Last week, a patient told me she had missed an important meeting because the clinic had called her at 10.30 in the morning and asked her to come in for a scan before 1 pm. Her follicles had grown faster than expected. She could not postpone the scan, could not explain the real reason to her manager, and did not want to invent another migraine.
My short answer about IVF and work is this: you do not have to tell your boss everything, but you should not underestimate how difficult it is to keep IVF secret. If your treatment will require repeated appointments, sudden changes, a day off for egg retrieval, or recovery after a procedure, telling one trustworthy person at work usually makes life easier. Tell only what is necessary. Tell the person who can actually help. Do not assume that every manager deserves your confidence.
That is a practical answer. The emotional answer is harder. IVF is already an intimate, uncertain and physically demanding process. The last thing most people want is to discuss their ovaries, sperm, embryos or pregnancy plans with a manager who may be judging their commitment to work.
I understand that reluctance. I run an IVF clinic, but I also employ people and have backed companies where a founder’s absence can affect an entire team. I have seen both sides of this conversation. I have also seen how much unnecessary suffering is created when an employee is forced to choose between lying at work and exposing something deeply personal.
The first few appointments look manageable. Then the timetable stops being yours.
At the beginning of an IVF cycle, many patients believe they can fit treatment around their existing life. They will attend a scan before work, take an injection in the evening, and continue as normal. Sometimes that is possible.
But ovarian stimulation is not a railway timetable. We monitor how the follicles respond, and the next scan or change in medication depends on what we see. A patient may need four to eight scans during stimulation, often with blood tests. The appointments are usually scheduled in the morning because the results need to be available before the clinical team reviews the treatment plan later in the day.
The first one or two scans can often be booked in advance. After that, the exact dates become less predictable. A patient may receive less than a day’s notice. Egg collection is generally planned several days ahead, but the precise date depends on follicular growth. It usually means taking the day off, arranging transport and ensuring that someone accompanies her home after sedation.
These are not appointments that can always be shifted to suit a quarterly review or a client presentation. Biology does not care about the office calendar.
There is also the physical side. Hormonal medication can cause bloating, headaches, fatigue and mood changes. Most patients manage these effects, but “manage” does not mean “feel exactly as usual”. Egg retrieval is a procedure, not a quick blood test. Some women return to normal quickly; others need the rest of the day, or longer, to recover.
For the male partner, the burden is often less visible but still real. He may need to attend consultations, provide a semen sample at a particular time, accompany his wife for egg collection, or be present when difficult news arrives. I have met men who believe that because they are not taking injections, they have no legitimate reason to ask for time away from work. That is nonsense. Treatment is a couple’s experience, even when one partner undergoes most of the medical procedures.
IVF appointments are medical appointments. They are not a test of whether an employee is sufficiently organised.
IVF and work: what should you tell your manager?
I would not advise every patient to make a dramatic announcement to the whole office. You do not need to tell your colleagues that you are undergoing IVF. You do not need to disclose your diagnosis, your age, your ovarian reserve, your embryo number or whether you intend to transfer one embryo or two.
What you need is a workable arrangement.
There are three broad possibilities:
| Workplace situation | What may work | What I would consider telling the manager |
|---|---|---|
| Appointments are few and predictable | Use ordinary medical leave, annual leave or flexible hours | “I have a series of medical appointments over the next few weeks.” |
| Appointments may change at short notice | Agree on remote work, adjusted hours and a backup for urgent meetings | “I am undergoing a time-sensitive medical treatment and may occasionally need short-notice appointments.” |
| There may be procedures, side effects or emotional distress | Plan for a full day off and reduce non-essential responsibilities temporarily | “There may be one or two days when I am not fit to work, and I will give as much notice as I can.” |
The level of disclosure should match the level of practical disruption. If two appointments can be handled with a late arrival, you may not need to mention IVF at all. If you will need several sudden absences and a day for egg collection, a vague explanation may create more suspicion and stress than a limited, honest one.
I prefer the phrase “time-sensitive medical treatment”. It communicates that the timing is not entirely under the employee’s control without requiring a personal disclosure. If the manager is decent and the relationship is trusting, the employee may choose to say “fertility treatment” or “IVF”. If the manager is intrusive, hostile or known to gossip, there is no virtue in offering more information than necessary.
Before speaking to anyone, I would check the employment contract, leave policy and any fertility-treatment policy. Some employers allow medical appointment leave, flexible working, unpaid leave or remote work. Others do not have a specific policy but will treat IVF appointments as ordinary medical appointments. The exact legal position depends on the country and employment arrangement, so Indian employees should not assume that guidance written for the United Kingdom or the United States applies to them. If the consequences are serious, obtain advice from an Indian employment lawyer or HR professional.
The important point is simple: a company’s policy should not force a person to lie about a medical procedure. If an employee is unwell after treatment, that absence should be handled like other sickness absence. If the employee needs a medical appointment, the organisation should apply its normal rules fairly.
Why people keep IVF secret
Patients usually do not hide IVF because they are ashamed of wanting a child. They hide it because they are afraid of what the information will do once it leaves their control.
