Zora Health / Employer guide / Bulgaria
Support employees through fertility treatment, and keep the talent you have invested in.
Fertility treatment rarely fits around a work calendar, and most employees go through it quietly, often while doing some of their best work. Zora Health helps you build practical fertility support, from policies and manager guidance to confidential care navigation and access to 128+ partner clinics in 16 countries, around your workforce and budget. Companies including Hilton, LinkedIn, Sanofi, HSBC, Mastercard, Carousell and Singapore Management University work with us.
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Five things Bulgarian HR leaders should know
- Bulgaria’s total fertility rate of 1.72 in 2024 was the highest in the EU (Eurostat), and 6.5% of children born in 2024 were conceived through assisted reproduction.
- The Centre for Assisted Reproduction pays up to BGN 6,000 (€3,068) per IVF attempt, for up to 4 attempts, to citizens and permanent residents while the woman is under 43.
- Sofia’s donor egg programme has been open to women without a partner, up to age 45, since March 2026; other municipalities run their own funds.
- There is no statutory IVF leave, but Article 333 of the Labour Code limits dismissal of an employee in an advanced stage of IVF treatment.
- Private IVF in Sofia is listed at about €800 to 3,500, usually before drugs, so a fixed allowance keeps the employer’s budget predictable.
Why fertility is a business problem for employers
Fertility treatment does not fit around a work calendar. A clinic sets the date of a scan the day before. Egg collection happens when the body is ready, usually about 36 hours after a final trigger injection. Then comes a two-week wait, and for many couples, another cycle. Your team feels it: missed meetings, unexplained absences, a strong performer who suddenly goes quiet.
The World Health Organization estimates that about 1 in 6 people worldwide are affected by infertility. We found no Bulgarian survey on fertility treatment at work. In Carrot Fertility‘s 2023 survey of 5,000 people in Canada, India, Mexico, the UK and the US, 79% felt uncomfortable discussing fertility at work.
- Resignations. 39% of employees with fertility challenges in Ferring‘s 2025 survey of more than 3,600 employees and employers in Australia, France, Japan, Poland and the UK had left or considered leaving their job during treatment.
- Lower performance. 55% in the same Carrot survey said fertility challenges had hurt their work performance.
- Dismissal rules HR must know. Under Article 333 of the Labour Code, an employee in an advanced stage of IVF treatment, like a pregnant employee, can be dismissed only on restricted grounds, and disciplinary dismissal needs prior permission from the Labour Inspectorate (CMS, February 2025; Innovires, March 2026).
What employers gain
Keep the people you spent the most to develop
Replacing an employee costs one-half to two times their annual salary, according to Gallup. A written policy, paid time off and a funded allowance remove some of the reasons people leave.
Stand out in a tight labour market
In the Carrot survey, 65% said they would change jobs for an employer with fertility benefits. The law gives no paid time off for treatment, so a written fertility policy is something candidates can compare. We found no published example of a Bulgarian employer with a fertility benefit.
Make fertility support financially predictable
Aon projected a gross medical trend rate of 21.0% for Bulgaria in 2026, after 23.0% in 2025, against a European average of 8.2% (Aon Global Medical Trend Rates Report 2026). A fixed annual or lifetime allowance is easier to budget than open-ended cover.
Zora helps employers structure benefits around local treatment costs and the state and municipal funds, so HR can run the programme within an agreed budget.
Want to see what this would look like for your Bulgarian workforce?
What IVF costs, and what the state pays
Bulgaria adopted the euro on 1 January 2026 at a fixed rate of €1 = BGN 1.95583 (European Commission). Amounts set in leva are converted at that rate. The Centre for Assisted Reproduction (CAR) at the Ministry of Health pays up to BGN 6,000 (€3,068) per IVF attempt, including tests and drugs, up to BGN 600 (€307) per frozen embryo transfer and up to BGN 3,000 (€1,534) for fertility preservation, after a 20% rise in 2023 (Ministry of Health, 2023). The BGN 6,000 ceiling was still in place in July 2026, and the 2026 draft budget is €11.25 million, the same as 2025 (Politis, July 2026).
