It was the start of a seven-year series of failed embryo transfers, surgeries, medical hormone treatments and a miscarriage. She’s spent the past three years pursuing IVF treatment, and it was all for one goal: “I wanted to hear my baby cry.” 

Now age 35, Ferneau gave birth to her daughter nine months ago. The Arkansas-based senior manager of marketing went through three embryo transfers for which she had to travel to her hometown in St. Louis. Her saving grace, she said, was the employee benefits she could access through her employer while she was neck-deep in nearly $25,000 of infertility-related bills.  

Ferneau had a hard pregnancy. She was hospitalized twice, and her baby spent five days in the neonatal intensive care unit when she was finally born. 

Beforehand, she had undergone two laparoscopic surgeries in two years to treat her endometriosis. Neither worked. 

Ferneau felt like the few clinics in her state weren’t the right fit for her. “I see my personal health as something that I need to advocate for and research,” she told Fortune, adding that she knew “full well that certain technologies, like intrauterine insemination, wouldn’t work for me, a patient with a very intense level of endometriosis.” 

That’s what the fertility clinic she visited in Arkansas pushed her to do, and it wasn’t  the first red flag she noticed. “They required a marriage certificate,” she said, adding that although she’s married she found that “very interesting.” 

At the time, Ferneau was working with a company that offered benefits for fertility treatments, but none of the clinics she visited would accept the insurance. Her employee insurance, under UnitedHealthcare, made $15,000 available for infertility treatments–but she was only able to use about $1,000 of it towards some of her medications. 

Naomi Cahn, a University of Virginia professor who studies family law, said that two things could make this situation better: states could move towards establishing infertility insurance requirements, and employers, even those based in states without minimum infertility insurance standards, can offer those benefits. 

“Under half the states require infertility to be covered by insurance,” Cahn said. Even in states that have requirements, she said, coverage “may not apply to self insured or self funded insurance plans.” 

Currently 19 states require at least some form of infertility coverage in insurance, according to Revolve, a national infertility association. Cahn said that “employers can of course go well beyond that minimum, and often do.”

After the Supreme Court overturned Roe v. Wade in June 2022, several companies, like Patagonia and Dick’s Sporting Goods, restated their commitment to abortion care policies on LinkedIn. 

Now, as states impose restrictions on telehealth and medication-by-mail, and states pass laws that attempt to punish employers who want to increase access to care, some workers feel their employers aren’t providing enough help.

In a survey of over 1,000 employed U.S adults conducted by Catalyst in October, about 44% of respondents said they wanted to see their employers doing more to ensure abortion access. 

Similarly, the high price of IVF makes it important to cover, said Cahn. Cycles can cost up to $20,000, she said, adding that “many people will absolutely need to rely on employers for assistance with payment.” 

Beyond that, infertility is quite common. According to the Centers for Disease Control and Prevention, about one in five women are infertile in the U.S.–and the problem has gotten worse. 

Ferneau underwent two of three rounds of mini IVF, a lower dose version of IVF, in St. Louis. Both failed. The total cost of the procedures plus room and board was about $17,000.

The financial strain made her double down on her side hustle: a private dinner service for clients in a word-of-mouth business model that she co-runs with her husband, a classically trained chef. 

The duo used to own a restaurant in Little Rock called Cathead’s Diner, which shuttered during the pandemic. They now offer a personalized menu for dinner parties, something they started 12 years ago when they first met. The duo worked at least three parties each month, putting “every ounce of profit into a jar.” 

Her financial luck finally turned in June 2022, when she started a new job at Compt which affords employees a $4,000 yearly stipend for out of state care–an initiative Ferneau believes the company’s CEO Amy Spurling began with women like her in mind.

“There are women in this community that have gotten part-time jobs at Starbucks just so they can access fertility benefits,” Ferneau said. “They’re already going through so much and then on top of it, they’re working two jobs.” 

The corporate benefit is “one of the single best things that have helped my family feel comfortable financially while navigating such a heavy experience,” Ferneau said. It covered almost all of the cost for her third transfer attempt. This time, she transferred two embryos and got pregnant with both, although she miscarried one of them later that month.

Through Compt, she’s been reimbursed just over $8,000. After a second hospitalization during her daughter’s birth, she had amassed almost $25,000 in bills.

The birth, which was difficult, left her scared of another pregnancy. It’s a mounting pressure as she considers what to do with her remaining frozen embryo in the St. Louis clinic as state legislation on women’s reproductive freedom increasingly cracks down. 

“As this has all gone on, it’s made us question what we need to do,” Ferneau said. “If we need to jump on it before anything drastic happens where we might not have access to it or who knows what could happen.”