A New Sense of Normal: Fertility Coverage for Veterans

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.