| Item | Listed private price (€) | Notes |
|---|---|---|
| IVF or ICSI package, Nadezhda Women’s Health Hospital, Sofia | 3,200 to 3,500 | Package for visiting patients; listing headline price from 3,500; does not say whether stimulation drugs are included |
| IVF cycle, Aphrodite MC, Sofia | from 1,172 | No detail of inclusions |
| IVF to blastocyst transfer, Dr. Shterev Hospital, Sofia | 815 to 1,528 | Excludes hormonal stimulation and other drugs |
| IVF with donor eggs | 2,955 to 6,700 | Dr. Shterev Hospital and Nadezhda |
| Freezing of eggs, per egg | about 56 (BGN 110) | Dr. Shterev Hospital; the stimulation and retrieval cycle is extra |
| Storage of eggs or embryos | about 236 a year (BGN 462) | Dr. Shterev Hospital |
Sources: WhatClinic, Sofia IVF listings, WhatClinic, Bulgaria IVF listings and WhatClinic, Sofia egg freezing listings, viewed October and November 2026. These are clinic listings on a third-party site with no effective dates; the clinics’ own websites publish no dated price lists we could open. Drugs are usually extra, about €600 to 1,000 a cycle according to EuroFertile (March 2026).
| Item | Public support (or own savings) | What the employee still carries |
|---|---|---|
| Centre for Assisted Reproduction (national) | Up to €3,068 per attempt, 4 attempts; woman under 43 at application; citizen or permanent resident; clinic with a CAR contract | Costs above the ceiling, and long-term storage |
| Sofia Municipality donor egg programme | Up to BGN 3,620 (about €1,851) per applicant, up to 2 attempts, for cases CAR has not funded; woman up to 45; 3 years’ address in Sofia; open to women without a partner since March 2026, when the rule of 3 earlier failed attempts was also dropped | Services outside the municipal list |
| Other municipal funds, for example Dobrich | Up to BGN 3,000 (about €1,534) for IVF, couples only, woman up to 49; activities CAR already funds are excluded | The rest of the cycle |
| Elective egg freezing | No public funding found (own savings) | The full private price, drugs and yearly storage |
Sources: Politis, July 2026; Ministry of Health consultation on the age limit, 2022; Sofia Municipality IVF rules, 2024; Sofia Municipal Council Decision 241, 12 March 2026; BNT, March 2026; Dobrich Municipality rules, amended July 2025. We found no tax relief for IVF costs in Bulgaria.
Age is one of the strongest predictors of IVF success. Bulgaria publishes no national IVF results by age; one Bulgarian clinician put the pregnancy rate at about 30% per cycle (Fakti, November 2025), and in Germany’s national registry the birth rate per fresh embryo transfer in 2023 was 30.9% for women aged 30 to 34, 26.3% at 35 and 9.3% at 41 to 44 (Deutsches IVF-Register, Jahrbuch 2024).
Give Employees Access to Fertility Specialists
Help employees navigate fertility care with access to doctors and clinics, treatment information, and clear guidance on IVF, egg freezing and other fertility options. Employees can explore their options privately, without needing to go through HR.
Fertility support that fits your workforce and budget
You do not need to overhaul your existing health insurance to support employees through fertility treatment. Start with awareness and manager education, add confidential one-to-one support, or introduce a funded allowance across your offices. There is no minimum company size.
Where included in the employer programme, eligible employees can use talks and care navigation without paying Zora a separate fee. Care navigation allowances are set in each proposal. Treatment and other third-party costs are paid separately, either by employees or through the fertility allowance their employer provides.
Companies starting the conversation
Essentials
Expert-led talks for employees and managers, fertility and menopause policy templates, manager guides and full access to the Zora app. Up to 2 talks a year.
Employees supported one to one
Navigation
Everything in Essentials, plus confidential one-to-one care navigation and access to our partner clinic network.
Large and multi-country teams
Complete
Everything in Navigation, plus quarterly anonymised reporting, a dedicated account manager and scheduled review meetings with HR.
