Authors: Dr Valentina Paolucci Assistant Professor in Human Resource Management, School of Business, ALL Institute Member, and Co-Investigator of ReproWork, Maynooth University & Professor Marian Crowley-Henry, Professor of Human Resource Management, School of Business, ALL Institute Member and Co-Investigator of ReproWork, Maynooth University.
It is Friday. You have a doctor’s appointment at 3pm: an embryo transfer that cannot be moved because the timing is dictated by your body’s hormones, not by your employer’s calendar. You are an early-career academic on a fixed-term contract. No one knows at work why you are not in the office. Disclosure feels risky when your position is not yet secure. Silence protects the job that pays the clinic bill. You use a day of annual leave. Your partner cannot be there; he has no ‘right’ to be. Ten days later, at lunchtime, the nurse calls: “Can you speak? … I’m sorry, the treatment has failed” – again. You deliver your lecture, answer your emails, and hope no one comments on how lovely your “long weekend” must have been.
This is the reality for thousands of people in Ireland undergoing fertility treatment while in employment. Around one in six people globally experience infertility, one of the most overlooked public health challenges. In Ireland, over 6,000 IVF cycles are completed each year. That number is growing: uptake of state-funded IVF rose by 50% in the past year alone. Fertility treatment is no longer rare. Yet Irish workplaces, and policy, are still treating it as invisible. Our research project, ReproWork, is the first systematic, interdisciplinary study to ask why and what needs to change.
Ireland has made genuine progress on public funding for fertility treatment. But access remains tightly bounded. Age thresholds, restrictions on the number of funded cycles, eligibility criteria based on family form, and narrow medical criteria mean that many people still do not qualify. Most treatment is financed privately, often costing several thousand euro per cycle, with multiple cycles frequently required. Waiting lists add further pressure. For some, travelling abroad becomes less a choice than a consequence of restricted eligibility, high costs, or limited domestic capacity. And because success is rarely achieved in a single attempt, this process can stretch over years.
Alongside this funding landscape, Ireland has no dedicated statutory framework guaranteeing fertility leave or structured workplace accommodation. In practice, employees rely on annual leave, sick leave, or informal arrangements negotiated case by case. Support therefore depends on managerial discretion rather than enforceable rights.
This absence of protection matters. Fertility treatment is clinically time-sensitive and physically demanding. It involves repeated scans and blood tests during working hours, invasive procedures, recovery after unsuccessful cycles or early miscarriage, and prolonged uncertainty. In rigid roles, accessing care requires disclosure. Without clear legal safeguards, that disclosure carries professional risk. It is therefore unsurprising that a significant proportion of employees undergoing fertility treatment report considering leaving their jobs.
It is at the intersection of these two gaps: inadequate funding and absent employment protection, that inequality becomes most acute. People in permanent, secure roles with stable incomes have more options: they are more likely to take leave, absorb costs, and negotiate flexibility. Those in temporary, fixed-term, probationary, or low-paid contracts have far fewer. Employment precarity is not simply a financial problem: it acts as a structural barrier to reproductive health access, shaping who can realistically begin, sustain, or openly navigate fertility care.
Gender compounds this further. Fertility continues to be treated as a women’s issue in both organisational cultures and policy conversations. Women carry the visible medical burden and the implicit expectation of discretion. Men, even where male-factor infertility is central to a couple’s situation, are rarely recognised as patients in their own right. Their need for time off, workplace support, and acknowledgment remains largely invisible, and Irish policy has yet to meaningfully address it. The exclusion extends further still: eligibility rules tied to relationship status or prior children can disadvantage same-sex couples and single individuals, while those seeking fertility preservation encounter the same gaps in funding and workplace recognition. Reproductive autonomy in Ireland is shaped not only by healthcare systems, but by the absence of coherent and inclusive workplace protections.
Some Irish employers have begun to respond. A small number of organisations have introduced fertility leave or informal accommodations, often in direct response to increasing employee demand. This reflects genuine and welcome awareness. But without overarching statutory standards, these initiatives remain uneven, concentrated in larger, better-resourced organisations, and leaving employees in smaller firms, lower-paid sectors, and precarious contracts, where many workers are in their prime reproductive years. The result is a patchwork of provision that can widen, rather than close, existing inequalities.
This is the context in which ReproWork operates. Funded by Research Ireland under the New Foundations scheme, ReproWork is a civic-academic partnership between Maynooth University’s School of Business and Merrion Fertility Clinic, Ireland’s only not-for-profit fertility clinic. Rather than treating infertility as an individual coping challenge, ReproWork creates a structured space to examine it as a workplace and public policy issue. The project does not seek to produce clinical or organisational evaluations. Instead, it uses a multi-round Delphi process to bring together clinicians, HR professionals, and individuals with lived experience to identify and prioritise the most pressing questions at the intersection of reproductive healthcare and working life. In doing so, it builds a shared agenda for future research, dialogue, and policy engagement.
The project is organised around three connected priorities: what meaningful workplace accommodation might look like when grounded in clinical reality; what forms of resources employers require to support staff during treatment; and how employees can be better supported around disclosure, access, and continuity of care. Its outputs are designed to translate research into accessible information and guidance for the wider public and key stakeholders, including employers, trade unions, employees, clinicians, and policymakers. The aim is to provide more adequate and equitable workplace accommodations around fertility treatment.
Ireland is at a moment of genuine transition on reproductive health. The establishment of the Assisted Human Reproduction Regulatory Authority marks real institutional progress, and public debate on Assisted Reproductive Technology regulation is intensifying. But employment protection remains largely discretionary, and the intersection of fertility and work has been almost entirely absent from national policy conversation, until now. Reproductive health equity is not only a question of whether treatment exists and is funded. It is a question of whether Ireland’s employment and funding frameworks make treatment realistically accessible, for everyone, not just those fortunate enough to have the right contract, the right employer, and the right financial conditions.
That is the question ReproWork is working to answer.
Funding: ReproWork is funded by Research Ireland under the New Foundations Scheme; the industry partner is Merrion Fertility Clinic.
