Oncofertility and fertility benefits: What employers need to know about preserving parenthood after a cancer diagnosis

What you need to know:

Oncofertility helps people preserve fertility after a cancer diagnosis, but coverage can be inconsistent and time-sensitive, so employers play a critical role in providing access through fertility benefits.

• Fertility preservation often needs to happen quickly, before chemotherapy or radiation
• Coverage varies widely by state, insurer, and employer health plan design
• Out-of-pocket costs can be substantial without dedicated fertility benefits
• Maven supports egg freezing through expert navigation and coordinated fertility care when preservation benefits are included in a member’s plan

A cancer diagnosis changes everything. For many, it also raises a second, urgent question: will treatment affect my ability to have children?

Chemotherapy, radiation, and certain surgeries can damage reproductive health, making fertility preservation a time sensitive decision. For people diagnosed during their reproductive years, the window to act can be short, and access to care depends heavily on whether egg freezing, sperm freezing, or embryo freezing is covered through insurance or employer benefits.

This intersection of oncology and reproductive health is known as oncofertility. It focuses on helping people preserve fertility before treatment begins and supports long term reproductive autonomy after survivorship.

Learn more about Maven’s partnership with Color Health to expand oncofertility access.

Oncofertility is becoming increasingly relevant for employers as cancer costs rise and workforce needs evolve. The cost of cancer care is expected to surpass $240 billion by 2030, and the financial burden continues to be felt by patients and employers alike.

At the same time, access to fertility preservation remains uneven. State mandates and insurance rules vary widely, and many employees face high out-of-pocket costs unless fertility benefits are intentionally designed to close coverage gaps. As a result, employers are increasingly including fertility preservation within broader fertility benefits, especially for employees navigating medically induced infertility, including fertility challenges related to cancer.

In this article, we explain what oncofertility is, why employers should consider coverage, and how Maven can support egg freezing, sperm freezing, or embryo freezing through comprehensive fertility benefits.

Understanding oncofertility

What is oncofertility?

Oncofertility refers to fertility preservation and reproductive planning for people who have been diagnosed with cancer and may undergo treatment that impacts future fertility.

The term exists because timing matters. Cancer treatment decisions often need to happen quickly, but fertility preservation may be most effective when planned before treatment begins. This can create a narrow window for employees to understand their options, consult specialists, and confirm what they may have coverage for.

As Maven Chief Medical Officer Neel Shah highlights in his newsletter, the Preprint, "Cancer survivors helped advance fertility preservation from experimental to mainstream, yet many still find parenthood out of reach because of gaps in the health system.” Hear more here.

How cancer treatment can impact fertility

Cancer care can affect fertility in different ways depending on the treatment type, intensity, and the individual’s age and reproductive health. For some, fertility may recover after treatment, while for others, the impact can be permanent.

Common fertility related effects include:

• Reduced ovarian reserve or egg quality after certain chemotherapy protocols
• Damage to reproductive organs or hormonal systems following radiation
• Fertility loss after surgeries affecting reproductive anatomy
• Reduced sperm count or quality after chemotherapy or radiation

Because risk varies, clinical guidance is needed early. In recent updates, the American Society of Clinical Oncology (ASCO) recommends discussing fertility preservation as early as possible and referring patients to reproductive specialists when appropriate. 

Fertility preservation options after a cancer diagnosis

Oncofertility is not a single procedure. It describes a range of fertility preservation and family building pathways that may be considered before treatment. Depending on medical appropriateness and timing, options may include:

Egg freezing (oocyte cryopreservation)

Egg freezing is one of the most widely used fertility preservation methods for people with ovaries and has rapidly increased in the U.S., with demand for services growing by 194% from 2020-2023 alone. During the process, eggs are retrieved and frozen for future use. It  typically requires ovarian stimulation and monitoring, which is why timing is important.

Embryo freezing

Embryo freezing involves fertilizing eggs with sperm (from a partner or donor) prior to freezing. For some people, this can be an option when they already have a family building plan in mind.

Sperm freezing

Sperm cryopreservation can often be completed quickly and is commonly recommended prior to treatment for people producing sperm.

Ovarian tissue cryopreservation

This option may be recommended in specific situations, especially when urgent treatment is required. It involves surgically removing and freezing ovarian tissue for potential use later.

Because each option has different timing and eligibility considerations, patients benefit most when fertility preservation is integrated into early care planning, not treated as an afterthought.

Legislative landscape: coverage is expanding, but still inconsistent

In many cases, the biggest barrier to oncofertility is not clinical access— it’s insurance coverage.

Over the last decade, fertility preservation coverage has expanded through state level mandates. However, the legislative environment remains uneven, and employers often operate across multiple states with different requirements.

A 2024 review notes that 16 U.S. states have enacted fertility preservation insurance mandates, though policies differ substantially in how they define iatrogenic infertility (fertility loss caused by medical treatment such as chemotherapy or radiation), what services are covered, and which plans are subject to regulation. 

