Zora Health / Employer guide / South Africa
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 South African HR leaders should know
- Stats SA puts the 2026 total fertility rate at 2.12, and 19 of South Africa’s 23 assisted reproduction centres reported 10,554 procedures in 2022.
- Schemes must fund listed infertility tests as Prescribed Minimum Benefits, but not IVF; Discovery’s Executive and Comprehensive plans pay 75% of its rate, up to R140,000 a year.
- Public IVF runs at a few academic hospitals in 4 provinces, and the NHI Act, signed in May 2024, is not in force.
- Surrogacy needs High Court confirmation and a genetic link to a commissioning parent; since 3 October 2025, two employed parents share 4 months and 10 days of leave.
- Most employees pay privately, about R50,000 to R75,000 a cycle in 2024 and 2025 quotes, so a fixed annual allowance keeps the 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 South African survey of employees in fertility treatment. In a 2023 Carrot Fertility survey of 5,000 people in Canada, India, Mexico, the UK and the US, 79% said they felt uncomfortable discussing fertility at work.
- Resignations. In Ferring‘s 2025 survey of more than 3,600 people in Australia, France, Japan, Poland and the UK, 39% of employees in fertility treatment had left or were considering leaving their job.
- Lower performance. 36% in the same survey felt pressure from their employer to be at work during treatment, and 17% took sick leave because their workplace lacked flexibility.
- Uneven access. In February 2026 the Eastern Cape became the fourth province with IVF at a state hospital (Daily Dispatch); in 2020 Steve Biko Academic Hospital in Pretoria took fertility patients from 4 provinces (Rekord).
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
73% of employees with fertility challenges said they would be attracted to a role that offers fertility support (Ferring, 2025), and 65% said they would change jobs for fertility benefits (Carrot, 2023). In South Africa, labour force participation was 54.9% for women and 64.4% for men in the second quarter of 2026 (Stats SA).
Make fertility support financially predictable
Employers can set annual or lifetime allowances and decide which treatments qualify. With medical trend at 9.5% (Aon, via Moonstone), a cap fixes the cost in advance.
Zora helps employers structure benefits around local treatment costs, medical scheme cover and workforce needs, so HR can run the programme within an agreed budget.
Want to see what this would look like for your South African workforce?
What IVF costs, and what the state pays
Public programmes need a referral and charge by household income. Private clinics set their own prices.
| Item | Typical cost (R) | Notes |
|---|---|---|
| IVF, one private cycle | About 50,000 to 75,000 | Aevitas about 50,000 and Cape Fertility about 70,000, 2024; Cape Fertility 65,000 to 75,000, page updated June 2025 |
| IVF, all-in estimate | 54,000 to 110,000 | EWN, February 2024 |
| IVF medication | 10,000 to 20,000 per cycle | ICSI adds 5,000 to 10,000; guideline figures, August 2024 |
| IUI | 4,000 to 8,000 per cycle | Guideline figures, August 2024 |
| Elective egg freezing | 40,000 to 50,000 at most clinics | Cape Fertility doctor, 2023 article updated June 2026; at least 40,000 excluding medication in 2024 |
| Infertility treatment at Tygerberg or Groote Schuur | 150 to 6,600 | Means-tested on income and dependants; an IVF cycle was about 6,700 in 2024 |
| IVF at Nelson Mandela Academic Hospital, Mthatha | 35,000 | Eastern Cape health MEC, February 2026; own eggs up to 40, donor eggs up to 47 |
Sources: Pretoria News, March 2024 and Medical Brief, April 2024; Cape Fertility, updated June 2025; EWN, February 2024; Bizcommunity, August 2024; BabyYumYum, quoting Cape Fertility, updated June 2026; Women’s Health SA, April 2024; Western Cape Government; Daily Dispatch, February 2026.
| Item | Public support (or own savings) | What the employee still carries |
|---|---|---|
| Infertility investigations | Prescribed Minimum Benefit on every medical scheme: listed tests, laparoscopy, hysteroscopy and some surgery | Any gap above the scheme rate; IVF itself |
| IVF on a medical scheme | Only where the plan has a benefit; Discovery Executive and Comprehensive pay 75% of the Discovery rate up to R140,000 a year, two cycles a year at 25 to 39 and one at 40 to 42, then donor-egg cycles only to 50 | 25% co-payment, costs above the scheme rate, or the full price on other plans |
| Egg freezing before cancer treatment | Discovery Oncology Programme members up to 42, with storage up to 5 years | Later IVF to use the eggs |
Sources: Medical Schemes Act regulations, Annexure A, note on code 902M; Council for Medical Schemes, CMScript; Discovery Health, Assisted Reproductive Therapy Benefit, 2026. Scheme rules change each January; check the employee’s plan.
