In recognition of National Infertility Awareness Week (NIAW), our goal is to raise awareness not only about infertility and its prevalence but also about the legal aspects surrounding fertility.
Infertility affects people of all backgrounds and experiences, making it important to know what the fertility laws are in your state and how they could potentially affect your fertility journey. The legalities surrounding fertility treatments like in vitro fertilization, treatment financing, surrogacy, and more differ from state to state.
California lawmakers have been pushing to make fertility treatments more accessible to individuals and couples of all backgrounds, regardless of socioeconomic background, gender identity, or sexual orientation.
If you’re an individual or couple considering starting your fertility journey, read on to learn about the top 5 California fertility laws you should know before starting fertility treatments.
Table of Contents
- 1. SB 729: Expanded Insurance Coverage for Fertility Treatments
- 2. SB No. 600: Fertility Preservation Declared as Basic Health Care
- 3. SB No. 848: Employee Right to Reproductive Loss Leave
- 4. AB No. 2684: Parentage Rights for Nontraditional Conception
- 5. AB No. 1217: Legally Binding Surrogacy Agreements
- #ALLinForAccess
1. SB 729: Expanded Insurance Coverage for Fertility Treatments
California has long recognized the importance of fertility care, with HSC § 1374.55 (Health and Safety Code Section 1374.55) requiring many health insurance policies to offer some form of infertility treatment coverage. But historically, this law had one major catch: it specifically excluded in vitro fertilization (IVF). While this law was a step forward when it was first enacted, it left many people, especially those who needed IVF or were part of the LGBTQ+ community, without meaningful access to care.
That’s where Senate Bill 729 comes in. SB 729 passed in 2023 and is taking effect on July 1, 2025. This California law builds on and significantly modernizes HSC § 1374.55 by removing exclusions and making fertility coverage more inclusive and comprehensive.
Here’s how SB 729 improves on the older law:
- IVF is now included: HSC § 1374.55 did not mandate IVF coverage, however, SB 729 now requires it for most group plans.
- More inclusive definition of infertility: SB 729 allows providers to diagnose infertility based on factors like age, sexual orientation, medical history, or reproductive goals. This moves away from the previous basis that infertility was defined as not being able to get pregnant after a year or more of trying without birth control.
- LGBTQ+ and single-parent families are protected: SB 729 explicitly extends fertility coverage to all Californians, regardless of sexual orientation, gender identity, or marital status, which was not explicitly stated in HSC § 1374.55.
- Standardized benefits: SB 729 mandates coverage for up to three egg retrievals and unlimited embryo transfers, as well as prescription fertility medications, ensuring consistency across eligible plans.
- Parental equity: The updated law ensures that fertility preservation and family-building care are available to everyone, regardless of gender identity, sexual orientation, or relationship status.
- No extra barriers allowed: Under SB 729, insurance companies cannot add extra steps or costs, like prior authorization hurdles or higher copays, because the service is fertility-related.
In short, SB 729 modernizes California’s fertility insurance landscape, building upon HSC § 1374.55 while addressing its gaps. It’s a major win for fertility equity and access, especially for LGBTQ+ families and anyone whose path to parenthood includes IVF or third-party reproduction.
Exclusions and Limitations
While SB 729 is a groundbreaking step forward in expanding fertility coverage, there are a few important exclusions and limitations to be aware of.
- First, the law includes a religious exemption for certain employers. Faith-based organizations, such as religiously affiliated schools, hospitals, or churches, are not required to offer fertility coverage if doing so conflicts with their religious beliefs. These employers must formally request this exemption, and employees working at such organizations may need to explore alternative coverage options through a spouse or partner.
- Another limitation is that SB 729 applies only to fully insured health plans regulated by the state of California. It does not apply to self-insured plans, which are often offered by large employers and governed by federal law. These employers are not required to follow SB 729, though some may voluntarily offer comparable fertility coverage.
- Finally, while SB 729 expands access and redefines infertility to be more inclusive, coverage still depends on meeting certain medical necessity or eligibility criteria. This may include a documented diagnosis, a provider referral, or a demonstration of previous attempts to conceive.
2. SB No. 600: Fertility Preservation Declared as Basic Health Care
Senate Bill No. 600 is a California fertility preservation law. SB 600 states that health insurance coverage for fertility preservation services is mandated when medical treatments could potentially cause infertility.
The fertility preservation services pertain to individuals whose fertility may be impacted due to medical treatments such as chemotherapy, radiation, and/or surgery.
SB 600 declares that standard fertility preservation services like egg freezing and sperm freezing are considered basic health care services. Meaning, that insurance plans have to cover these services, even if they typically do not cover infertility treatments.
This California fertility law aims to support individuals undergoing treatments that might affect their ability to have children, providing them with the option to preserve fertility without financial burden.
Exceptions
SB 600 only applies to health insurance plans regulated by the state like HMOs and Managed Care Plans. At this time, it does not apply to certain government healthcare plans.
If you get your health care through certain Medi-Cal plans or through organizations that work with the California State Department of Health Care Services, covered fertility preservation services don’t apply to you.
3. SB No. 848: Employee Right to Reproductive Loss Leave
Struggling with infertility is not only physically challenging but also mentally and emotionally difficult. Senate Bill No. 848 protects employees who are going through difficult reproductive experiences.