Even when mandates exist, coverage may be limited by:

• Plan type (for example, fully insured vs. self-funded plans)
• Definitions of medical necessity
• Specific eligibility criteria
• Limits on services, medication coverage, and storage duration

For employers, the practical takeaway is that employees’ access to oncofertility support can vary widely even within the same organization, depending on where they live and which plan option they are enrolled in.

Why employers should cover oncofertility treatment through fertility benefits

Fertility preservation after a cancer diagnosis sits at the intersection of health equity, mental health, and workforce stability. For employers, it is also increasingly relevant as healthcare costs rise and employees expect benefits that reflect real life needs.

1) It supports employees at a time of acute vulnerability

Cancer is a health crisis, and the possibility of fertility loss can add grief, distress, and decision fatigue to an already overwhelming time. Fertility preservation benefits help employees retain future choice, even if family-building is not an immediate priority, by protecting the option to pursue parenthood later.

2) It reduces inequity and improves inclusion

Without fertility benefits, oncofertility is often only accessible to employees who can pay out of pocket on short notice, creating an equity gap that can disproportionately impact those already facing structural barriers to care. Inclusive coverage should also reflect the full range of family-building paths by supporting donor services, different family structures, and definitions of infertility that don’t exclude LGBTQIA+ employees or single parents.

3) It strengthens retention and long term trust

Employees remember how employers show up in high stakes moments. Maven’s State of Women’s & Family Health Benefits report found that 85% of employers say reproductive and family health benefits are important or very important for retaining employees. However, oncofertility support carries additional weight as it demonstrates an employer’s commitment to survivorship, whole person care, and long term wellbeing.

4) It fits into the reality of rising cancer costs and cost pressure

Cancer costs continue to rise, increasing the financial burden across the healthcare system, including for employers sponsoring health plans. In this context, it becomes even more important that benefits are aligned with employee needs, but also coordinated and easy to navigate so employees can access timely support without unnecessary fragmentation.

What fertility benefits should include to support oncofertility

If employers want to offer meaningful oncofertility support, it is not enough to include a line item for fertility preservation. Benefits need to be understandable, accessible, and time responsive, especially when treatment timelines are moving quickly. 

Employees should be able to get rapid clarity on what is covered (including egg freezing, fertility medications, and any pre authorization requirements), what out-of-pocket costs to expect (if any), and which clinics are in-network or preferred. Access to fertility specialists also matters, since timing can make the difference between preserving options and missing the window. 

Because these decisions are often made under significant stress, mental health support should also be built into the experience, not treated as separate care. In 2023, only 41% of young women with breast cancer reported being counselled about fertility options. And yet for those who were, 1 in 5 modified their treatment, even choosing less effective treatments to protect their fertility.

Finally, benefits should be inclusive by design, supporting different family-building paths, including LGBTQIA+ employees, single parents, and donor services where relevant, without relying on restrictive eligibility rules or outdated assumptions about who qualifies for fertility care.

How Maven supports egg freezing and fertility preservation navigation

Supporting employees through fertility preservation after a cancer diagnosis can feel complex, especially when care decisions are time sensitive and benefits are difficult to navigate. Maven can help employers deliver more coordinated fertility benefits by supporting egg freezing and fertility preservation pathways through Maven’s Fertility and Family Building program.

Maven provides an integrated platform that combines clinical guidance, emotional support, and benefit navigation in one place. This gives employees access to knowledgeable, compassionate care during one of the most vulnerable periods of their lives—including support from providers with expertise in the intersection of cancer and fertility. This also helps HR teams reduce fragmentation across clinics, carriers, and reimbursement processes.

In particular, Maven's specialized oncofertility care pathway will enable members to receive immediate access to a dedicated virtual care team from both Maven and Color Health. This team includes oncologists, dietitians, mental health providers, fertility preservation specialists, and care advocates who guide them through their options, as well as strategies to preserve ovarian reserve during cancer treatment, while navigating the clinical, emotional, and financial complexities of time-sensitive fertility decisions and the intersection with fast-moving cancer treatment plans.

For employers who offer Maven Managed Benefit, Maven can also help administer the financial components of fertility preservation by streamlining benefit access, reimbursements, and cost visibility in one program.

When egg freezing or fertility preservation benefits are included in a member’s plan, Maven can support employees by providing:

• On-demand virtual access to fertility specialists, reproductive endocrinologists, and mental health providers
• Guidance on fertility preservation options, timelines, and next steps, including egg freezing
• Coordinated navigation support to help employees understand coverage, eligibility, and how to access care quickly
• Emotional wellbeing support to help employees cope with high stress medical decision making
• Financial benefit administration through Maven Managed Benefit, including transparent cost guidance and reimbursement support for eligible fertility preservation services
• A streamlined experience that supports both employees and employers by simplifying access to expert care and fertility benefits

Learn more about Maven’s Fertility and Family Building program and book a demo today.