Age is one of the strongest predictors of IVF success. The 2021 and 2022 African registry report gives no South African outcomes by age (ANARA). As a clinic estimate, Aevitas Fertility Clinic says a woman of 34 needs about 12 frozen eggs for an 80% likelihood of one live birth, against 24 at 37 (Women’s Health SA, April 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 South Africa:
- Are local-plan employees covered, or only staff on international health plans?
- Do you require an infertility diagnosis before support starts?
- Which clinics can employees use in Johannesburg, Pretoria, Cape Town and Durban, and how do you support staff in provinces far from a fertility centre?
- How does the allowance work alongside medical scheme cover, including PMB-funded investigations and scheme IVF benefits with co-payments?
- Can the allowance pay for donor egg cycles and surrogacy-related medical costs within the limits of the Children’s Act?
- How is employee health information handled as special personal information under POPIA, and what does the employer see?
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: R 1,879,167 to R 5,316,667 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 South Africa’s Protection of Personal Information Act (POPIA), under which health information is special personal information.
Clinics and doctors in South Africa
Zora’s clinic and doctor directory does not list providers in South Africa 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 South Africa can still use Zora’s education and the Zora app. Ask us how your team in South Africa would use Zora before you launch. See Zora’s employer guides for every country.
Rules and eligibility in South Africa
Who can use assisted reproduction, and donation rules
The Regulations Relating to the Artificial Fertilisation of Persons define the recipient as a woman, with no marital status condition. Donor identity is confidential, one donor’s gametes may not be used once 6 children have been conceived, and donors may claim only reasonable expenses. Embryos unclaimed for 10 years must be destroyed (Government Gazette, March 2012).
Surrogacy needs court confirmation
A surrogate motherhood agreement must be in writing and confirmed by the High Court (Children’s Act). The commissioning parent’s inability to give birth must be permanent and irreversible, the surrogate must act altruistically and have a living child, and at least one commissioning parent’s gametes must be used (Ex parte JVDM, 2025). Payment is banned except for pregnancy and birth expenses, lost earnings, insurance and reasonable legal and medical fees (section 301). The Constitutional Court upheld the genetic link rule on 29 November 2016 (AB v Minister of Social Development), and on 19 April 2024 the Supreme Court of Appeal rejected a challenge based on a genetic link to a sibling (KB v Minister of Social Development); we found no later Constitutional Court ruling in that case.
Maternity and parental leave
The court found the Basic Conditions of Employment Act leave sections discriminated between parents ([2025] ZACC 20). Until Parliament amends them, within 36 months, an only employed parent gets at least 4 consecutive months, and two employed parents share 4 months and 10 days, also for adoptive and commissioning parents (Moonstone). The court left Unemployment Insurance Fund benefits to Parliament. Maternity benefits run for up to 17.32 weeks (UIA section 24) at 66% of earnings (Department of Employment and Labour, 2023), within a monthly earnings ceiling of R17,712 set in June 2021 (SARS). A draft Labour Law Amendment Bill, released for public comment in February and March 2026, would write the Van Wyk leave split into the Act and turn UIF maternity benefits into parental benefits shared between parents (Moonstone, 2026). We found no statutory fertility or IVF leave.
Discrimination and health data
The Employment Equity Act bars unfair discrimination, direct or indirect, on grounds including pregnancy, marital status, family responsibility, sexual orientation, age and HIV status (EEA section 6). Under the Protection of Personal Information Act, information about a person’s health or sex life is special personal information that may be processed only under limited conditions (POPIA section 26). Employers should receive only anonymous, aggregated data.
NHI on hold, scheme pricing under pressure
The President signed the National Health Insurance Act on 15 May 2024. No section is in force, and the government agreed in February 2026 not to proclaim any until the Constitutional Court rules on public participation challenges (TimesLIVE). The court heard them on 5 to 7 May 2026 and reserved judgment (EWN), with no ruling by 30 October 2026 (BusinessTech). In July 2026 the Council for Medical Schemes set 3.8% as the anchor for 2027 increases, and funders asked for updated Prescribed Minimum Benefits (Business Day, September 2026).
