Bill would expand fertility coverage for veterans
In this photo taken Aug. 6, 2012, Brenda and Chuck Isaacson play in their back yard with their 16-month old daughter, in Sun Prairie, Wis. A bill being considered in the Senate would expand the VA's medical benefits package so other veterans, and their spouses or surrogates, don't have to bear the same expense. The department currently covers a range of medical treatment for veterans, including some infertility care, but the legislation would authorize the VA to cover the cost of IVF and to pay for procedures now covered for some critically injured active-duty soldiers. (AP Photo/Andy Manis)
(AP) The roadside bomb that exploded outside Andrew Robinson's Humvee in Iraq six years ago broke the Marine staff sergeant's neck and left him without use of his legs. It also cast doubt on his ability to father a child, a gnawing emotional wound for a then-23-year-old who had planned to start a family with his wife of less than two years.
The catastrophic spinal cord injury meant the couple's best hope for children was in vitro fertilization, an expensive and time-consuming medical procedure whose cost isn't covered by the Department of Veterans Affairs. Robinson and his wife were forced to pay out of pocket, with help from a doctor's discount and drugs donated by other patients.
A bill being considered in the Senate would expand the VA's medical benefits package so other veterans, and their spouses or surrogates, don't have to bear the same expense. The department currently covers a range of medical treatment for veterans, including some infertility care, but the legislation specifically authorizes the VA to cover IVF and to pay for procedures now provided for some critically injured active-duty soldiers.
The bill is meant to help wounded veterans start families as they return home from war and to address a harrowing consequence of combat that can radically change a couple's marriage but receives less attention than post-traumatic stress disorder and brain injuries.
"It's common sense: a male veteran cannot have a kid by himself. It doesn't happen. They need obviously to have it with their wife or a partner," said Robinson, of New Jersey, who is now 29 and was injured in a 2006 explosion in Al Anbar province. "So for the VA to say, 'Oh, we can only cover this part of it,' it just kind of doesn't make sense."
In vitro fertilization, the process of mixing sperm and eggs in a laboratory dish and transferring the resulting embryo into a woman's uterus, costs thousands of dollars and each cycle can take weeks. It's physically taxing too, requiring hormone injections and other invasive steps, and can take multiple tries to produce a viable pregnancy. For many wounded veterans, it represents the most promising option.
More than 1,830 veterans of the wars in Iraq and Afghanistan have suffered pelvic fractures and genitourinary injuries since 2003 that could affect their abilities to reproduce, according to Pentagon figures provided to Sen. Patty Murray, the bill's sponsor and chairwoman of the Senate Veterans Affairs Committee.
"Because they served our country, they now can't have a family, which is part of their dream," said the Washington state Democrat, who hopes the committee will act on the bill after returning from August recess. "I think we now have a responsibility to not take that dream away."
Combat injuries can dampen a soldier's ability to have children in any number of ways, said Mark Edney, a Maryland urologist and Army reservist who treats veterans. For men, a blast to the genitalia can harm sperm-producing testicles, while a spinal cord injury can cause erectile dysfunction or ejaculatory problems. For women, shrapnel can injure the pelvis and fallopian tubes, preventing fertilization.
Although expertise exists to help them become parents, Edney said veterans with fertility problems form a "relatively small subset of patients that are just forgotten in terms of policy."
The legislation would likely have helped spouses like Brenda Isaacson, who said the VA's insurance plan covered the cost of recovering sperm from her husband, Chuck an Army staff sergeant paralyzed by a 2007 helicopter crash in Afghanistan but not the more than half-dozen IVF attempts the couple underwent before finally having a daughter nearly a year and a half ago. She bristled at being told by officials that infertility services were not medically or psychologically necessary.
"You tell that to a man who's just been wounded that it's not psychologically necessary to have children when that's all we'd talked about, having babies," she said.
The proposal comes as technological improvements have made IVF a more common and reliably successful way to have children, with the number of births as a result of it and similar procedures rising in the past decade. It's more openly discussed in popular culture, too, from television talk shows to celebrity magazines. And the VA is becoming more sensitive to family health concerns as it encounters younger veterans trying to start post-war lives, said Patty Hayes, the agency's chief consultant for women's veterans' health.
