For the women and men of America's military, fertility issues can be an added and expensive complication.
"The biggest issue is the financial implications related to it. The average cost for comprehensive coverage is around $45,000 and a single cycle can cost anywhere from like $14,000 to $20,000," said Rachel Branaman, executive director of the Modern Military Association of America.
The 2025 National Defense Authorization Act could have eased that burden by potentially moving to expand insurance coverage for IVF to members of the U.S. military. However, it was not included in a compromise bill.
As it stands now, in order to get insurance coverage for IVF, U.S. service members must prove that their fertility issues are related to an injury or disease tied to their military service. If the new spending bill passes, though, that restriction would end, and not without opposition.
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"Sixty-seven percent of military families have reported struggles with fertility and family building," said Briana Thompson with the Yale Veterans Legal Services Clinic, "and it's not just female service members - male service members experience male factor infertility."
However, some members of Congress opposed the IVF expansion for service members.
In a letter to the Armed Services committees in both the U.S. House and Senate, Republican Congressmen Matt Rosendale of Montana and Josh Breechen of Oklahoma argued that expanding IVF to service members will, "…cost taxpayers approximately $1 billion per year. While we have great sympathy for couples who are having difficulty starting a family, IVF is ineffective, leads to the destruction of innocent human life, and does nothing to treat the root cause of a couple's infertility."
Yet, starting in 2025, members of Congress and their staff will have access to fertility treatments, like IVF, through their government health insurance.
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"The fact that civilian federal employees and Congress also have IVF and family building benefits that they receive, I think really just speaks to the fact that service members and veterans deserve more," said Trudel Pare, with the Yale Veterans Legal Services Clinic.
Two Democratic lawmakers, Rep. Sara Jacobs of California and Sen. Tammy Duckworth of Illinois, also wrote letters to the same committees arguing in favor of IVF to service members, saying, "…it would be hypocritical for members of Congress to enjoy high quality fertility benefit coverage next year, right on the heels of denying such IVF coverage to brave Americans willing to defend our country in uniform."
A 2020 study found 15% of the nation's more than 200,000 active-duty military women reported fertility issues. Supporters of expanding IVF care said the issue is not just about the health of one individual, but also about the overall health of the armed forces.
"The military is in a recruiting and retention down cycle and has been for a while - and part of the reason people join the military is the benefits," Thompson said. "And so, to both honor their service and to also have service members and veterans feel like their service is valued, we would hope that the agencies would expand coverage so people can access it as they need it."
If it had been included in the defense bill, the IVF expansion for the military would have cost around $1 billion. For context, the total defense spending bill for 2025 stands at more than $923 billion.