SB 848 introduces a new section to the Government Code that declares employees are allowed to take up to five days off of work due to a reproductive loss event.
A reproductive loss event is an event in which something occurs that prevents the individual from becoming pregnant or a parent as intended.
Reproductive loss events are defined in this bill as:
- Miscarriages: When a pregnancy ends before the baby can survive outside the womb.
- Failed Adoptions: When an adoption doesn’t happen because of problems with the adoption agreement or because someone contests the adoption.
- Stillbirths: When a fetus dies in the womb and is born after at least 20 weeks of pregnancy.
- Failed Surrogacies: When a surrogacy agreement falls apart or when an embryo transfer to the surrogate isn’t successful.
- Unsuccessful Assisted Reproduction: When an attempt at assisted reproduction like intrauterine insemination (IUI), in vitro fertilization (IVF), or other fertility treatments doesn’t result in a successful pregnancy.
Reproductive Loss Leave
According to California law, employees are entitled to take up to five days off work in the event of a reproductive loss. If an individual experiences more than one event in a year, they can take up to 20 days off in total.
This law is meant to protect employees who are going through difficult reproductive experiences. It ensures they have time off to deal with these events without fear of losing their job or facing discrimination at work.
Employees can take this leave within three months of the reproductive loss event. If they’re already on leave for another reason when the event happens, they have three months from when that other leave ends to take their reproductive loss leave.
If the employer has a policy for other kinds of leave, like vacation days or sick leave, employees can use those. However, if the employer doesn’t have a policy, the reproductive loss leave might be unpaid.
4. AB No. 2684: Parentage Rights for Nontraditional Conception
As of January 1, 2020, Assembly Bill (AB) No. 2684 has been added to California’s Uniform Parentage Act to increase access to the Parentage Opportunity Program, acknowledging diverse modern families and ensuring equal treatment to same-sex parents, transgender parents, and their children.
The amendment in the Uniform Parentage Act allows both different-sex and same-sex parents who conceived using assisted reproduction to use the Voluntary Declaration of Parentage process to establish legal parentage.
The Parentage Opportunity Program is a program in California designed to help unmarried parents establish legal parentage for their children more easily and affordably. It allows parents to establish legal rights and responsibilities for their child(ren) without having to go to court.
Now, the Parentage Opportunity Program includes circumstances where a child is born through sperm donation or egg donation, for both different-sex couples and same-sex couples.
The addition of AB 2684 expands legal protections for family relationships as every family may look different.
For same-sex couples
In the cases of same-sex couples, according to California Family Code § 7573, to utilize the Voluntary Declaration of Parentage process, at least one individual of the couple has to be genetically related to the child. The genetic relationship can be established through sperm donation, egg donation, or giving birth without the use of egg donation.
In cases of surrogacy or adoption, there are other legal ways of establishing parenthood through binding surrogacy agreements or adoption papers.
5. AB No. 1217: Legally Binding Surrogacy Agreements
Assembly Bill No. 1217 regulates California surrogacy, where a woman carries a child for another person or couple. AB 1217 was mandated to solidify the parental establishment in surrogacy agreements.
AB 1217 specifically details California gestational surrogacy agreements. Gestational surrogates are not genetically related to the child.
With concern over legal parentage due to the nature of surrogacy, AB 1217 regulates the specific requirements in the contractual agreement between the surrogate mother and the intended parent(s).
In California, this law requires that both parties involved, the surrogate and the intended parent(s), have to have separate legal representation. This is to ensure that both parties’ interests, such as parent-child relationships and compensation, are protected.
This law also states that the surrogate agreement must include specific information, such as:
- The date the agreement was signed.
- Details about the origin of the donated sperm or eggs used in the conception.
- Identification of the intended parent(s).
All parties involved must sign this agreement and the signatures are required to be notarized or witnessed by an equivalent method of confirmation that is required in the area where the agreement for the surrogate is taking place.
If the agreement is completed successfully and all requirements have been met, then the surrogacy agreement is valid and legally binding, therefore establishing legal parentage for the intended parent(s).
After the Surrogate Agreement is signed
The law states that no further action can be taken until the surrogacy agreement has been properly signed and completed.
The bill prohibits parties from undergoing the embryo transfer procedure or starting medication for assisted reproduction until the surrogacy agreement is fully executed. This makes sure that everyone involved understands and agrees to the terms before any medical procedures begin.
In addition, once the agreement has been signed the intended parent(s) can initiate legal action to establish the parent-child relationship before the child is born.
#ALLinForAccess
Infertility affects 1 in 6 people worldwide, meaning almost as much as 20% of the population is facing barriers when it comes to building their families. With fertility laws differing from state to state, some people may not only face physical barriers to family-building but also legal barriers.
By bringing awareness to infertility during NIAW, let’s show we’re all in for access by participating in Resolve’s Advocacy Day on May 20, 2025, a virtual event held in partnership with the American Society for Reproductive Medicine (ASRM), connecting the family building community with lawmakers to address key issues! Register Here.
California lawmakers have been pushing for more pro-family laws to make starting a family more accessible to those who are struggling with fertility challenges. The fertility laws mentioned are laws specific to California.
It is important to know the fertility laws in your area before beginning your fertility journey, as they could potentially affect how you grow your family.
