,” she said, adding that although she is married, she found it “very interesting.”
At the time, Ferneau was working with a company that offered benefits for fertility treatments, but none of the clinics she visited accepted insurance. Her insurance for her employees, under UnitedHealthcare, provided $15,000 for infertility treatments, but she could only use about $1,000 for some of her medications.
Naomi Cahn, a University of Virginia professor who studies family law, said two things could improve this situation: States could move toward establishing infertility insurance requirements, and employers, even those based in states without minimum infertility insurance standards, they can offer such benefits. .
“Less than half of states require infertility to be covered by insurance,” Cahn said. Even in states that have requirements, he said, coverage “may not apply to self-insured or self-funded insurance plans.”
Currently 19 states require at least some form of infertility insurance coverage, according to Revolve, a national infertility association. Cahn said “employers can obviously go well beyond that minimum, and often do.”
After the Supreme Court ruling Roe v. Wade in June 2022, several companies, such as Patagonia and Dick’s Sporting Goods, reiterated their commitment to abortion care policies on LinkedIn.
Now, as states impose restrictions on telemedicine and mail-in medications, and states pass laws that attempt to punish employers who want to increase access to care, some workers believe their employers aren’t providing enough help.
In a survey of more than 1,000 employed U.S. adults conducted by Catalyst in October, about 44% of respondents said they would like to see their employers do more to ensure access to abortion.
Likewise, the high price of IVF makes coverage important, Cahn said. Bikes can cost up to $20,000, she said, adding that “many people will absolutely have to rely on employers for assistance with payments.”
Besides that, infertility is quite common. According to the Centers for Disease Control and Prevention, about one in five women in the United States is infertile, and the problem has gotten worse.
Ferneau underwent two of three cycles of mini IVF, a lower-dose version of IVF, in St. Louis. Both failed. The total cost of the procedures plus room and board was approximately $17,000.
Financial difficulties caused her to double down on her side business: a private dinner service for clients in a word-of-mouth business model that she runs together with her husband, a classically trained chef.
The duo owned a restaurant in Little Rock called Cathead’s Diner, which closed its doors during the pandemic. They now offer a customized menu for dinners, something they started 12 years ago when they first met. The duo threw at least three parties every month, putting “every ounce of profit in a jar.”
His financial fortunes finally changed in June 2022, when he started a new job at Compt that offers employees a $4,000 annual stipend for out-of-state care — an initiative that Ferneau believes the CEO of company, Amy Spurling, started with women like her in mind.
“There are women in this community who have gotten part-time jobs at Starbucks just so they can access fertility benefits,” Ferneau said. “They’re already going through so much and then on top of that, they’re working two jobs.”
The business benefit is “one of the best things that helped my family feel financially comfortable during such a trying experience,” Ferneau said. He covered almost the entire cost of his third transfer attempt. This time, she transferred two embryos and became pregnant with both, even though she miscarried one later that month.
Through Compt, she was reimbursed just over $8,000. After a second hospitalization during the birth of her daughter, she had racked up nearly $25,000 in bills.
The birth, which was difficult, left her fearful of another pregnancy. There is growing pressure on her as she considers what to do with her frozen embryo left in the St. Louis clinic as state legislation on women’s reproductive freedom grows increasingly strict.
“All of this has gone on, it’s made us question what we need to do,” Ferneau said. “If we have to intervene before something drastic happens, we may not have access to it or who knows what could happen.”