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 South Africa?
No. We found no statutory fertility or IVF leave in South Africa. The Basic Conditions of Employment Act provides annual, sick, family responsibility and maternity or parental leave, and since the Constitutional Court’s Van Wyk ruling of October 2025, two employed parents share 4 months and 10 days of parental leave until Parliament amends the law. Time off for treatment depends on company policy or sick leave.
Do medical schemes in South Africa pay for IVF?
Not by default. Every scheme must fund a set list of infertility investigations and treatments as Prescribed Minimum Benefits, but IVF is not on that list. Some plans add a benefit: in 2026 Discovery’s Executive Plan and Comprehensive Series pay 75% of the Discovery rate, up to R140,000 per person a year, with a 25% co-payment and age-based cycle limits.
Can employees freeze their eggs in South Africa?
Yes. Egg freezing is legal and is usually paid privately. Cape Fertility put the cost at R40,000 to R50,000 at most clinics (BabyYumYum, updated June 2026), and Women’s Health SA reported in April 2024 that it starts at about R40,000 excluding medication. Discovery covers freezing only for members on its Oncology Programme, up to age 42.
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 South African 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 South African team. No obligation.
Not ready to talk yet? Explore how Zora works
Sources
- Statistics South Africa, Mid-year population estimates 2026 (P0302), July 2026
- Statistics South Africa, Gender gaps persist in South Africa’s labour market (QLFS Q2 2026)
- Reproductive BioMedicine Online, Assisted reproductive technology in Africa: the African Network and Registry for ART, 2021 and 2022
- Acts Online, Medical Schemes Act regulations, explanatory notes to Annexure A (code 902M infertility)
- Council for Medical Schemes, CMScript issue 1 of 2010: Prescribed Minimum Benefits for infertility
- Discovery Health, Assisted Reproductive Therapy Benefit, 2026
- Western Cape Government, Infertility programme
- Daily Dispatch, Eastern Cape gets first public IVF clinic, February 2026
- Rekord, Steve Biko offers fertility services to four provinces, March 2020
- Pretoria News, The shocking difference in IVF costs at public hospitals and private clinics, March 2024
- Medical Brief, Huge IVF cost disparities between private and public sectors, April 2024
- Cape Fertility, IVF and ICSI costs in South Africa, updated June 2025
- Bizcommunity, The high cost of hope (budgeting for fertility treatment), August 2024
- EWN, Gynaecologist breaks down the process and cost of IVF in South Africa, February 2024
- Women’s Health SA, misconceptions about egg freezing in South Africa, April 2024
- BabyYumYum, Infertility: what you need to know about freezing your eggs in South Africa, updated June 2026
- University of Johannesburg, South Africa needs to adopt fertility-friendly workplace policies, May 2023
- Moonstone, Global medical cost growth is cooling. Why isn’t South Africa’s? (Aon), September 2026
- Government Gazette, Regulations Relating to the Artificial Fertilisation of Persons, 2012
- Acts Online, Children’s Act 38 of 2005, chapter 19: surrogate motherhood
- Acts Online, Children’s Act 38 of 2005, section 301
- SAFLII, Ex parte JVDM and Others [2025] ZAGPPHC 187
- SAFLII, AB and Another v Minister of Social Development [2016] ZACC 43, 29 November 2016
- SAFLII, KB and Another v Minister of Social Development [2024] ZASCA 54
- SAFLII, Van Wyk and Others v Minister of Employment and Labour [2025] ZACC 20, 3 October 2025
- Moonstone, Employers must update leave policies after landmark ConCourt ruling, October 2025
- Acts Online, Unemployment Insurance Act 2001, section 24
- Department of Employment and Labour, media statement on UIF maternity benefit applications, August 2023
- SARS, Unemployment Insurance Fund ceiling on earnings
- Acts Online, Employment Equity Act 1998, section 6
- POPIA, section 26: prohibition on processing of special personal information
- TimesLIVE, Court orders halt in NHI litigations pending ConCourt judgment, February 2026
- EWN, ConCourt reserves judgment in NHI challenge, May 2026
- BusinessTech, NHI hits a roadblock in South Africa, October 2026
- Business Day, Medical scheme association challenges regulator’s 2027 fee hike guidance, September 2026
- Moonstone, Amendment Bill reshapes parental leave and UIF benefits, March 2026
- 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.