The Birth Rate is Rising Among Older Women. Got IVF Coverage? 

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May 24 2018

We were interested to see in a recent release by the National Center for Health Statistics that while the number of US babies born in 2017 fell 2 percent from 2016, the birth rate among women over 40 actually rose slightly.

The study does not speculate about why the birth rate has slowed among women under 40. Possible economic factors include stagnant wage growth, growing student loan debt, and low rates of home ownership in this age bracket (only 14% of housing wealth is held by Americans under age 45). On a more positive note, easier access to contraceptives under the ACA may have helped reduce unintended pregnancies among teens.

But employers should take note that more women are choosing to have children later in life. While 56% of employers with 500 or more employees cover some type of infertility service, only about a quarter (26%) cover in vitro fertilization (IVF), according to Mercer’s 2017 National Survey of Employer-Sponsored Health Plans. Prevalence of all types of infertility treatment coverage is higher among the largest employers (those with 20,000 or more employees). IVF coverage is also more common in organizations that pay more – the average salary is almost $20,000 higher for the employers that cover IVF than for those that don’t.

Access to this coverage is highly valued by those who need it. In line with our recent analysis on the connection between lower turnover and greater use of well-being best practices, the average turnover rate in 2016 for employers offering IVF was 18%, compared to 23% among employers not covering IVF.


Employers with 500 or more employees:


Average annual salary

Average turnover in 2016

Offer Center of Excellence for women's health (infertility/pregnancy)

Offers IVF




Does not offer IVF





Of the employers that offer IVF coverage, 53% provide access to a Center of Excellence (COE) for women’s health, and 11% also provide incentives for employees to use the COE. An employer that used a COE approach to significantly improve outcomes was featured in our whitepaper on employer innovations in healthcare – you can read about it here .

Coverage for IVF has grown only slightly over the past five years --from 23% in 2012 to 26% in 2017. But as women choose to have children later in life, employers looking to enhance benefit programs may want to consider adding this coverage. It may be an easier decision if COEs for infertility treatment are available, as these organizations have been shown to reduce the likelihood of multiple births and help families achieve their desired outcome: a single healthy baby.

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