SexHealthMatters.org is the website of the Sexual Medicine Society of North America, Inc.

sm-youtube
top-image

Addressing Fertility and Sex Health Issues for Veterans

An Army doctor tends to a simulated wounded soldier in a training exercise.Many of our patients dream of having a family. When fertility problems interfere, the effect can be devastating. Couples face difficult decisions about adoption, surrogacy, and in vitro fertilization (IVF). Their attempts at having a family might not even work, adding more anxiety and frustration.

When one member of the couple is a wounded veteran, the situation can take another turn.

Many veterans struggle with injuries to their genital and pelvic areas, which can make conceiving a child difficult. Men with testicular damage may have problems producing sperm. Those with spinal cord injuries may have problems with ejaculatory and erectile function. Women may have damage to the uterus.

The Department of Veterans Affairs (VA) has provided limited access to certain reproductive services, such as IVF. For example, the VA has covered the retrieval of sperm from a male veteran, but not covered the rest of the IVF process, which includes forming embryos, transferring them to the mother’s uterus, and accompanying hormone injections. Not all trials result in a pregnancy and sometimes this cycle is repeated multiple times, costing thousands of dollars that the couple must pay out of pocket.

However, a bill before Congress may provide some help. On September 12, the Senate Committee on Veterans Affairs approved the Women Veterans and Other Health Care Improvement Act of 2012, designed to improve access to fertility and reproductive healthcare for veterans.

Washington Senator Patty Murray, Chairman of the Veterans Affairs Committee, introduced the bill in June. In a press release, Senator Murray said,

“Reproductive injuries are some of the most impactful and serious wounds of these wars. VA has an obligation to care for the combat wounded. For those with such catastrophic injuries, that includes access to the fertility care they need. Veterans and their spouses are specifically barred from accessing In Vitro Fertilization services at the VA and often times have to spend tens of thousands of dollars in the private sector to get the advanced reproductive treatments they need to start a family. These veterans deserve far more.”

Specifically, the legislation would provide the following:

  • Enhanced reproductive treatment and care for severely wounded veterans, including access to IVF, which is currently excluded from the VA’s medical benefits package. This would also include surrogacy. For example, if a female veteran’s uterus is injured and she cannot carry a child, one of her fertilized embryos may be implanted into a surrogate’s uterus.
  • Fertility treatment for an eligible family member or surrogate of a severely wounded veteran, at the same level of the veteran’s eligibility. For example, if a veteran’s sperm is retrieved and an embryo is implanted, his spouse would receive fertility treatment.
  • More research on the long-term reproductive healthcare needs for veterans, including infections specific to men and women and reproductive and urinary tract trauma sustained in battle.
  • A childcare program for veterans receiving readjustment counseling at VA’s Vet Centers.
  • Improved outreach to women veterans, ensuring that they are aware of and can access VA health care and benefits.

The Women Veterans and Other Health Care Improvement Act has been sent to the House and Senate for consideration. The time frame for further action is unknown, but as practitioners, it’s worthwhile to follow this bill and determine how it would affect our current patients.

Do you serve many veterans in your practice? What are your thoughts on the proposed legislation? Feel free to share your views by leaving us a comment.

To learn more about problems that may face your male patients with spinal cord injuries, please click on the following links:

Spinal Cord Injury
Anejaculation
Retrograde Ejaculation
Spinal Cord Injury and Ejaculation

For information on sexuality for women with spinal cord injury, this link may be helpful:

Women and Spinal Cord Injury

This link provides information on sexuality for both men and women with spinal cord injury:

Adjusting to Spinal Cord Injury

 

Resources

Associated Press via ABC News
Tucker, Eric
“Senate Panel OKs Veterans Infertility Bill”
(September 12, 2012)
http://abcnews.go.com/US/wireStory/senate-panel-takes-bill-infertile-veterans-17215651#.UFjjiVFqf3A

Associated Press via the Huffington Post
Tucker, Eric
“Veteran Fertility Coverage Could Be Expanded Thanks To New Bill”
(August 18, 2012)
http://www.huffingtonpost.com/2012/08/18/veteran-fertility-coverage_n_1801023.html

GovTrack.us
“S. 3313: Women Veterans and Other Health Care Improvement Act of 2012”
(Status check of bill. Accessed September 18, 2012)
http://www.govtrack.us/congress/bills/112/s3313

United States Senator Patty Murray
“Chairman Murray Introduces Bill to Provide Veterans with Genital and Reproductive Wounds with Access to In Vitro Fertilization through the VA”
(Press release. June 19, 2012)
http://www.murray.senate.gov/public/index.cfm/newsreleases?ID=b492f332-d42c-4699-b755-58ff799a1d05

“Women Veterans and Other Health Care Improvement Act of 2012”
http://www.murray.senate.gov/public/_cache/files/fff168a9-0aaf-45f4-aba9-22692d29a846/Women%20Veterans%20Health%20Care%20Improvement%20Act%20of%202012%20-%20One%20Page%20Summary.pdf

 

Photo
Col. Lionel M. Nelson assists Soldiers during a Mass Casualty training exercise.
Public Domain
Wikipedia Commons
http://commons.wikimedia.org/wiki/File:Flickr_-_The_U.S._Army_-_Volunteer_doctor.jpg