Lauren Westgate, 28, threw away her birth control pills the day she got married 2006, but she couldn't start trying to have a baby for another 16 months. That's because her husband, a U.S. soldier was deployed to Afghanistan.
"Sometimes I laugh when people tell me that the first year of marriage is the hardest one," says Lauren. "That statement takes on a whole different meaning for me now."
Trying to have a baby is a challenge for more than 2 million married American women, according to the National Center for Health Statistics, and these women are increasingly looking to science for help.
Serving in today's military only complicates the fertility struggle, as lost time and deployments disrupt the rhythm of baby making.
For Lauren and her husband, it would be early 2008 before they were together long enough to try to conceive. But the irregular cycles that had plagued her during the deployment (easily attributed to stress) continued even after her husband returned, and she'd stopped ovulating.
Still in their 20s, they had to wait another year before they could be referred to a specialist, standard for health care providers.
In-vitro fertilization and artificial insemination are viable, if expensive, options for couples forced to go through long separations. TRICARE, the healthcare network for U.S. troops and their families, doesn't pay for either treatment.
"The military health system does make artificial insemination and in-vitro fertilization available at four military treatment facilities, but even there the patient pays all the costs," says Austin Camacho, chief of public affairs at TRICARE Management Activity.
Military spouses haven't necessarily lobbied to change this. "I've received more questions about how to access artificial insemination or in-vitro fertilization...than requests for help in getting the benefit changed to add the coverage [under TRICARE]," says Joyce Wessel Raezer, executive director of the non-profit National Military Family Association, based in the Washington, D.C. area. "Many military families would like these procedures to be covered, but most know they're not covered in the civilian sector, either."
To offset this near-universal lack of coverage, Sen. Kirsten Gillibrand (D-NY) has introduced the Family Act of 2011 to give tax credits based on the costs of certain infertility treatments, including IVF. In preparing the bill (still in committee as of September 2011), Gillibrand's staff confirmed that only 15 states require insurance companies to cover infertility treatments.
Military couples who are residents of these states could buy extra health insurance to take advantage of this coverage, but TRICARE isn't subject to these state mandates.
Gillibrand's tax credits would be a welcome break for the military spouses who chronicle on Facebook how they've financed IVF by taking out a second home mortgage, getting a second job or even maxing out credit cards (a single round can cost as much as $15,000).
Artificial insemination averages about $1,500 a try.
Ironically, serving in combat provides a pay bump (by way of hazardous duty bonuses and tax exemptions) that could make these procedures more affordable for a military couple.
But the normal stresses of military life can take its toll on fertility, too. After nearly three years of marriage -- and a few intermediate hormone therapies -- Lauren finally got a prescription for Clomid, also covered by TRICARE. Four rounds later, she was pregnant.
Sadly, ten days before the Westgates set out to move across country to Arizona and 11 weeks along in her pregnancy, she lost the baby. They would live in Arizona only five months before Lauren's husband was transferred again. "The only thing we accomplished in Arizona was receiving my PCOS diagnosis," says Lauren, referring to polycystic ovary syndrome.
The couple then settled outside Ft. Bragg, N.C. There was only one reproductive endocrinologist in the area so Lauren wound up on a waiting list, miscarrying again in November 2010 before she was able to see him.
Though he's been a "wonderful doctor" and TRICARE has "thankfully" continued to pay for fertility drugs, ultrasounds, blood draws and doctor's visits, Lauren is aware she's not only working against her biological clock, but also the military's clock. "I'm stressed that we'll have to move again before I can get pregnant, and stay pregnant," she says.
It's been nearly five years of marriage and three disrupted years of trying to conceive. Since her husband is currently deployed again, Lauren is trying to keep the baby-making on track through intrauterine insemination, similar to AI. So far, she's had three rounds and she'll repeat the procedure at least once more while he is away. None of the procedures are covered by insurance. So far, the couple has spent $1,350 on fertility treatments, while TRICARE Prime has paid for fertility checkups, blood draws and meds.
"I'm able to do all my [hormone] injections alone," says Lauren. "It was hard, though, when I got a negative result with the first IUI. It was difficult to have to work through my emotions with him being so far away."
Military IVF Treatment Facilities
Military treatment facilities offering IVF and AI (though TRICARE won't pay for the procedures):
- Wilford Hall Medical Center in San Antonio
- Tripler Army Medical Center in Honolulu
- Walter Reed Army Medical Center in Washington, D.C.
- Naval Medical Center in San Diego
Getting Help and Financial Assistance
As IVF and other fertility treatments have become more popular, non-profit groups have organized around the idea of donating grants to cover them. Here's a sampling of where to apply:
- The International Council on Infertility Information Dissemination (INCIID) secures donated clinical services and drugs to provide IVF cycles for their scholarship winners.
- Fertile Dreams advocates on behalf of "family building" and offers the Embracing Hope Grant.
- Parenthood for Me offers grants to families who are paying for IVF treatments, as well as those who have adoption fees.