Optional add-ons can be added to any programme, subject to availability: hormone and fertility diagnostics and telehealth with specialists. Pricing is tailored to your headcount, your countries and the services you choose. Most companies start with a single talk.
Request a proposal See how Zora works for employers
Comparing fertility benefit providers? Use our RFP question bank
Our RFP question bank has 40 questions, with why each one matters, what a good answer looks like and a scoring sheet for three providers. Six of the questions for Bulgaria:
- Are local-plan employees covered, or only staff on international health plans?
- Do you require an infertility diagnosis before support starts?
- How does the allowance sit alongside Centre for Assisted Reproduction funding and municipal programmes such as Sofia’s, so employees apply for public funding first and claim drugs, ICSI, genetic testing and storage from the allowance?
- Can employees who do not qualify for state funding, such as women 43 and over, staff without permanent residence, women without a partner outside Sofia or those choosing elective egg freezing, use the benefit?
- Which clinics in Sofia, Plovdiv, Varna and Stara Zagora do you work with, and which hold a contract with the Centre for Assisted Reproduction?
- How do you handle health data as special category data under the GDPR and the Personal Data Protection Act, and what will the employer see when an employee asks for time off, reassignment or an allowance?
Your download link appears here as soon as you submit. Zora Health may contact you about employee benefits; see our privacy policy.
Plan your fertility benefit budget
Fertility benefit budget planner
Model the annual claims budget for a fertility allowance. Change any number.
This is a claims budget, not a Zora quotation. Zora’s programme fees, implementation and optional services are separate.
Illustration only. Utilisation is an editable assumption, not observed Zora data. The calculation assumes each user claims their full annual allowance, and excludes programme fees and setup costs. For a tailored model, request an employer proposal.
Estimate the potential workforce impact of fertility challenges
A rough planning scenario. It applies a global infertility estimate to your headcount, so it is not a prediction for your workforce, a measured loss or a forecast of savings from any programme.
Range: €90,200 to €255,200 a year, depending on replacement cost.
Assumptions: infertility affects about 1 in 6 adults (World Health Organization, 2023), applied to employees aged 25 to 44. Replacing an employee costs one-half to two times their annual salary (Gallup, 2019); the headline uses the low end. Absence is valued at salary divided by 250 working days. Exit rate and days lost are your own assumptions.
This is a hypothetical cost scenario, not a prediction of actual employee departures, an estimate of Zora’s financial impact or a guaranteed saving from fertility benefits.
Already have corporate health insurance? Here is where Zora fits
Your medical plan may cover some consultations and tests, but fertility treatment is often limited or excluded, so check your policy wording. Employees still need to understand their options, the public funding they qualify for and which clinic suits them.
Zora works alongside your existing insurance and benefits. We help employees get reliable information, navigate their care options and reach suitable specialists, and we give HR manager guidance, policy templates and, on the Complete programme, anonymised reporting. You strengthen fertility support without replacing your medical plan.
How Zora works
For your employees
Employees join the Zora app with a company code, or single sign-on for larger teams. They can learn about fertility and egg freezing, understand what your benefit covers, book a confidential care navigation call and find partner clinics and specialists.
For HR
- Kick-off, week 1. Agree goals, countries and which employees are eligible.
- Policy and benefit design, weeks 2 to 4. Draft or update your fertility policy using our templates.
- Launch, typically weeks 4 to 6. A launch talk for employees and managers, plus a communications pack for HR to send.
- Live support. Employees book care navigation calls and use the Zora app.
- Reporting, every 3 months, on the Complete programme. Anonymised usage, common themes and our recommendations, reviewed with your account manager.
Privacy
Employee privacy is central to our programmes. On the Complete programme, routine employer reports contain aggregated engagement and utilisation information, with safeguards to prevent identification of individual employees. On every programme, personal health information is not included in standard HR reporting, and employees can get help without telling their manager. Where eligibility checks or claims administration need individual-level data, access is limited to authorised parties for defined purposes, as agreed in writing before launch. Employee data is handled in line with Singapore’s Personal Data Protection Act and the EU General Data Protection Regulation (GDPR) and Bulgaria’s Personal Data Protection Act, under which health data is special category data.
