WA lawmakers push for greater access to fertility services for service members and veterans

Every other Thursday, Dr. Ginny Ryan provides counsel and treatment for veterans, mostly women, whose ability to start families is complicated by the rules of the military in which they served.

Veterans and active duty service members unable to conceive children naturally can face hurdles as the military health plan doesn’t cover reproductive assistance, such as in vitro fertilization, intrauterine insemination, a surrogate or adoption.

And those unable to start a family following a combat-related injury will only be eligible if they can prove their infertility is linked to what happened.

If you can’t make that physiological connection, you can’t get coverage, said Ryan, a reproductive endocrinologist and infertility specialist for the University of Washington Medicine who spends a couple days of month working at VA Puget Sound health care sites.

Legislation introduced in Congress on Thursday by two Washington Democrats would, in Ryan’s opinion, “be a game-changer” by knocking down many of the hurdles.

Sen. Patty Murray and Rep. Rick Larsen introduced the Veteran Families Health Services Act, a more expansive version of a bill they pushed unsuccessfully in 2021.

Murray said it would transform how family planning care is delivered through the Department of Defense and Department of Veterans Affairs by expanding the fertility treatments and family-building services covered under the U.S. military health plan known as TRICARE.

“Servicemembers and veterans have sacrificed so much for our country—but they shouldn’t have to sacrifice their ability to start a family,” she said in a statement.

The legislation would allow servicemembers to cryopreserve, or freeze, their eggs or sperm before deployment to a combat zone or hazardous duty assignment and after an injury or illness.

Ryan said this would be valuable for women veterans she sees. They want to start a family but are older and encountering fertility challenges following their service, not surprising as there are studies showing a link between trauma, such as one might experience during military service, and infertility, she said.

“It would be wonderful if (cryopreservation) was offered to military folks before they are deployed and age or are injured,” she said.

Another provision in the new congressional bill would assure veterans and servicemembers access to fertility treatment and counseling, including assisted reproductive technology like in vitro fertilization, or IVF. And it would allow couples, including those who are unmarried and of the same sex, to use donated gametes.

Right now, only individuals who are married to opposite-sex partners that can provide gametes for IVF are eligible for IVF services, Murray’s staff said. This means unmarried veterans and servicemembers whose partners are infertile, the same sex, or unable to provide gametes are excluded.

This legislation would, for the first time, allow veterans and servicemembers to use gestational surrogates for covered IVF services, according to Murray’s office. Also, the legislation aims to create a less onerous process to access services for which an individual is eligible.

“Congress should take the long-overdue step of permanently overturning outdated limitations on IVF to give servicemembers and veterans the opportunity to start a family,” Larsen said.

The bills introduced Thursday are unlikely to make it to President Joe Biden’s desk this year. However, some provisions could make their way into key spending bills under negotiation today.

The House, for example, has approved a pilot program allowing active-duty service members to freeze their sperm or eggs before deployment. It made it into the National Defense Authorization Act passed by the Republican-led chamber. Such a program is not in the Senate version.

Larsen, who has championed this program for several years, called it “a positive step toward helping our nation’s servicemembers and  their loved ones build a family. Congress should create this initiative to keep faith with the women and men sent into harm’s way.”

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