IVF protections face possible narrowing as EEOC signals regulatory rethink

A regulatory review by the Equal Employment Opportunity Commission could redefine what counts as a pregnancy-related accommodation, potentially narrowing protections for workers undergoing in vitro fertilization.

The Pregnant Workers Fairness Act, signed into law by President Biden in 2023, requires most employers to provide reasonable accommodations for pregnancy, childbirth and related conditions. A 2024 EEOC regulation clarified that those related conditions include miscarriage, abortion, lactation and fertility treatments. Andrea Lucas, the Trump-appointed chair of the EEOC, has signaled that she wants to revisit that regulation, signaling a potential rollback that could reshape how fertility care is treated in the workplace.

The shift comes at a time when the White House and conservative factions inside the Republican coalition are recalibrating how reproductive health and family policy are pitched. In 2024, Democrats held a majority on the five-member EEOC, and Lucas was outvoted. After President Trump's inauguration, he fired two Democratic commissioners and named Lucas to acting chair, a move that set the stage for broader regulatory change. The October confirmation of Brittany Panuccio, a Republican, solidified conservative control and intensified expectations that the agency could revisit the rule governing pregnancy- and fertility-related accommodations. Advocates say the change would narrow protections for workers seeking IVF accommodations, such as time off for appointments or other adjustments that support fertility treatment.

For workers pursuing IVF, flexibility around scheduling is not a luxury but a necessity. IVF often requires precise timing of cycles, appointments, and procedures, and patients may be called in at short notice for procedures like egg retrieval. Advocates argue that limiting accommodations would force workers to choose between their jobs and pursuing fertility treatment. “Employers frequently balk at IVF appointments, seeing them as elective and not as necessary,” said Inimai Chettiar, president of the workplace justice nonprofit A Better Balance. “The protections of the Pregnant Workers Fairness Act are really critical when it comes to IVF.”

Those protections have already shown measurable value. A 2013 study estimated that 250,000 women per year had their requests for reasonable accommodations rejected, underscoring the need for clear workplace protections. Supporters note that workers without sick leave or with physically demanding jobs are especially vulnerable, as are patients of color and older patients who may require more IVF cycles to achieve a pregnancy. Advocates also point to reports of retaliation against workers pursuing fertility treatments and highlight cases where employees have alleged job loss after requesting time off for IVF-related care.

The potential rollback is part of a broader conversation within conservative circles about pronatalism—the idea that birth rates are too low and that policy should incentivize larger families. Trump allies and some MAGA officials have voiced concerns about population decline and have pushed policies to bolster fertility. Yet within the movement, there is deep disagreement over IVF. Some on the so-called tech right view fertility treatments as a practical tool to raise birth rates and even to screen potential traits, while anti-abortion groups and religious conservatives oppose IVF on moral grounds because some embryos are destroyed during the process. Analysts say the question is not simply about IVF access but about how to balance reproductive rights with ideological commitments.

Trump has repeatedly touted his support for IVF, describing himself as a proponent of fertility treatment. A White House plan unveiled in October proposed guidance to employers on IVF coverage and a discount on fertility drugs through a forthcoming federal portal, but critics warn the plan did not go far enough to guarantee broad access or affordability. Observers are watching to see where the EEOC will land, given the tension between pro-natalism goals and concerns from social conservatives who fear that expanding IVF access could be interpreted as endorsing broader reproductive rights that they oppose.

While supporters emphasize the potential public health and demographic benefits of enabling people to pursue families, opponents warn that narrowing IVF protections could stigmatize fertility treatment and impede access just as the country debates abortion policy. Some researchers and advocates argue that ensuring workplace accommodations is part of creating conditions where people can pursue fertility care without risking their livelihoods, and they warn that any rollback could undercut the administration’s stated aims to improve fertility care and stabilize birth rates.

If the EEOC moves to narrow the regulation, patients undergoing IVF could face more obstacles in balancing work with treatment schedules. That would contrast with recent signals that the administration intends to push for broader access to fertility care. “You can say we’re going to improve insurance coverage, and we’re going to do all these things, and then I can’t leave work to go to my doctor’s appointment,” said Sharita Gruberg, vice president for economic justice at the National Partnership for Women & Families. “We’re looking at a future where workers under this administration would not have the actual right to access IVF.”

The current stalemate in Washington means the trajectory of IVF protections remains unresolved. Observers say the EEOC is likely weighing competing priorities and legal arguments as it prepares any rule revision, with the potential to come in the coming months. Regardless of the timing, advocates warn that any rollback would be a setback for workers pursuing fertility treatment and could undermine efforts to ensure that employment policies support reproductive health choices. As the country debates how best to address fertility and family formation, the question remains whether the workplace can be a stabilizing factor for those pursuing IVF or whether protections will be narrowed, leaving patients to navigate a more precarious balance between employment and treatment.