Clinics and doctors in Bulgaria
Zora’s clinic and doctor directory does not list providers in Bulgaria yet. It lists 421 clinics and 1,185 doctors across 25 countries, mostly in Asia Pacific and the Middle East (browse clinics or browse doctors). Employees in Bulgaria can still use Zora’s education and the Zora app. Ask us how your team in Bulgaria would use Zora before you launch. See Zora’s employer guides for every country.
Rules and eligibility in Bulgaria
Who can use assisted reproduction
The Health Act and Ordinance N-2 of 12 July 2023 on assisted reproduction activities (State Gazette 63/2023) regulate treatment (UniPAR national report, April 2025). Privately paid treatment has no upper age limit set by CAR (Ministry of Health, 2022). Access for women without a partner is uncertain at national level. Sofia opened its programme to them in March 2026 (Decision 241/2026), but we could not confirm in primary text whether national law or CAR funding covers them; EuroFertile reports wider access since 2023 or 2024 but has not verified it. Employers should not assume a single employee qualifies for state funding.
Anonymous donation, surrogacy not permitted
The draft ordinance set anonymous egg and sperm donation, up to 5 donations per anonymous donor and a minimum egg donor age of 18 (Ministry of Health, draft ordinance reasons, 2022), and the consultation accepted a donor compensation cap of 3 minimum wages per donation (consultation summary, 2023). We could not open the adopted text to confirm these figures. The woman who gives birth is the legal mother (Family Code, Article 60), the ordinance does not permit surrogate pregnancy with donor gametes, and mediation for gain between a woman carrying a child and others is a criminal offence under Article 182a of the Criminal Code (UniPAR, 2025).
Funded for medical reasons, private otherwise
CAR funds preservation before medical treatment such as chemotherapy, up to €1,534. The consultation added preservation for medical or social reasons to the draft standard (consultation summary). We found no statutory maximum storage period; patients state their preferred period in writing (draft ordinance reasons).
Maternity, paternity and leave
Maternity leave is 410 calendar days, 45 of them before the birth, paid at 90% of average insurable income with at least 12 months of insurance; the second year to age 2 is paid at €398.81 a month in 2026 (Innovires, October 2026). From 1 August 2026, the insurable income on which the benefit is calculated is capped at €2,300 a month (Innovires, October 2026). Fathers get 15 days from the child’s discharge from hospital, paid at 90% with 6 months of insurance, and since August 2022 a further 2 months until the child is 8, paid at the minimum wage with 12 months of insurance (Lockton, March 2023). An employee in an advanced stage of IVF treatment can be moved to suitable work with a benefit under Article 48 of the Social Insurance Code (CEEOL).
Discrimination and flexible work
The Protection against Discrimination Act bans direct and indirect discrimination on grounds including sex and marital status (Article 4(1)). On 18 December 2025 Parliament gave final approval to a change letting parents of children up to 12 agree flexible working hours with their employer year-round (BTA, December 2025).
Why employers choose Zora
Companies including Hilton, LinkedIn, Sanofi, HSBC, Mastercard, Carousell and Singapore Management University work with Zora Health. We work alongside your existing insurance, helping employees use the cover they already have and find suitable specialists based on their needs.
Trying to conceive with a heavy workload took a toll on my husband and me. It helped us understand our options.
Questions HR teams ask us
Is fertility leave mandatory in Bulgaria?
No. Bulgarian law gives no paid leave specifically for fertility treatment. It does give an employee in an advanced stage of IVF treatment special protection from dismissal under Article 333 of the Labour Code, and she can be moved to suitable work with a benefit under the Social Insurance Code. Many employers add their own paid days for appointments and procedures.
Does the state pay for IVF in Bulgaria?
Partly. The Centre for Assisted Reproduction at the Ministry of Health pays up to BGN 6,000 (about €3,068) per IVF attempt, for up to 4 attempts, if the woman is under 43 when she applies, the applicants are Bulgarian citizens or permanent residents and they use a clinic with a contract with the Centre. Some municipalities, including Sofia, add their own funds for cases the Centre does not cover.
Can employees freeze their eggs in Bulgaria?
