Other paths in Washington:
AT A GLANCE
Dense — Major fertility clinics in Seattle, Tacoma, Spokane and surrounding metro areas
Limited — Rural and remote areas may require travel to regional centers
2–4 weeks
Initial consultation to diagnosis; 4–8 weeks for first IUI or IVF cycle
Intended parents are legal parents regardless of genetic connection
RCW 26.26A.610–.615 protects non-genetic parents and solo parents
Fertility care doesn't have to begin with a problem. It can begin with information. The earlier you know your baseline, the more time and the more options you have, on your terms.
Source: ASRM, "Optimizing natural fertility" (2022)
Fertility care covers a range of medical treatments from diagnostic workup through IVF and egg freezing.
Your starting point is almost always a consultation with a reproductive endocrinologist (RE), who will recommend a treatment path based on your specific situation, goals, and family configuration.
Your care team needs a clear picture of your fertility.
For people with a uterus: bloodwork to assess hormone levels and ovarian reserve, plus a transvaginal ultrasound. For people with sperm: a semen analysis is the starting point.
IUI places a prepared sperm sample directly into the uterus at the fertile window.
Most cycles complete in about two weeks. It is less intensive than IVF and a common first step.
Ovarian stimulation lasts 8–14 days with daily injectable hormones.
Egg retrieval is a brief outpatient procedure under light sedation. Fertilization and embryo culture in the lab lasts 3–7 days. Before transfer, you have the option of preimplantation genetic testing (PGT) for chromosomal abnormalities or specific genetic conditions.
One embryo is placed into the uterus.
Fresh transfers happen a few days after retrieval. Frozen embryo transfers (FET) happen in a later, simpler cycle. A pregnancy test follows approximately 10–12 days after transfer. Many families pursue multiple cycles; most clinics offer multi-cycle packages.
Most fertility care patients do not need an attorney before treatment begins. However, Washington's Uniform Parentage Act provides clear legal protections: non-genetic intended parents are legal parents if they consent in writing, and donors are not parents regardless of whether they are anonymous or known.
Source: RCW 26.26A.605; RCW 26.26A.610–.615
Under Washington's Uniform Parentage Act, a person who consents in writing to assisted reproduction with the intent to be a parent is a legal parent of the resulting child — regardless of whether they are genetically related to the child.
This covers non-gestational partners, solo parents using donor sperm, and same-sex couples. Most fertility clinics include a consent form that serves this function.
A sperm or egg donor is not a parent of a child conceived through assisted reproduction.
This applies whether the donor is anonymous or known, as long as the donation is made through a clinical process or with a written agreement in place. This clear legal structure protects all parties.
Washington requires fertility clinics and sperm/egg banks licensed in Washington to collect and retain each donor's identifying information and medical history.
When a donor-conceived person turns 18, they can request that information. Donors can choose to opt out of identity disclosure, but they cannot opt out of sharing their medical history. Non-identifying medical history is available at any age on request.
Fertility care is a significant expense. Washington does not currently have a comprehensive law requiring most health plans to cover IVF. However, starting January 1, 2026, IUI is covered under the EHB expansion for small group plans. Self-pay costs range from $500–$3,000 for diagnostic workup to $15,000–$30,000 for a full IVF cycle.
Source: WA HCA benchmark plan documents; IRS Publication 502
Before you can know what's covered, you need to know what kind of health plan you have.
This matters a lot for fertility care. Look at your Summary Plan Description or call your HR department and ask: Is our health plan fully insured or self-funded? This determines whether Washington state insurance mandates apply to you.
Starting January 1, 2026, Washington added artificial insemination (IUI) to its list of Essential Health Benefits.
If you have a plan through a small employer (fewer than 50 employees), your plan is likely a small group fully insured plan, and IUI must now be covered. Your plan cannot impose annual or lifetime dollar limits on it. If you're on a large employer's self-funded plan, coverage depends on which state benchmark your plan uses — ask HR.
If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), most fertility expenses — including IVF, medications, and monitoring — are eligible expenses you can pay with pre-tax dollars.
