(Editor’s note: The following is an opinion piece. The writer is not employed by Military Times and the views expressed here do not necessarily represent those of Military Times or its editorial staff, nor those of the Defense Department.)
“I tried to get in vitro fertilization and I couldn’t afford it. That’s the only reason we do not have a child today.”
“Women are strongly urged to forgo a family until later in their career so if I wanted to get contraception I could. When I wanted to get pregnant, I was on my own. There are programs for maternity care but there is nothing to assist you when you need to pursue a family via IVF.”
“I did not even know the options for infertility treatment were available.”
These are just a few of the stories female veterans shared in a recent survey on access to reproductive services by the Service Women’s Action Network. Women make up 10 percent of the veteran population, and it’s estimated that 16 percent of them struggle with infertility.
However, in 2015 only 22 percent of veterans diagnosed with infertility actually received evaluation and/or treatment. Even more frustrating, the Veterans Affairs Department was barred specifically from providing veterans with in vitro fertilization, or IVF, until 2016. It’s now available, but funding for the procedure requires annual yearly review and congressional approval.
Female veterans experience combat, suffer from injuries and delay starting a family for our country. Yet when their service is completed, we are not providing them the reproductive assistance they need. I am an obstetrics/gynecology resident physician pursuing a career in reproductive endocrinology and infertility; these are the women I am dedicating my life to serving.
As women age, their risk of suffering from infertility increases. By delaying childbearing in the service of the country, our female veterans are sacrificing their peak fertile years and potentially putting their ability to conceive at risk. Although more than 85 percent of infertility cases can be treated with medications or surgery, the only option for some women is to use assisted reproductive technology such as IVF. IVF involves removing eggs from a woman’s ovaries, fertilizing them in a lab with her partner’s sperm and injecting the fertilized egg, or embryo, back into the uterus.
Infertility is associated with painful stigma. Infertile couples may hear that that they are destined to never have children. But infertility is a disease with treatment options and does not need to be inevitable.
Many people point to adoption as an alternative for women who can’t afford IVF. While adoption is the right choice for many families, it shouldn’t be the only option.
Others say that IVF is expensive and insurance companies shouldn’t have to cover it. But if we look at the broader picture of medical interventions, a cycle of IVF — which accounts for less than 5 percent of fertility treatments in the U.S. — costs about one third as much as a hip re-placement.
Infertility is a health crisis which is detrimental to individuals, their families and their communities. IVF may be the only chance our veterans have of achieving the family they desire and they deserve. We must do better.
This week, the American Society for Reproductive Medicine and RESOLVE: The National Infertility Association are coming together to inform Congress about the serious need for permanent assisted reproductive technology coverage among veterans and active-duty servicemen and women. Veterans deserve to have a family regardless of their ability to pay; we need to act now so that not one more veteran says that lack of coverage is the only reason she does not have a child today.
Dr. Colleen Miller is an OB-GYN in Indianapolis and a junior fellow of the American College of Obstetricians and Gynecologists. She recently completed a women’s health advocacy fellowship in Washington D.C.