Miriam Zoll raises concerns about Intel’s employees’ fertility benefits.
At first blush, last week’s announcement that Intel will be joining the ranks of Apple and Facebook in January 2016 by boosting its employees’ fertility benefits seemed like good news. The computer chip giant raised the lifetime cap of $10,000 for fertility services and $5,000 for medications to $40,000 and $20,000 respectively. To its credit, it also raised adoption benefits from $5,000 to $15,000.
Ogden Reid, Vice President and director of compensation and benefits at Intel was quoted by media as saying that the company considered data indicating that the average treatment cycle costs up to $20,000 and is 20 percent to 30 percent likely to succeed. “We’re hopeful that we can increase the odds by going from paying for half of one cycle to paying for two full cycles,” he said.
Intel’s position is a hopeful one, looking at the per cycle outcome glass as being 20 to 30 percent full, rather than 70 to 80 percent empty.
Intel has also dismissed the need for a medically indicated diagnosis of infertility to access fertility services. By doing so it is enabling healthy older couples facing natural fertility decline, as well as same-sex couples, to access what the industry calls “cutting-edge technologies” – in-vitro fertilization (IVF), intra-cytoplasmic sperm injection (ICSI), and embryo and egg freezing, among other techniques.
But there are serious concerns to be raised about the efficacy and safety of many of these fertility services. For example one recent study identified a “lack of will” among the medical establishment and the public to question the perceived success of IVF. The authors of that study stressed that many infertility clinics were increasingly over prescribing IVF to couples that would likely conceive naturally eventually.
Another study revealed that the use of ICSI–a procedure developed to treat male infertility where sperm is injected directly into the egg–has more than doubled in the last two decades. That same study found that ICSI was regularly employed, regardless of whether the male had a fertility problem. Further, it found that ICSI did not improve live birth rates.
There are also few studies that track the health of women who inject hormones and undergo egg retrieval. The limited evidence on safety that does exist is, at best, inconclusive. Even less is known about whether eggs absorb the liquid nitrogen they are frozen in, and whether it is toxic to embryonic cell development.
Furthermore, the Society for Assisted Reproductive Technology estimates that even in younger women under the age of 38, the chance of one frozen egg leading to a live birth is only 2-12 percent. The failure rates increase as women age.
Current evidence also suggests that IVF-ICSI is associated with an increased risk of low birth weight, preterm birth, neonatal death, birth defects, autism, and intellectual/ developmental disabilities.
Over time we may be able to assess whether Intel’s new benefits package actually serves as an incentive package that, intentionally or not, encourages women workers to delay childbearing. Evidence shows that advanced maternal age raises pregnancy health risks, including gestational diabetes, preeclampsia, and hypertensive disorders that place severe stress on a woman’s cardiovascular system––and the fetus––due to increased blood volume and flow.
The high failure rates and risks linked to reproductive technologies and delayed childbearing, behoove Intel to ensure that strong mental health supports for employees are also built into the new benefits package.
The question we need to ask is whether Intel has been fully informed about these serious physical and mental health concerns for women and infants. If it does know about them, why would they encourage their female employees to expose themselves to procedures with such questionable therapeutic benefit?
Companies that want to offer safe benefits for their workers and possible progeny must receive broad counsel from a multidisciplinary medical team comprised of representatives from maternal fetal medicine, neonatology, genetics, and psychology.
Companies that only rely on infertility clinics and doctors for information about reproductive technologies are doing themselves and their employees a disservice.
Miriam Zoll is an Author (Cracked Open: Liberty, Fertility and the Pursuit of High-Tech Babies) and Emeritus Board Member of Our Bodies Ourelves @miriamzoll