How are Gen Z women supposed to treat fertility like another long-term financial planning category, alongside retirement, college savings, and homeownership? Answer: they can’t. Fertility is fundamentally different. The timeline, medical need, treatment path, and outcome can all be uncertain.

But the financial stakes are becoming harder to ignore. An American Society for Reproductive Medicine survey found 75% of women who had been through fertility treatment reported financial strain. Meanwhile, more employers are adding fertility benefits, but those benefits can still leave workers exposed to substantial costs, especially if coverage is capped or tied to a job they may not keep for long.

Below are a few questions to help women in their twenties financially plan for fertility.

Why do women keep pushing fertility down the list?

“Women often carry some of the heaviest financial burdens. Women spend about 30% more out of pocket on health care than men, often before fertility planning even enters the picture. Add housing costs in cities like San Francisco and New York,” Laura McDonald, co-founder and co-CEO of fertility insurer FLORA , said in an interview, “and long-term goals get pushed back. Fertility is often the first to go.”

Dr. Tara Harding, DNP, FNP-C, owns Simply You Wellness, a women’s health and fertility practice in North Dakota. “In our twenties and early thirties we’re given the advice to pay off our student loans, put money into our retirement, build up an emergency fund, save for a house and advance our careers,” she said in an interview. “Fertility hardly appears on that list. We either think that we’ll be able to have children when we’re ready, or we suppose that if we do have problems then our health insurance will cover the treatment. Unfortunately, neither is guaranteed.”

That creates a planning problem. Women are being asked to make financial decisions about fertility during the same years they may be paying down student debt, building emergency savings, trying to buy a home and establishing a career.

When should women start planning?

“Financial planning for fertility doesn’t mean you’re planning to have infertility,” Dr. Harding continues. “It means you’re financially preparing yourself to have choices.”

FLORA co-founder and co-CEO Dr. Christy Lane points to another complication: “Egg freezing tends to be most effective when women are younger, which is often when they’re earliest in their careers and least able to afford it.”

Dr. Harding’s solution is to incorporate fertility into financial discussions much earlier.

“We financially plan for homes which we have not yet bought, for children that we have not had, and for retirements that are many years in the future.”

It’s at the time of your first real job, she says, when you’re deciding what share of each check goes to retirement, a home, travel and an emergency fund. If kids matter to you someday, family building belongs in that conversation, even if it’s the smallest bucket.

That does not mean assuming you will need fertility treatment. It means recognizing that family-building decisions can carry costs before those decisions become urgent.

Can’t employer benefits handle this?

Employer fertility coverage has expanded significantly. Mercer’s employer survey found 47% of large employers covered IVF in their largest medical plan in 2024, more than double the 22% that did so in 2019.

But employer coverage creates its own vulnerability: fertility decisions may stretch across jobs.

Workers ages 25 to 34 had a median tenure of 3.0 years with their current employer as of January 2026, according to the Bureau of Labor Statistics. A worker can land a job with fertility benefits, begin planning or treatment, encounter a coverage limit and move to another employer a few years later.

Even staying put doesn’t guarantee full coverage. Among large employers covering IVF with a lifetime dollar cap, Mercer found the median cap was $20,000. Mercer notes that amount does not cover the typical cost of a single IVF cycle.

“Many women end up delaying, not because they don’t want children, but because the timing, cost and coverage don’t line up,” Dr. Lane says. “Your plans for a family shouldn’t depend on where you work.”

The larger financial question, then, is not simply whether an employer offers fertility benefits. It is how much those benefits cover, what happens when coverage runs out and whether the benefit follows the worker if her job changes.

What are the obvious and hidden costs?

Dr. Lane puts one egg-freezing cycle at $12,000 to $18,000, plus annual storage. Frozen eggs later require IVF as part of the process of trying to achieve a pregnancy.

Benefits consultancy Mercer puts a single IVF cycle at $25,000 to $35,000, depending on what’s included, and notes patients may need more than one cycle.

Those headline prices also do not capture every possible expense.

Dr. Harding walked through costs that can accompany fertility preservation or treatment: medications, ultrasounds, lab work, genetic testing when clinically indicated, annual storage fees and, if frozen eggs are later used, thawing, fertilization, embryo development and transfer.

Then there is the possibility of discovering a medical condition during the process. Endometriosis, PCOS, diminished ovarian reserve or a uterine abnormality, Harding says, can change the financial picture from paying for fertility preservation to managing a separate medical condition as well.

That helps explain why the American Society for Reproductive Medicine found such substantial financial strain among women who had undergone fertility treatment.

There are also new attempts to move fertility coverage outside the workplace. FLORA offers individually owned fertility coverage starting at $15 a month and recently announced a partnership with cycle-tracking app Clue that provides some policyholders with up to $50,000 in future fertility coverage.

The significance is less the individual product than the problem it is trying to address: employer-sponsored fertility benefits can disappear when someone changes jobs. Whether individually owned fertility insurance becomes a meaningful alternative will depend on cost, eligibility, coverage limits and how those policies perform when people actually need them.

How should women actually save?

The dollar figure isn’t the only thing that makes fertility different from a house or a 401(k). It is that you do not necessarily know what you will need, when you will need it or whether you will need treatment at all.