A woman may worry that her manager will assume she is about to become pregnant and will not be available for an important project. A man may worry that colleagues will make jokes about infertility. A younger employee may fear that the company will quietly decide not to promote her. A senior executive may believe that admitting vulnerability will weaken her authority.
These fears are not irrational. In many Indian workplaces, personal information travels quickly. A private conversation with a manager can become a corridor discussion by lunchtime. Women are sometimes treated as future maternity leave rather than as professionals with present capabilities. A failed IVF cycle can then become office gossip, which is a particularly cruel form of workplace intrusion.
There is another reason: IVF may fail. People hesitate to tell colleagues about a process when they do not know whether there will be a pregnancy to announce. They do not want to answer sympathetic questions after a negative result. They do not want to explain that the embryo did not implant, that the cycle was cancelled, or that the pregnancy ended.
I have written elsewhere about why I ask patients to embrace the journey rather than only the outcome. That advice is useful emotionally, but it does not mean patients owe their journey to their employer. A patient can accept the uncertainty of treatment while still protecting her privacy.
The cost of pretending that everything is normal
Keeping IVF secret can work for a short period. It becomes much harder when the employee has to invent a different illness for every appointment.
One day it is a stomach infection. The next day it is a dental procedure. Then there is an unexplained absence for egg retrieval, followed by fatigue and discomfort. The lies accumulate. The employee spends energy managing the story instead of managing treatment. If the cycle fails, she must continue pretending that nothing significant happened.
In a startup, this problem can be even sharper. A founder may believe that admitting the need for time away will alarm investors or demoralise the team. I have seen founders who refuse to take a single day off because they think the company will collapse without them. That is not dedication; it is poor organisational design. A company that cannot function when its founder attends a medical appointment has a concentration-of-risk problem.
The same applies to an employee. If a team cannot absorb one person’s occasional absence, the answer is not to demand that the person conceal treatment. The answer is to create handovers, backups and realistic workloads.
This is one place where my experience as an angel investor has influenced how I think about employment. I ask founders what happens if the founder is unavailable for a week. I ask who knows the passwords, who can speak to the customer, who can make the decision. I should ask the same questions of a manager planning a team. People will have illnesses, family emergencies, pregnancies, surgeries and difficult personal periods. A sensible organisation does not build itself around the fiction that everyone will be continuously available.
How I would have the conversation
I would keep the conversation short, practical and private. I would not begin with a long apology. I would not ask permission to have a medical life.
- Choose the right person. This may be your direct manager, HR, or both. If your manager is unsafe, speak to HR or a senior person you trust instead.
- State the minimum necessary fact. Say that you are undergoing time-sensitive fertility treatment, or simply a medical treatment, depending on how much you wish to disclose.
- Describe the likely work impact. Mention the possibility of several morning appointments, short-notice changes and one planned procedure day.
- Offer a workable plan. Suggest remote work, adjusted hours, advance handovers and a colleague who can cover urgent meetings.
- Ask for confidentiality. Be explicit that this is private medical information and should not be shared with colleagues.
- Put the arrangement in writing. A brief email confirming the agreed flexibility prevents later misunderstandings.
A possible script might be:
“I am undergoing a time-sensitive medical treatment over the next few weeks. I may need four or five morning appointments, sometimes with short notice, and one full day away for a procedure. I will give as much notice as I can, work remotely when appropriate, and arrange coverage for important meetings. I am sharing this with you in confidence and would appreciate your help in keeping the arrangement private.”
If the employee is comfortable naming IVF, she can do so. There is no prize for being more open than she wishes to be.
It helps to have the conversation before the most demanding part of treatment, not after missing two meetings. A manager is more likely to respond well when given a plan rather than a series of unexplained emergencies. I also advise patients to avoid promising that treatment will have no effect on work. That promise may be impossible to keep. Better to say, “I expect to remain fully engaged, but there may be occasional days when I cannot work normally.”
What if the boss reacts badly?
Not every boss will respond with kindness. Some will ask intrusive questions. Some will imply that the employee should have planned treatment outside office hours. Some will treat the possibility of pregnancy as a reason to exclude her from opportunities. A few may use the information against her.
That is why disclosure should be deliberate. Tell the person who has both the authority and the maturity to help. Keep records of requests, approvals and any subsequent adverse treatment. Use the formal HR process if necessary. Employment rights vary by jurisdiction, and IVF-specific protections are not identical everywhere, so I would not offer a sweeping legal assurance to an Indian employee without knowing the facts.
But the absence of a perfect legal remedy does not make discrimination acceptable. A person receiving fertility treatment is not less serious about work. A woman is not an unreliable employee merely because she may become pregnant. A man is not less committed because he needs to accompany his wife to a clinic.
Managers also need to understand the difference between flexibility and favouritism. Allowing an employee to attend a medical appointment is not giving her an unfair advantage. It is treating a medical need with ordinary humanity. The same flexibility should be available to someone undergoing chemotherapy, caring for a parent, attending psychiatric treatment or managing diabetes.
