As Canada's birth rate falls to record lows, new data from Manulife Canada point to rising demand for fertility support – and a sizable gap between what many workers need and what their benefits plans currently provide.
To coincide with Canadian Fertility Awareness Week, Manulife reported that claims for fertility medications under its group plans have climbed 21% over the past five years, reflecting increased use of fertility treatments across the country.
Yet, among employers with Manulife group benefits, just 56% provide coverage for fertility medication and fewer than 1% cover fertility clinic treatments, leaving most families to shoulder the bulk of in vitro fertilization (IVF) and related costs. One IVF cycle in Canada can run $10,000 to $20,000, and multiple cycles are often required, according to the company.
“For the one in six Canadian families who experience infertility, their journey is often marked by fear, anxiety, and financial strain that can quickly feel overwhelming,” said Jennifer Foubert, head of product at Manulife Group Benefits. “When fertility coverage is available, we’ve seen first-hand how it can relieve some of the pressure and fundamentally change how people experience this chapter of their lives – not just in the clinic, but in the everyday decisions that surround it.”
The new data land against a stark demographic backdrop.
Statistics Canada figures showed the average age of mothers at the birth of their first child reached 31.8 years in 2024, up from 26.7 in 1976, increasing the likelihood of age‑related fertility challenges. Canada’s total fertility rate fell to 1.26 children per woman in 2023 and 1.25 in 2024 – both record lows and well below the replacement rate of 2.1.
That placed Canada among a group of “ultra‑low fertility” countries that includes Switzerland, Luxembourg and Finland. At the same time, clinical and advocacy groups estimate that roughly one in six Canadian couples will experience infertility at some point, a prevalence that has roughly doubled over the past 40 years.
Manulife’s own experience suggests the impact of those trends is already visible in workplace benefits. Over the past five years, use of fertility drugs among women aged 25–34 under its plans has risen 13.5%, while use among women aged 35–44 is up 24%. Across its book of business, Manulife says 14.6% more people claimed fertility drugs in 2024 than in 2023.
There is no national framework for IVF and other fertility services in Canada, and public funding varies significantly by province. Ontario, for example, offers public funding for one IVF cycle for eligible patients, while other jurisdictions provide little or no direct support, leaving a patchwork of provincial programs and employer‑paid or out‑of‑pocket care.
Within Manulife’s group benefits portfolio, just over half of employers now include some fertility drug coverage, but coverage for clinic‑based treatments such as IVF or intrauterine insemination remains rare.
A 2023 survey of Canadian plan sponsors conducted by Mapol Inc. for Organon found that 53% of employers still did not offer any fertility benefits, and among those that did, typical maximums for combined drug and treatment coverage were under $3,500 – well below the cost of a single IVF cycle. Other research has suggested that only about one‑third of Canadian employers invest in fertility benefits at all, and only a small fraction cover both medications and procedures.
Manulife recommended that employers who opt in for fertility benefits set at least a $15,000 lifetime maximum per family, though some sponsors now offer up to $50,000. By comparison, the company’s own internal program goes further: in 2023 it removed cycle, dollar and lifetime caps for employees, extending coverage to treatments, procedures and drug costs.
The insurer has also begun layering services on top of financial coverage. In 2025, Manulife became the first Canadian insurer to partner with Maven Clinic, giving eligible group benefits members access to Maven’s digital programs across fertility, family building, maternity, parenting and menopause where employers choose to add the service.
“Group benefits plans have a unique opportunity to better reflect families today,” said Ashesh Desai, head of group benefits at Manulife Canada. “As more Canadians rely on fertility care to build their families, workplaces play an important role in shaping how employees experience this defining chapter of their lives. When benefits coverage reflects this reality, fertility care becomes part of a broader life journey – supporting people not just at work, but in moments that stay with them for years to come.”
As Canada’s fertility rate continues to fall and more people delay parenthood into their 30s and 40s, expectations are likely to grow that employers – and the insurers that support them – will treat fertility care as a core workforce and population‑health issue rather than a fringe benefit.
Manulife’s latest claims data suggest that shift is already under way; the open question for the market is how quickly benefits design, funding and support services will catch up.