"The culture has changed. There's a lot more veterans who need this," she said, adding that the VA was looking closely at expanding infertility treatment options.
The VA says it already covers some fertility services, including counseling, diagnostic tests and intrauterine insemination a method of artificial insemination for the veteran. But that leaves out many veterans and their spouses whose best hope for pregnancy is the more physically rigorous, but also more reliable, IVF process, where the average cycle costs $12,400, according to the American Society for Reproductive Medicine.
The process can be especially vexing for military couples coping with life after a catastrophic injury and trying to establish a new normal, said Barbara Cohoon, deputy director of government relations for the National Military Family Association, a nonprofit advocacy group.
"When someone has an injury and they're paralyzed from the waist down, being able to reconnect emotionally and physically as a couple is part of the therapy," she said.
The Defense Department recently made IVF a covered benefit for active-duty service members who are either seriously ill or catastrophically injured, with a policy that allows for coverage of three completed IVF cycles for the soldier's spouse, said spokeswoman Cynthia Smith. She said artificial insemination using donated sperm or eggs is excluded under its policy.
Robinson, the now-29-year-old Marine who suffered the broken neck, said he started exploring ways to have children something he and his wife had always discussed during an extensive rehabilitation process.
They tried artificial insemination, which didn't work because of poor sperm quality resulting from his injury. They spent $6,000 of their own money on IVF and got pregnant on the first try and now have 8-month-old twins Collin and Leah.
"Everyone deserves to have a chance at a family. We were able to save the money and stuff like that. But maybe for someone who isn't able to do that, I would hate to see that they don't have that option," he said.
Tracy Keil used IVF to conceive her twins after her husband, Matt, was shot in the neck in Iraq in 2007 and rendered a quadriplegic, six weeks after they wed. The couple was able to save the thousands of dollars needed for treatment because they live mortgage-free in a custom-made home designed by a nonprofit that builds houses for disabled veterans and their families. She's since become a leading advocate for the legislation, testifying on it this summer before a Senate committee.
"I agree with the fact that they had other hurdles to get over first, especially with PTSD and suicide and traumatic brain injury. They had other things that were just plain more important," Keil said of the VA. "But now we're at the point where those programs are in place and it's time to address this issue."
Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
- Study suggests feelings of guilt may be a top factor in PTSD Dec 06, 2011 | not rated yet | 0
- VA to ease way for vets to get stress disability Oct 14, 2009 | not rated yet | 0
- Many veterans not getting enough treatment for PTSD Feb 10, 2010 | not rated yet | 0
- Growing problem for veterans: Domestic violence Nov 06, 2008 | not rated yet | 0
- Improve care for veterans with PTSD: report Jul 13, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
19 hours ago From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
The latest makeover to a massive psychiatric tome honored by some, reviled by others and even called the "Bible" of mental disorders is being released Saturday with a host of new changes.
Psychology & Psychiatry 10 hours ago | not rated yet | 0
(HealthDay)—Most Medicare beneficiaries treated in inpatient psychiatric facilities (IPFs) exhibit characteristics associated with hospital readmission, according to a report prepared for the National Association ...
Psychology & Psychiatry May 17, 2013 | not rated yet | 0
Skydivers show the same level of physical stress before every jump whether a first-timer or experienced jumper, say Northumbria researchers.
Psychology & Psychiatry May 17, 2013 | not rated yet | 0 |
Children of depressed parents pick up on their parents' sadness—whether mom or dad realizes their mood or not.
Psychology & Psychiatry May 17, 2013 | 4.5 / 5 (2) | 1 |
(HealthDay)—As many as one in five American children under the age of 17 has a diagnosable mental disorder in a given year, according to a new federal report.
Psychology & Psychiatry May 16, 2013 | 2.2 / 5 (5) | 1 |
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).
12 hours ago | not rated yet | 0 |
A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.
10 hours ago | not rated yet | 0
Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.
21 hours ago | 5 / 5 (1) | 0
For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...
22 hours ago | 5 / 5 (1) | 0 |
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
12 hours ago | 5 / 5 (2) | 0