The challenges for pregnant workers are especially prevalent in obtaining fertility care, such as intrauterine insemination (IUI) and in vitro fertilization (IVF). Where this coverage is not offered or is exclusionary, LGBTQ+ people must spend thousands of dollars for fertility care, while it may be guaranteed for other individuals. Specifically, how insurers can be held liable in the context of fertility care to LGBTQ+ employees remains to be tested. Under Kulwicki’s medical plan, fertility treatment such as intrauterine insemination (IUI) and in vitro fertilization (IVF) is covered only for couples who can meet the plan’s definition of “infertile.” For heterosexual couples, infertility could be established by showing that six to twelve months of unprotected sex without contraception did not result in a pregnancy.