Self-Reported Infertility Among Male and Female Veterans Serving During Operation Enduring Freedom/Operation Iraqi Freedom

Katon, Jodie G.; Cypel, Yasmin; Raza, Mubashra; Zephyrin, Laurie; Reiber, Gayle E.; Yano, Elizabeth M.; Barth, Shannon K.; Schneiderman, Aaron

doi:10.1089/jwh.2013.4468

Cited by 28 publications

(24 citation statements)

References 38 publications

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“…In 1 recent study characterizing self-reported lifetime infertility among OEF/OIF/OND women Veterans, 15.8% reported infertility. 13 However, given that previous studies focused on self-reported infertility and the present work focused only on clinical diagnoses and receipt of VA-paid infertility care, it is impossible to make direct comparisons.…”

Section: Discussionmentioning

confidence: 93%

“…10 Exposure to sexual assault, including military sexual trauma (MST), has been historically linked with self-reported infertility among women Veterans, perhaps explaining some of the association between mental health conditions (ie, posttraumatic stress disorder and depression diagnoses are common among women Veteran with MST). 11,12 Most recently, Katon et al 13 utilized national survey data to examine self-reported infertility among male and female OEF/OIF/OND Veterans, including VA users and nonusers, and found 15.8% of women and 13.8% of men reported a lifetime history of infertility.…”

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confidence: 99%

“…Recent studies suggest that though most VA facilities provide basic women’s health services, 14,15 availability of advanced gynecologic care varies widely. 13,15,16 Much of this variation is dependent on the size and complexity of the services offered at each specific VA medical facility, which is often driven by the volume of female Veterans using that facility for their health care. If sex-specific services are not available on-site, they are provided in the community through non-VA (fee) care or contract services.…”

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confidence: 99%

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Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

Mattocks

Kroll‐Desrosiers²,

Zephyrin³

et al. 2015

Medical Care

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Background An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. Methods We 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–December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Results Less than 2% (n = 1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Conclusions Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the 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, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women’s use of VA infertility services is an important component of understanding VA’s commitment to comprehensive medical care for women Veterans.

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

Mattocks

Kroll‐Desrosiers²,

Zephyrin³

et al. 2015

Medical Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…After adjusting for confounding variables, they found similar rates of infertility between men and women; however, they noted that women veterans were more likely to seek care for infertility treatment. 58 Additional studies have demonstrated associations between elevated rates of lifetime sexual assault and infertility or lack of infertility evaluations in female veterans. 59 Given the varied definitions used for surveying the population for prevalence of infertility, direct comparisons between the military and nonmilitary populations are difficult.…”

Section: Risk For Infertilitymentioning

confidence: 99%

Fertility Preservation Before Deployment: Oocyte and Sperm Freezing in Members of the Active Duty Military

Martini

Doyle

2019

Semin Reprod Med

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Active duty military service and deployment has the potential to compromise fertility through combat-related genitourinary injury, gonadotoxic exposures, and physical separation from a partner. Despite a growing interest among the military community as well as promising efficacy and safety data, fertility preservation remains an uncovered benefit for active duty soldiers. In 2016, the Pentagon proposed a program that would cover oocyte and sperm cryopreservation for any member of the active duty military desiring its use. Regrettably, that funding was not secured and predeployment fertility preservation remains an out-of-pocket expense. Today, advocacy groups, non-for-profit organizations, and physicians remain vigilant in their attempts to drive another government initiative through Congress. While activism continues, it is important to stress the value of fertility preservation counseling in soldiers' predeployment preparation and military family planning.

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“…Almost 16% of Iraq and Afghanistan veterans self-report a lifetime history of infertility. 29 Data linking infertility or other reproductive health outcomes to certain exposures in the military are lacking. 2 However, women veterans may have questions regarding occupational exposures and fertility.…”

Section: Infertilitymentioning

confidence: 99%

Reproductive Health Management for the Care of Women Veterans

Zephyrin

2016

Obstetrics & Gynecology

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There are more than 2 million women veterans living in the United States. Many women do not identify themselves as veterans. As women's health care providers, it is important to understand and recognize the potentially complex health and social needs of women veterans and the role of military service on their lives. The reproductive health needs of women veterans may be shaped by their military experiences and coexisting medical or mental health conditions. Military sexual trauma and combat exposure are common causes of posttraumatic stress disorder and can affect overall health and well-being. Screening for military service is important in all women, and inclusion of this as a key demographic variable in research and clinical encounters can further inform health care considerations. The following key topics are addressed: who are women veterans, health and social risk factors associated with a history of military service, reproductive health across the life course, military sexual trauma and reproductive health of women veterans, how to take a military history, and the essential role of women's health providers, including obstetrician-gynecologists, in enhancing health systems and providing high-quality care to veterans.

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Self-Reported Infertility Among Male and Female Veterans Serving During Operation Enduring Freedom/Operation Iraqi Freedom

Abstract: Women Veterans are more likely than their male counterparts to seek care for infertility, and given their increasing numbers, the demand for infertility evaluation and care within Veterans' Affairs may increase.

Cited by 28 publications

References 38 publications

Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

Fertility Preservation Before Deployment: Oocyte and Sperm Freezing in Members of the Active Duty Military

Reproductive Health Management for the Care of Women Veterans

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