How to Qualify for VA Female Infertility Services?

What is Female Infertility?

Infertility is defined as the inability to conceive pregnancy after at least one year of frequent intercourse (or six months if the woman is over age 35). Female and male infertility affects millions of people in the United States. About one-third of the time, a couple’s infertility issues result from female factors. However, in the military women are three times more likely to suffer infertility than civilians. Based on a survey of active-duty, reserve, retired, and veteran women it was found that over 30% of women who currently serve or have served in the armed forces reported infertility.

Although the main symptom of female infertility is the inability to get pregnant, there may be no other outward signs or symptoms. Sometimes there may be a menstrual cycle that is too long, too short, irregular, or absent. Overall, women should see a doctor is they are experiencing or concerned about female infertility.

What Causes Female Infertility?

Ovulation Disorders

Ovulation disorders, meaning an individual ovulates infrequently or not at all, account for infertility in 1 in 4 women. Problems with the regulation of reproductive hormones can cause ovulation disorders. Examples of these disorders include: polycystic ovary syndrome, hypothalamic dysfunction, premature ovarian failure, etc.

Damage to Fallopian Tubes

Damaged or blocked fallopian tubes keep sperm from getting to the egg or can block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include: pelvic inflammatory disease, previous surgery in the abdomen, pelvic tuberculosis, etc.

Endometriosis

Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue causes scarring which can block fallopian tubes and keep an egg and sperm from uniting.

Uterine or Cervical Causes

Several uterine or cervical causes can impact fertility by interfering with implantation of the egg or increasing the likelihood of a miscarriage: benign polyps or tumors, uterine abnormalities present from birth, cervical stenosis, etc.

How to Qualify for VA Female Infertility Services?

Women veterans who qualify for infertility services may be eligible for a range of treatment options including genetic counseling, ultrasound procedures, tubal ligation reversal, and medication. To qualify, women veterans must:

  • Be legally married
  • Have a service-connected condition causing infertility
  • Have an intact uterus and at least one functioning ovary or have cryopreserved eggs
  • The veteran’s spouse must be able to produce sperm or have cryopreserved sperm

Veterans who need donor sperm, eggs, embryos, gestational surrogacy, or obstetrical care are ineligible for the ART/IVF benefit.

Women veterans who are enrolled in VA health care can schedule an appointment with a VA provider for an evaluation. According to the VA, it may be necessary to identify the cause of your female infertility before determining your eligibility for the benefits.

If eligible for ART/IVF, VA will refer the veteran and their spouse to a Reproductive Endocrinology and Infertility (REI) specialist in the community. The REI will work with the veteran and their spouse to perform any necessary evaluations and tests before developing a treatment plan. From there, treatment is provided according to the plan developed.

How are Conditions Rated?

Removal or Loss of Use of the Reproductive Organs

  • Complete Removal of the Uterus and Both Ovaries. Rated 100% for the first 3 months after the surgery and then after 3 months it is rated 50%.
  • Entire Uterus is Removed. Rated 100% for the first 3 months after the surgery and then after the 3 months it is rated 30%.
  • Removal of One or Both Ovaries. Rated 100% for the first 3 months after surgery. After those 3 months they complete removal of both ovaries is rated 30%. If a single ovary is removed and the other is non-functional then it is rated 30%. Anything less than the complete removal or loss of use of both ovaries is rated 0%.
  • Both Ovaries Non-Functional. Rated 20% if both are completely non-functional.

Diseases and Injuries         

There is a basic rating system for all diseases, injuries, or adhesions of the reproductive system.

  • If the symptoms cannot be controlled by constant treatment. It is rated 30%
  • If the symptoms can be controlled by constant treatment. It is rated 10%
  • If the symptoms to do not require constant treatment. It is rated 0%

The codes and conditions that are rated by this system include:

  • Diseases or injuries of the vulva and clitoris
  • Diseases or injuries of the vagina
  • Diseases of injuries of the cervix
  • Diseases, injuries, or adhesions of the uterus
  • Diseases, injuries, or adhesions of the fallopian tubes
  • Diseases, injuries, or adhesions of the ovaries

Endometriosis

Rating Symptoms
50% If the condition affects the bowel or the bladder, causes problems with going to the bathroom, and causes uncontrolled pain in the pelvic region or bleeding
30% If there is pain in the pelvic region and there is irregular bleeding that cannot be controlled by treatments
10% If the pain or bleeding can be controlled by continuous treatment

Veterans Help Group have been supporting veterans in getting the benefits they deserve since 1995. If you or a loved one served, and suffer from female infertility, we are here to help. Call Veterans Help Group at 855-855-8992 or complete our free veterans benefits case evaluation form.

 

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