Yes. The Centre for Assisted Reproduction pays up to BGN 3,000 (about €1,534) for fertility preservation for medical reasons, such as before cancer treatment. Elective egg freezing is paid privately; one Sofia hospital lists storage at about €236 a year, on top of the stimulation and retrieval cycle and drugs.
Does Zora replace our health insurance?
No. Zora works alongside your insurance. We help employees understand their options, find suitable specialists and use the cover they already have.
How much does a fertility benefit cost an employer?
It depends on the allowance, eligibility and expected uptake. Use the budget planner on this page for a first estimate, then ask us for a tailored proposal based on your headcount and countries.
How quickly can we launch?
Typically 4 to 6 weeks from contract to launch, depending on scope and countries. Most companies start with a single talk.
Related guides for Bulgarian employers
Build a fertility benefit for your team
Whether you are introducing fertility benefits for the first time or improving an existing programme, tell us your headcount, countries and priorities. We will come back within two working days with suitable services, an indicative budget and a practical rollout plan for your Bulgarian team. No obligation.
Not ready to talk yet? Explore how Zora works
Sources
- BTA, Bulgaria has highest total fertility rate in EU for third consecutive year in 2024, citing Eurostat, March 2026
- Fakti, Over 6% of Bulgarian children are now born through IVF, November 2025
- Politis, Nearly 1,400 babies born through Bulgaria’s state-funded fertility programme, July 2026
- Ministry of Health, Motives for the amendment of the Rules of the Centre for Assisted Reproduction (20% increase), 2023
- Council of Ministers consultation portal, consultation 7127 on the age limit of the Centre for Assisted Reproduction, 2022
- European Commission, Bulgaria adopts euro as of 1 January 2026
- BNT, Sofia expands IVF programme access to include single women, 25 March 2026
- Sofia Municipality, Rules for the IVF programme, 2024
- Sofia Municipal Council, Decision 241 of 12 March 2026
- Dobrich Municipality, Rules for financial aid for reproductive problems, amended July 2025
- WhatClinic, IVF in Sofia, clinic listings, viewed October 2026
- WhatClinic, IVF in Bulgaria, clinic listings, viewed October 2026
- WhatClinic, Egg freezing in Sofia, clinic listings, viewed November 2026
- EuroFertile, IVF in Bulgaria, March 2026
- Musseva and Dimitrova, UniPAR Impact national report: Bulgaria, April 2025
- Ministry of Health, Reasons for the draft Ordinance on assisted reproduction activities, 2022
- Ministry of Health, Summary of public consultation on the draft Ordinance on assisted reproduction activities, 2023
- Innovires, Maternity in Bulgaria: pregnancy and childbirth leave and benefits (2026), updated October 2026
- Innovires, Special dismissal protection in Bulgaria, March 2026
- CMS, Expert guide to dismissals: Bulgaria, February 2025
- Lockton, Bulgaria expands family leave entitlements, March 2023
- BTA, Parents of children under 12 entitled to flexible working hours year-round, December 2025
- Protection against Discrimination Act 2004, text published by CEFAN, Université Laval
- CEEOL, The benefit for reassignment due to pregnancy, breastfeeding or advanced stage of IVF treatment under Article 48 of the Social Insurance Code
- DLA Piper, Data Protection Laws of the World: Bulgaria
- BNR, Women’s employment rate in Bulgaria exceeds the EU average, August 2026
- Aon, Global Medical Trend Rates Report 2026
- Deutsches IVF-Register, Jahrbuch 2024, edition for couples
- Ferring Pharmaceuticals, Fertility Matters at Work and This Can Happen, workplace fertility survey, November 2025
- Carrot Fertility, Global Fertility at Work report, 2023
- Gallup, This fixable problem costs US businesses $1 trillion, 2019
- World Health Organization, 1 in 6 people globally affected by infertility, April 2023
Information on this page is correct as of 5 November 2026. Laws, public funding, insurance rules and treatment costs change often, so check current rules with the relevant authority, insurer or a qualified adviser before making decisions. This page is general information, not legal, financial, tax or medical advice.