Many WA fertility clinics offer discounted multi-cycle packages with partial refund programs. RESOLVE's Fertility Lifelines, Baby Quest Foundation, and other organizations offer grants to individuals who cannot afford treatment.
Washington lawmakers introduced the Building Families Act three times (2023–2026) to require IVF coverage.
The most recent version (HB 1129 / SB 5121) expired when the 2026 legislative session ended on March 12, 2026, without receiving a floor vote. It is not law. If you need IVF in Washington today, it is almost certainly out of pocket unless your employer has voluntarily chosen to cover it.
Washington's Paid Family and Medical Leave (PFML) can cover fertility procedure recovery. Medical leave may be available for serious health conditions like egg retrieval. Bonding leave provides up to 12 weeks per parent (up to 18 weeks for birthing parents). You are eligible if you have worked at least 820 hours in Washington in the past year.
Source: RCW 50A.05; paidleave.wa.gov
If your fertility treatment involves a procedure your provider considers a serious health condition — this applies most clearly to egg retrieval, which is a surgical procedure, and to any significant recovery period — you may be eligible for WA PFML medical leave.
Your provider will need to provide documentation to support your leave request.
Once a child arrives, you are entitled to paid bonding leave.
Birthing parents can receive up to 18 weeks of combined medical and bonding leave. Each partner or co-parent has their own separate entitlement of up to 12 weeks of bonding leave within the first 12 months after birth.
If your employer has 50 or more employees and you have worked there for at least 12 months, you are also covered by the federal Family and Medical Leave Act (FMLA), which provides up to 12 weeks of unpaid, job-protected leave.
In most cases, WA PFML and FMLA run at the same time — PFML pays you at approximately 90% of your regular wages, while FMLA protects your job.
Fertility care is one of the most emotionally demanding experiences a person can go through. Monthly cycles of hope and disappointment, financial pressure, medical stress, and the uncertainty of outcomes all take a toll. What you are feeling is real and valid. Support resources and mental health counseling are essential tools.
Source: RESOLVE: The National Infertility Association
After a failed cycle, recognize this as a loss — even if the medical team frames it as just part of the process.
You're allowed to grieve it. During the two-week wait between transfer and pregnancy test, anxiety is nearly universal. When someone in your life announces a pregnancy, you can be happy for them and still feel the weight of your own situation. Both things are true.
The emotional terrain has additional layers.
You may be explaining your path to providers who assume a default couple, navigating how much to share at work or with family, and sometimes feeling like your family configuration is an afterthought in clinical settings. You are not alone in this. Seek out providers and support communities that affirm your path from the start.
Many Washington fertility clinics include psychological consultation as part of IVF protocols — ask your care team.
Many insurance plans also cover mental health visits, and your fertility-related stress is a legitimate reason to use that benefit. If your employer offers an Employee Assistance Program (EAP), it may include free counseling sessions.
Washington has three key policies affecting fertility care: (1) IUI is now required coverage for small group plans as of January 1, 2026; (2) The Building Families Act for IVF coverage did not pass and expired on March 12, 2026; (3) The My Health MY Data Act gives you control over your reproductive health data.
Source: WA HCA; RCW 70.372
Starting January 1, 2026, Washington added artificial insemination (IUI) to its list of Essential Health Benefits (EHBs).
If you have a plan through a small employer (fewer than 50 employees), your plan is likely a small group fully insured plan and IUI must be covered. Your plan cannot impose annual or lifetime dollar limits on it. IVF is not included in this expansion.
Washington lawmakers introduced bills three times between 2023 and 2026 to require most health plans to cover IVF.
The most recent version (HB 1129 / SB 5121) would have required coverage of fertility preservation starting in 2026 and full IVF coverage (two egg retrievals, unlimited embryo transfers) starting in 2027. The 2026 legislative session ended on March 12, 2026 without a floor vote. The bill expired.
Washington's My Health MY Data Act (passed 2023) gives you strong control over your reproductive health data.
Health data — including information about fertility treatments, pregnancy, and reproductive health decisions — cannot be collected, shared, or sold by companies without your consent. This is relevant to fertility apps, telehealth platforms, and any digital tool you use while navigating fertility care.
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