MAY 1, 2024 – Infertility impacts 1 in 5 women according to the Centers for Disease Control and Prevention, and amongst Airmen and Guardians, about 17% reported they have sought infertility treatments while serving, according to a 2022 Department of the Air Force survey.
As Col. Larissa Weir, a board-certified OB-GYN and Chief Women’s Health Consultant to the Air Force Surgeon General, infertility can impact a member’s quality of life and is connected to the DAF’s readiness and ability to retain its members.
“Family building is a key factor when it comes to member retention of women in all the services, and we do know that women leave due to issues surrounding family planning,” said Weir. “Just like with any other health condition, supporting infertility care and treatment is vital for their readiness and our ability to retain talented Airmen and Guardians.”
The DAF Women’s Initiative Team actively addresses barriers impacting women in the Air Force and Space Force, including barriers that impact infertility treatments. A significant accomplishment, the team worked with DAF leaders to update DAF Instruction 36-3003, which allows Airmen and Guardians to take permissive temporary duty to get fertility treatments.
“In 2022, through the efforts from the WIT, the DAF updated the instruction to allow for permissive temporary duty for members to travel to any of the seven military bases where infertility services are available at a military treatment facility,” said Weir. “That update was shortly followed up with the Secretary of Defense’s policy that provided travel allowance for service members who needed to travel away from their local area for non-covered treatment. Since those policy changes, we are seeing utilization of both days away from duty and travel allowances for reproductive health services. I do think these policies are having a positive impact on our members ability to seek care.”
As the policy explains, depending on the member’s situation, an Airman or Guardian can elect permissive temporary duty or funded temporary duty to receive reproductive services.
The Women’s Initiative Team, or WIT, is made up of Airmen and Guardians who volunteer to advocate for a range of issues impacting women serving in the Air Force and Space Force. Among the volunteers is Lt. Col. Jessica Switzer, the Deputy Staff Judge Advocate for the U.S. Air Force Expeditionary Center, who leads the effort to support reproductive health and infertility.
“I was motivated to join after my husband and I had gone through a lot when trying to get pregnant,” said Switzer. “We were diagnosed with unexplained infertility and had to go through the in vitro fertilization route. That is when I noticed that TRICARE only covered a fraction of the cost associated with treatment, and I would see young service members essentially taking out the equivalent of a car loan for something that may or may not work for them. On top of that, I had to move in the middle of treatment, which added challenges. Seeing all this motivated me to join the WIT and to see what we can do to support others experiencing infertility.”
Switzer also stressed the impact that infertility has on mental health.
“Infertility can be a roller coaster,” said Switzer. “Every month, every cycle, every attempt. It’s not only costly, it’s also emotionally taxing. You see your friends having children and you think you’re next. Then next thing you know, they are having their second or third child. While you are so happy for them, many women and families usually suffer in silence.”
The WIT provides the necessary support and address barriers that Switzer and many others often encounter when seeking infertility treatment. Currently, the WIT is evaluating the impact of relocation and deployments on those receiving infertility treatments.
“These treatments often require multiple visits with a provider they have established a plan with. If a member is getting in vitro fertilization treatment, then something like a short-notice deployment can throw off that whole plan,” said Weir. “So, we are taking a closer look into what can be done to address that barrier and ensuring members can receive the full treatment without disruption.”
For Weir, advocating for policy supporting women’s health is not only her job, but something she understands on a personal level, especially when it comes to infertility and seeking treatment.
“My family was created through [in vitro fertilization], so I understand the challenges surrounding seeking treatment and how easily it can eat away at your time and resources,” said Weir. “I remember it being challenging to navigate that care as an officer and OB-GYN physician, so I know how hard it can be to navigate the world of infertility for most Airmen and Guardians. We are doing what we can to remove barriers for those seeking treatment and making things as accessible as possible.”
Understanding that seeking infertility treatment can be costly, Weir encourages Airmen and Guardians to connect with their provider to see what can be covered and what treatments are available at their home MTF.
“TRICARE does allow for the evaluation for infertility and, in some cases, treatment if it is linked to an underlying cause,” said Weir. “For example, if there is an abnormality of the uterus or fallopian tubes, sometimes those can be addressed surgically and could possibly get covered by insurance. I encourage our members to talk with their providers to see what infertility support they can receive and what their options are.”
Switzer echoed the same sentiment, encouraging Airmen and Guardians to advocate for themselves when getting care.
“I think a lot of people are getting left behind or paying out of pocket simply because they do not know or do not understand how to advocate for themselves,” said Switzer. “TRICARE can cover initial diagnostic and testing, and if your MTF can’t do that, then they will refer you out to a fertility specialist. While many fertility interventions are not covered, some aspects of treatment are, and I encourage everyone to speak with their provider.”
For those motivated to support other members experiencing infertility, Switzer encourages them to join the WIT and help provide support and make important policy changes to improve access to care.
“We are always looking for people to help,” said Switzer. “We have several lines of effort that touch on a range of issues from flying standards to postpartum and childcare.”
For those who are interested joining the WIT, more information is available on the WIT’s Air Force Portal page. [Note: This site is restricted and requires a common access card; users without a common access card will receive a website error message].
Story by Shireen Bedi
Air Force Medical Service