Fertility treatment doesn't fit neatly around a work schedule. An 8am ultrasound, blood tests on a specific cycle day, egg retrieval in the middle of the working week — everything happens when it needs to, not when it's convenient. This creates real tension between medical necessity and professional obligations.
Legal protections for employees undergoing fertility treatment vary considerably across Europe. Some countries have specific provisions; in others you have to rely on general employment and anti-discrimination law. This article provides an overview — but for your specific situation, always consult a lawyer or trade union representative in your country.
Most medical procedures involved in fertility treatment — including egg retrieval and embryo transfer — are formally medical interventions. This means sick leave should be available on the same basis as for any other outpatient procedure.
The difficulty is that fertility treatment involves many appointments that aren't 'procedures' in the narrow sense: monitoring scans, blood draws, consultations. These are harder to cover with a medical certificate, and employees often end up using annual leave or taking unpaid time. This is particularly unfair given that one IVF cycle can involve ten or more appointments.
In some European countries this is beginning to change. Spain introduced specific paid leave for women's health reasons in 2023, including gynaecological procedures. Portugal guarantees the right to sick leave for IVF. The Netherlands and Belgium allow medical leave. Check the current rules in your country.
One of the most common questions: do I have to tell my employer I'm undergoing fertility treatment? The short answer is no. In most European countries, medical information is confidential, and employees are not obliged to disclose a diagnosis or the nature of their treatment.
When requesting sick leave, you provide a doctor's certificate confirming temporary incapacity — without stating a diagnosis in the vast majority of cases. Your employer has no right to demand details of your medical condition.
That's the theory. In practice many people face pressure — explicit or implied — to explain frequent absences. The key point is that you can share as much as you choose. 'I am receiving medical treatment' is a complete and legally sufficient answer that requires no further detail.
If you decide to tell your employer more, that is your choice, and it may make negotiations about flexible working easier. But assess your workplace: unfortunately, stigma around fertility treatment exists, and not every manager will respond with understanding.
Negotiating flexible working for the period of treatment is one of the most practical approaches. In most EU countries, employees have the right to request flexible working, and employers are obliged to consider the request in good faith — though they are not always obliged to grant it.
If remote working is possible in your role, it is often the most convenient format: you can have a blood test early in the morning and then work from home, or go to a retrieval and return to work later. Many people complete full IVF cycles without taking formal sick leave precisely because of flexible schedules.
If your job doesn't allow flexibility, it's worth having a conversation with your line manager in advance — without necessarily disclosing details — about adjusting some of your schedule. 'I have a number of medical appointments over the next two or three months' is often enough to reach a practical arrangement.
This is a legally complex area, and the answer depends on the country. In several EU states, fertility treatment falls under anti-discrimination protections on grounds of sex or health — particularly for women, since most procedures involve the female body.
A key EU-level precedent is the European Court of Justice ruling in Mayr (2008): the court held that dismissing a woman after follicle aspiration but before embryo transfer in IVF constitutes sex discrimination under the Equal Treatment Directive. This ruling applies across the EU, though its practical application varies.
The broader principle: if an employer makes decisions negatively affecting an employee that are directly or indirectly connected to that person undergoing fertility treatment, that is potentially discriminatory. In practice, proving the connection is difficult, and most cases remain in a grey area.
If you are concerned about discrimination: document all interactions with your employer in writing, or follow up verbal conversations in writing. This creates an evidential record if the situation escalates.
Most legislation on fertility treatment protection is oriented towards women — reflecting the medical reality that most procedures involve the female body. Partners' rights (whether male or female) during treatment are considerably weaker in most countries.
That said, partners also attend procedures — most notably sperm collection and, if present, the retrieval itself. In some countries there is specific leave for IVF partners; in others, only general sick leave applies. Check what applies in your country.
For same-sex female couples the situation is particular: both partners may need to be absent from work — especially in reciprocal IVF, where one undergoes stimulation and retrieval. Legal recognition of both as equal parties in treatment varies by country.
If you've decided to inform your employer about your treatment — whether partially or fully — a few practical principles will help make the conversation productive.
Be specific about what you need, not about what you're going through. 'I'll need scheduling flexibility over the next two or three months, with the ability to move meetings at times' is a constructive request. The medical details are your private business.
Where possible, offer a practical solution. How will you cover your absence? Remote working during other hours, redistribution of tasks, a temporary shift in schedule? Employers respond better when offered a ready solution rather than just a problem.
If possible, have the conversation at a relatively calm moment — not on the day of egg retrieval and not immediately after a negative test result. Choose a reasonably stable time and plan the conversation in advance.
Record agreements in writing. If your manager agreed to something verbally, follow up with a written summary by email or message. This protects both sides.
For many people, work during fertility treatment is not only an obligation but a resource. Daily structure, professional identity, social contact — all of these can be important anchors during a period when everything else feels uncertain.
On the other hand, work can create additional stress — deadlines, travel, the need to present normally at a moment when you're emotionally stretched. It's worth honestly assessing: is work helping or getting in the way right now? If it's the latter, reducing the load, taking accumulated leave, or using employer-provided psychological support may be the right move.
Employee Assistance Programmes (EAPs) are offered by many large European employers. They are confidential, free to the employee, and include access to counsellors and psychologists. If your employer offers one, it may be a genuinely useful resource right now.
Fertility treatment and work are not mutually exclusive, but combining them requires planning, communication and knowing your rights.
You are not obliged to explain your diagnosis. You have a right to medical confidentiality and to sick leave for medical procedures. You can request flexible working without disclosing the reason. And if you have faced discrimination, you have legal tools to respond.
The legal landscape in this area is developing actively. Stay informed about legislative changes in your country, and consult a trade union or employment lawyer if needed.
EAP (Employee Assistance Programme) — a psychological and social support service provided by employers. Typically confidential and free to the employee.
Equal Treatment Directive (2006/54/EC) — the main EU instrument prohibiting sex discrimination in employment. Applied by the Court of Justice in cases involving fertility treatment.
Indirect discrimination — a neutral-seeming rule or practice that in practice disadvantages a particular group. For example, a rigid prohibition on flexible working may disproportionately affect people undergoing medical treatment.
Mayr ruling (C-506/06) — landmark 2008 European Court of Justice decision holding that dismissing a woman after follicle aspiration during IVF is sex discrimination.
Medical confidentiality — the principle that a patient's medical information may not be disclosed without their consent. In employment, it protects employees from having to disclose a diagnosis to their employer.
Reasonable adjustment — an employer's obligation to make reasonable changes to working conditions for an employee in particular circumstances. The precise scope depends on national law.
Sex discrimination — less favourable treatment of an employee on the basis of their sex. EU courts have found in some cases that dismissal connected to fertility treatment constitutes sex discrimination.
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