Around 10–20% of recognised pregnancies end in miscarriage, and with IVF also becoming more common, fertility treatment and pregnancy loss are increasingly part of everyday life and workplace conversations.
Against this backdrop, a fertility doctor is warning that some of the language still used at work, such as “at least you can try again”, can fail to reflect just how emotionally and physically complex these experiences really are.
Dr Abhijit Kulkarni, Consultant in Reproductive Medicine at Create Fertility, explains why IVF, miscarriage and menopause are fundamentally different from typical health conditions, and what needs to change in how they are discussed.
How IVF, miscarriage, and fertility-related experiences differ from other common workplace health situations in terms of emotional impact
‘Typical’ illnesses, like a flu or a chest infection, are usually temporary hurdles that the body eventually clears. IVF, miscarriage, and menopause are fundamentally different from a standard illness because they are deeply tied to a person’s identity, future, and biological transition. Unlike a temporary infection, these experiences involve profound hormonal shifts that can affect every aspect of a person’s physical and mental well-being over a long period. A miscarriage is a significant bereavement that requires emotional processing alongside physical recovery, while IVF and menopause involve systemic changes that can be unpredictable. These are life-altering events rather than short-term medical issues, and they require a more empathetic and sustained level of support.”
Why phrases like “at least you can try again” can be harmful when speaking to someone who has suffered from pregnancy loss
“Clinically, “trying again” is never a guarantee and ignores the reality of ovarian reserve. For a patient with low anti-müllerian hormone (AMH) levels, a failed cycle or miscarriage represents a dwindling biological window that may not open again. This phrase also ignores cumulative trauma — the physical and hormonal exhaustion that builds up with each attempt. By focusing on a hypothetical future, we risk dismissing the very real physical recovery and grief the patient is going through.”
What colleagues and managers should say (and avoid saying) to someone undergoing fertility treatment
“The most effective support is direct and practical, avoiding ‘silver lining’ platitudes such as “everything happens for a reason,” “at least it happened early on,” which, even with good intentions, can feel incredibly cruel. Instead, colleagues can use language that recognises the emotional reality, such as:
“I am sorry you are going through this; I’m here if you want to talk or if you need anything while you’re going through this.”
Managers, on the other hand, should focus on practical and workplace adjustments, such as:
“I’m happy to adjust your workload and cover meetings so you can focus on your appointments and wellbeing,” or “Let’s make sure you have the flexibility you need for treatment and recovery time.”
Managers should treat these situations like any other specialised medical need, granting the employee autonomy to attend appointments or take rest without repeatedly justifying their situation. The goal is to provide comfort and clarity so the employee doesn’t feel their career is at risk because of their biology.”
Why workplace stress or stigma worsens symptoms or recovery, and how
“High levels of workplace stress and the fear of stigma can trigger the chronic release of cortisol and adrenaline. These fight or flight hormones are significant disruptors of the endocrine system, which is already under intense pressure during IVF, miscarriage, or menopause. In a clinical setting, we see that elevated cortisol can interfere with the body’s ability to regulate other essential hormones. For someone managing menopause, this stress-induced inflammation can physically worsen the frequency and severity of vasomotor symptoms like hot flashes and night sweats.
Furthermore, stigma can create a state of hyper-vigilance. When an employee feels they must hide a miscarriage or a failed IVF cycle to protect their professional standing, their body remains in a state of high tension. This prevents the parasympathetic nervous system from taking over, which is the state required for deep tissue repair and hormonal balancing. Stigma also acts as a barrier to care; patients often delay seeking medical help or skip recovery days to avoid being perceived as unwell or incapable, which can turn a standard recovery into a prolonged health crisis.
A supportive, open culture is therefore a biological necessity; it provides the physiological safety the body needs to shift its resources toward healing and recalibration.”
Why “brain fog” in menopause or IVF is more than just a lack of concentration
“During menopause or high-intensity IVF cycles, the brain’s estrogen receptors, which are responsible for how the brain uses glucose for energy, are effectively starving or being overwhelmed. This leads to a genuine ‘power failure’ in the parts of the brain responsible for memory and executive function. When a colleague undergoing IVF struggles to find a word or loses focus in a meeting, it is crucial to recognise that this may reflect a physiological response to significant hormonal and emotional stress rather than simple distraction or reduced effort.”
How the “90-day window” change shows we should support colleagues
“Reproductive health is rarely a ‘day-of’ event. For instance, it takes approximately 90 days for a sperm cell to mature or for an egg to be prepared for ovulation during an IVF cycle. This means the lifestyle choices, stress levels, and workplace environment an employee experiences today will directly impact their clinical results three months from now. When we talk about workplace support, we aren’t just talking about the day of an egg retrieval or the week after a miscarriage. We are looking at a three-month biological ‘lead-in’ where keeping stress hormones like cortisol low is vital for the success of the treatment or the health of a future pregnancy. True support is about a sustained environment, not just a one-off day of leave.”
What employers should understand about supporting employees undergoing fertility treatment and pregnancy loss
“Workplace support should not be viewed solely as an employee wellbeing initiative, but as a factor that can influence treatment tolerance, recovery, and overall health outcomes. In reproductive medicine, we routinely see that stress, lack of flexibility, and uncertainty in the workplace can add to the physical and emotional burden of fertility treatment and pregnancy loss.
For this reason, employers are encouraged to move beyond informal or case-by-case adjustments and instead implement clear, consistent frameworks. These should include protected time for medical appointments and treatment cycles, as well as appropriate leave and recovery support following pregnancy loss — at any stage. It’s also equally important that managers are trained to handle these discussions sensitively, so employees are not put in a position where they must repeatedly disclose or justify private medical information, unless they choose to.
Confidentiality, flexible working arrangements, and access to emotional support should be considered core components of any occupational health approach in this area. It is also essential to recognise that fertility-related experiences are highly individual; therefore, effective policies must remain adaptable and responsive to different clinical pathways rather than applied through a rigid model.”