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Veterans Law

VA Disability for Female Infertility

March 13, 2020

What is Female Infertility?

Generally speaking, infertility is defined as the inability to conceive pregnancy after at least one year of frequent intercourse.  Female and male infertility affect millions of people in the United States.  About one-third of the time, a couple’s fertility issues result from female factors; however, female infertility can be difficult to diagnose.  Although the main symptom of female infertility is the inability to get pregnant, there may be no other outward signs of symptoms.  It is possible that women will have a menstrual cycle that is too long (35 days or more), too short (less than 21 days), irregular, or absent.  Such factors may indicate that you are not ovulating, thereby indicating potential fertility issues.  Overall, women should see a doctor if they are experiencing or concerned about female infertility.

Potential Causes of Female Infertility

Ovulation Disorders

Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 1 in 4 infertile women.  Problems with the regulation of reproductive hormones can cause ovulation disorders.  Examples of such disorders include polycystic ovary syndrome (PCOS), hypothalamic dysfunction, premature ovarian failure, etc.

Damage to Fallopian Tubes (Tubal Infertility)

 Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus, thereby causing infertility.  Causes of the fallopian tube damage or blockage can include pelvic inflammatory disease, previous surgery in the abdomen or pelvis, pelvic tuberculosis, etc.

Endometriosis

Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations.  The extra tissue growth can cause scarring, which may block fallopian tubes and keep an egg and sperm from uniting.

Uterine or Cervical Causes

Several uterine or cervical causes can impact fertility by interfering with implantation of the egg or increasing the likelihood of a miscarriage: benign polyps or tumors, uterine abnormalities present from birth (e.g., abnormally shaped uterus), cervical stenosis, etc.

Prevalence of Female Infertility Among Women Veterans

According to a study of veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), or elsewhere during the same time period, 15.8% of women self-reported that they had experienced infertility (defined as “trying with a partner to get pregnant for more than 12 months).  Furthermore, the study found that the causes of female infertility in diagnosed cases were similar to those listed above.  VA offers female infertility services to qualifying women veterans who are registered in the VA health care system.

How to Qualify for VA Female Infertility Services

Women veterans who qualify for infertility services may be eligible for a wide range of treatment options including genetic counseling, ultrasound procedures, tubal ligation reversal, and medication.  VA may also be able to help with in vitro fertilization (IVF) or another form of assisted reproductive technology (ART).  To qualify, women veterans must:

  • Be legally married
  • Have a service-connected condition causing infertility
  • Have an intact uterus and at least one functioning ovary or have cryopreserved eggs
  • The veteran’s spouse must be able to produce sperm or have cryopreserved sperm

Importantly, veterans who need donor sperm, eggs and embryos, gestational surrogacy, or obstetrical care are ineligible for the ART/IVF benefit.

Getting IVF Treatment for Female Infertility

Women veterans who are enrolled in VA health care can schedule an appointment with a VA provider for an evaluation.  According to VA, it may be necessary to identify the cause of your female infertility before determining your eligibility for the benefit.  Veterans can contact their local VA medical facility to schedule an appointment, or call the Women Veterans Call Center at 855-829-6636 with any questions or concerns.

If eligible for ART/IVF, VA will refer the veteran and their spouse to a Reproductive Endocrinology and Infertility (REI) specialist in the community.  The REI will work with you and your spouse to perform any necessary evaluations and tests before developing a treatment plan.  From there, treatment is provided according to the treatment plan that was developed.

Female Infertility Care Among OEF/OIF/OND Women Veterans

A 2015 study examined infertility care among OEF, OIF, and Operation New Dawn (OND) women veterans using VA health care.  The study analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC) – Contingency Tracking System Deployment File of Military Discharges from October 1, 2001 through December 30, 2010.  This included 68,442 women veterans between the ages of 18 and 45 who utilized VA health care after separating from military service.

The study further examined the receipt of infertility diagnoses and care using International Classification of Diseases, Ninth Edition and Current Procedural Terminology codes. Overall, a small proportion of OEF/OIF/OND women veterans received infertility diagnoses from VA during the study period, and an even smaller proportion received infertility treatment.  Nearly 40% of those who received infertility treatments received these treatments from non-VA providers.

The study concluded that understanding women’s use of VA infertility services is an important component of understanding VA’s commitment to comprehensive medical care for women veterans.  As demonstrated above, VA has increased efforts towards offering more expansive infertility services and treatment for women veterans.