Semin Reprod Med 2019; 37(01): 012-016
DOI: 10.1055/s-0039-1692127
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Infertility Services for Veterans: Policies, Challenges, and Opportunities

Stephanie W. Edmonds
1  Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
,
Laurie C. Zephyrin
4  Manhattan VA Medical Center, New York, New York
5  Department of Obstetrics and Gynecology, New York University, New York, New York
,
Alicia Christy
2  Women's Health Services, VA Office of Patient Care Services, Veterans Health Administration, Department of Veterans Affairs, Washington, District of Columbia
,
Ginny L. Ryan
1  Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
3  Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa
› Author Affiliations
Further Information

Publication History

Publication Date:
11 June 2019 (online)

Abstract

Infertility prevalence and care needs among male and female Veterans are understudied topics. The Veterans Health Administration (VHA) medical benefits package covers full infertility evaluation and many infertility treatments for Veterans but not, by law, for their spouses. In vitro fertilization (IVF) is also specifically excluded from this medical benefits package by regulation. Congress passed a law in 2016 that allowed VHA to provide IVF to Veterans and their legal spouses, and broader infertility benefits to the legal spouse, if the Veteran has a service-connected condition associated with his or her infertility, with some limitations. As the Veteran population becomes increasingly female, research efforts in reproductive health, including infertility, are expanding and evolving. This includes a nationwide study currently underway examining infertility among male and female Veterans and associations with military-related trauma, such as injury, posttraumatic stress disorder, military sexual trauma, and toxin exposure. In this review, we describe the state of the science and policy on infertility care in the VHA along with challenges and opportunities that exist within the VHA system.