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A New Sense of Normal: Fertility Coverage for Veterans

Our service people returning from duty suffer with depression and PTSD. But did you know that many have problems conceiving as a result of being on the front lines?

When we think of veterans and health care, we most often think of the mental health issues that they face upon their return. But with an increasing number of veterans suffering from infertility, fertility insurance coverage has come into sharper focus over the past month.

It’s not necessarily the case that servicemen and women have fertility issues when they first join the military, but rather is a case of acquired infertility as a result of combat. In fact, more than 1,830 veterans of the wars in Iraq and Afghanistan have suffered pelvic fractures and genitourinary injuries since 2003 that could affect their abilities to reproduce, according to Pentagon figures.

Combat related injuries for men can include a blast to the genitalia, reducing the number of sperm produced, while a spinal cord injury (reported in the news as paralysis, or having a leg or legs blown off) can cause severe erectile dysfunction or ejaculatory problems. For women, shrapnel can cause pelvic and fallopian tube damage and infection, preventing fertilization.

Overall these types of injuries are most commonly sustained by soldiers on foot patrol encountering roadside bombs. And although they wear special Kevlar to protect the genitalia and slow down shrapnel damage, reproductive injuries are often severe, resulting in complicated fertility issues.

But fertility coverage has been limited and poorly applied for veterans. Some coverage include procedures that treat the male partner (only) to extract sperm, shifting the financial responsibility for any additional treatment such as in vitro fertilization to the couple. In fact, forced to turn to the private sector, veterans and their spouses often report they pay tens of thousands in out-of-pocket to access IVF services.

A strange and ironic concept given that servicemen and women deliberately risk their own lives. Apparently that is not a high enough cost:

"You tell that to a man who's just been wounded -- that it's not psychologically necessary to have children -- when that's all we'd talked about, having babies," said Brenda Isaacson, whose husband, an Army staff sergeant was paralyzed by a 2007 helicopter crash in Afghanistan.

But things are slowly changing.

Legislation proposing infertility coverage for disabled veterans was approved by a Senate committee last month. The bill introduced by U.S. Senator Patty Murray, Chairman of the Senate Veterans’ Affairs Committee will end the Department of Veterans Affairs (VA) ban on providing In Vitro Fertilization (IVF) services to combat injured veterans. An amendment allowing adoption assistance to veterans with resulting infertility was also introduced.

This legislation is needed on multiple levels; reproductive technology should be offered to young veterans trying to reintegrate and start their lives off again.

While we cannot necessarily take away the harrowing images witnessed by our service people, nor tell them that life will ever be the same again, we can offer hope. Hope that they can have a new sense of normal-- one in which their original innocence and trust in the world is reflected back to them through their baby’s eyes.

Fenella Das Gupta is a licensed Marriage and Family Therapist ( #47275) working in Northern California,specializing in fertility counseling. She works with individuals and couples as they make their way through the fertility maze.

Fenella Das Gupta PhD Neuroscience, MFT October 23, 2012 at 10:39 am
From Facebook:
"I think this is part of the larger question of how we treat veterans. I don't like war and i think we create way too many of them but as a country, if we are going to send people to fight, especially in those conditions, then we should properly take care of them when they return. The toll those deployments takes on them and their families is unbelivable and most of us would never be willing to go through that. They deserve to receive any needed coverage, including fertility!"
Fenella Das Gupta PhD Neuroscience, MFT October 23, 2012 at 10:42 am
From Facebook:
" I did not but when I think about it i could see how the stress would affect their fertility! Thank you for sharing and making more people aware!"
Donna Angelo October 26, 2012 at 09:55 am
I'm glad that Vets who are dealing with infertility as a side result of just doing their JOB are getting help. The bigger issue is for individual states to recognize that Infertility is a LEGITIMATE medical condition that requires treatment in order to have it covered by private health insurance. If women in Europe are covered for 1-3 IVF attempts under the National Healthcasre System, why aren't we? I'd feel better about my $1,500.00 deductible and 30% co-pay if I knew it was going towards my most pressing health concern.
Fenella Das Gupta PhD Neuroscience, MFT October 26, 2012 at 01:50 pm
Dear Donna
You know, i think its an issue that is getting more attention. The problem til now has been that those with this disease have often felt isolated and shamed by others insensitivity which has ultimately pushed those with this disease into silencing their voices (perhaps based on the thought of " whats the point of talking about this?). But with more older mother pregnancies reported, with celebrities speaking out, with venues like this to voice concern and with politicians taking more notice of women's reproductive rights, things are changing. With these things slowly changing, larger HMOs, and other health care systems will have to respond. I believe it will come, one day..... but after many have suffered... and isnt that always the way....unfortunately

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