What colleagues should and should not do
If a colleague tells you that she is undergoing IVF, do not turn yourself into a fertility counsellor. Do not ask how many embryos were created. Do not ask whether she is pregnant yet. Do not tell her stories about your cousin’s successful treatment unless she asks. Do not offer unsolicited advice about diet, yoga, supplements or “relaxing”.
Offer practical help instead. Take notes in a meeting if she has to leave. Cover a client call. Accept that she may not want to discuss the treatment again. If the cycle fails, say, “I am sorry. I am here if you need anything,” and leave the door open. Do not demand an update.
For managers, the best support is often boring. Allow the appointment. Clarify the work priorities. Arrange cover. Do not make the employee repeatedly justify the same request. Do not discuss it with the team under the guise of planning. A manager’s job is not to extract the medical details; it is to ensure that the work is covered and the employee is treated fairly.
Should you tell the whole team?
Almost never, at least not initially.
There may be circumstances where a broad explanation is useful. A senior leader may choose to say that she is taking time for medical treatment, particularly if she wants to normalise the fact that people have lives outside work. But this should be her choice, not an expectation imposed by a workplace that wants a convenient explanation for her absence.
Most employees should tell one or two people and leave it there. If colleagues ask questions, “I have a medical appointment” is a complete sentence. If someone presses, “I would prefer not to discuss the details” is also complete.
Privacy is not dishonesty. It is a boundary.
The partner’s position is often overlooked
When I counsel couples, the woman’s treatment schedule naturally dominates the conversation. She has the injections, scans and egg retrieval. But the partner may be carrying a different kind of pressure. He may be expected to remain fully productive while worrying about his wife, attending consultations and dealing with his own fears about the results.
Men often find it particularly difficult to ask for flexibility. They tell themselves that their role is only to provide a semen sample and emotional support. This trivialises the reality of the process. A partner may need time away for egg collection, embryo transfer or a failed cycle. He may also need to be present because his wife does not want to travel home alone after sedation.
I have seen couples become isolated because both partners keep treatment secret at work. They return home exhausted, each pretending to be fine, because they have spent the day performing normality for colleagues. The workplace should not become another place where the couple has to carry this burden alone.
What happens after embryo transfer?
Patients often ask whether they should tell their employer after embryo transfer because they may be pregnant. The answer depends on the workplace, the work itself and the patient’s comfort with disclosure.
Embryo transfer does not guarantee pregnancy. The waiting period can be emotionally difficult, and many people prefer not to tell anyone until the pregnancy test is positive. Others may need to disclose because their work involves heavy physical activity, exposure to chemicals, radiation, infection risk or travel that cannot easily be changed.
I do not tell every patient to behave as if she is pregnant in every aspect of life after transfer. I do tell her to follow the clinic’s medical instructions and to raise any occupational safety concern with us. If her work carries a possible risk, she should not hide that risk merely to avoid a conversation with her employer.
Once pregnancy is confirmed, the practical and legal position may change. The specific rights will depend on Indian law, the employer’s policy and the nature of the job. Patients should obtain current advice rather than rely on an internet article written for another country. Medical confidentiality and workplace safety are separate questions; both deserve attention.
What employers should change
Most organisations do not need an elaborate fertility programme. They need sensible policies and managers who can apply them without embarrassment.
A good policy would explain how employees can request time for fertility appointments, whether flexible hours or remote work are available, how sickness absence is handled, and who will maintain confidentiality. It should include partners, not only the person undergoing ovarian stimulation. It should also cover unsuccessful treatment and the emotional impact of a failed cycle.
Training managers is more useful than putting a glossy paragraph in an employee handbook. A manager who says, “You should have thought about this before taking the job,” can cause more damage in one sentence than a policy can repair.
There is a business case for decency, but I do not want to reduce this to a business case. People should not have to prove that kindness improves retention before being treated kindly. Still, managers should understand that forcing employees to lie creates exactly the disruption they claim to fear. An employee who can take a scheduled morning off is easier to manage than an employee who is anxious, secretive and inventing emergencies.
My own instinct, as a doctor and an investor, is to design for uncertainty. IVF has uncertain timing and uncertain outcomes. Startups do too. In both settings, the people who cope best are not those who pretend uncertainty does not exist. They are the ones who name the risks early, make a plan, and keep enough flexibility to respond when reality differs from the plan.
I would not tell every patient to announce IVF to her boss. I would tell her not to sacrifice her mental health merely to preserve an illusion of perfect availability. If her manager is trustworthy, a limited disclosure can remove an enormous burden. If the manager is not trustworthy, she should protect her privacy, use ordinary medical-leave channels and seek advice before sharing more.
And I would tell every manager this: when an employee says she needs time for IVF, do not make her prove that the treatment is serious enough to deserve your cooperation. She is already attending a clinic where every scan, blood test and phone call carries hope and fear. The least you can do is ensure that she does not have to lie about a 10.30 appointment simply to remain a good employee.