When my husband and I married in 2015, we had no idea that we would struggle with infertility. After a few unsuccessful months of trying to conceive, I began to wonder whether I was the reason we couldn't get pregnant. I was approaching 30 and knew that my biological clock was ticking.
We have spent the past nine years on our family-building journey. My husband and I were diagnosed with unexplained infertility, which means we are experiencing difficulties getting or staying pregnant, but the doctors couldn't pinpoint the exact cause.
We have done three rounds of intrauterine insemination (IUI), in vitro fertilization (IVF) that included one egg retrieval and two frozen embryo transfers (FET). During that time, we have experienced four losses, including one that put my life at risk.
In the 2010s, pregnancy loss and infertility weren't really mainstream topics. Occasionally, they were surface-level discussions on TV shows and movies. It wasn't until I experienced pregnancy loss and infertility that I saw how taboo it was to talk about them. I felt so alone.
According to the World Health Organization, one in six people experience infertility globally, but recent studies have shown that within the military community, those numbers are much higher. The Blue Star Families 2021 Military Lifestyle Survey found that 67% of respondents have experienced at least one family-building challenge, and the 2024 Military Family Building Survey from the Building Military Families Network found that 70% identified as having an infertility connection.
When I started opening up about our infertility struggles in 2019, I began to suspect that infertility was more common within the military. At one military function I attended, eight out of the 15 families present had experienced infertility.
While infertility is very common within our community, most military families can't access fertility treatments. When my husband and I moved from Arizona to Illinois, I thought we had really lucked out because Illinois had an IVF coverage mandate. We thought that meant our IUIs -- and if we needed IVF -- would be covered. However, because we are on Tricare, which is a federal plan, that coverage mandate didn't apply to us.
With data showing that infertility impacts military families at four times the global average, our community needs to access the medical treatments available to treat infertility. It is a medical condition just like diabetes, cancer and heart disease, yet current Tricare policies only cover IUI and IVF if the service member has suffered a documented service-related injury or illness, causing their infertility. Tricare coverage does not include IUI and IVF for common causes of infertility like polycystic ovary syndrome (PCOS), endometriosis or low sperm count, which affect the majority of those in our community longing to have a family.
As military families, we are constantly moving and changing medical providers. A lack of continuity of care can lead to infertility: its causes going undiagnosed, delays in finding answers, or sadly, overworked doctors who do not take patients' concerns seriously. When I hit the one-year mark of trying to conceive, instead of getting a referral to a fertility clinic from my doctor, we got permanent change-of-station (PCS) orders instead.
When I met with my new doctor, they brushed off my concerns and told me that because my husband traveled for work, we hadn't been trying for a full year. Then my husband deployed. It took me two extra years to get an unexplained infertility diagnosis. Our military families deserve coverage for IUI and IVF so that doctors at military treatment facilities stop brushing off patients because they know that treatments won't be covered. Simply put, the lack of coverage is preventing access to care that treats diseases.
But it's not just barriers to getting a diagnosis; there are also barriers to accessing treatments. During our first year of marriage, we continued to save money. When we started to suspect that infertility was going to be part of our journey, we started cutting nonessentials from our budget, too.
Paying for fertility treatments out of pocket is expensive. The costs for an IVF cycle vary depending on location, but the national average is between $12,000 to $25,000 for one cycle. Those numbers don't include the cost of medications, many of which aren't covered by Tricare. Out-of-pocket costs for IVF medications vary depending on the protocol being used, but they can range from $2,000 to $10,000 on average. The cost without Tricare coverage is a tremendous barrier for military families who are already struggling with other financial burdens.
My husband and I had to get creative at times, because like many military families, we were also dealing with spouse unemployment, frequent moves with unexpected expenses and other circumstances. My husband and I gave up a second car, vacations, date nights and other unnecessary costs to save every penny we could to pay for fertility treatments. This journey cost us relationships, strained others and made things harder for us emotionally, because we frequently had to say no so we could save. But we would do it all over again, because it got us our miracle baby.
Not everyone is as lucky as we are. I have heard countless stories of military families who are desperate to have a family but can't pay for treatments. They shouldn't have to go into debt or pinch pennies to afford treatment for a condition that impacts our community more than most.
Starting in January 2025, members of Congress and their staff now have access to coverage for diagnostics and treatment of infertility, including IVF, and standard fertility preservation services, which can help couples conceive at a later date. The IVF coverage members of Congress have included three egg retrievals, medications for three cycles and unlimited embryo transfers. In the last year, Congress has had multiple opportunities to extend the same or similar coverage to our community. Instead, lawmakers have failed us.
Insurance coverage for IUI and IVF would have saved us tens of thousands of dollars. Our doctors determined that it was in our best financial interest to first try the least expensive option to give us our miracle. Instead, we were met with heartache and repeated losses. If Tricare expanded coverage, there are so many sacrifices we likely wouldn't have needed to make. We would have still had two cars and maybe that would have made it a little easier for me to find employment. Maybe we would still have the friendships that our infertility experience ruined. The most important thing we might not have lost is our dream of being a family of four. After nine years, four losses and tens of thousands of dollars spent, we still haven't achieved that dream, and we are still trying to come to terms with that.
Our military families give and sacrifice so much for our country. It is cruel for Congress to deny the same level of coverage for IVF to our community. Our service members serve this great country during their prime reproductive years, they risk their lives, and when they want to build a family, they should have access to the support to do that. Everyone deserves to have the family they dream of with coverage: no service requirements, no strings attached, just access to the treatments for the disease of infertility.
Julie Eshelman is the founder, CEO, and president of the Building Military Families Network, where she took her struggles and lack of support in family building and created an organization to fill that gap for military and veteran families. She uses her infertility and pregnancy loss journey to help others realize that they are not alone and advocate for insurance coverage and care for military and veteran families. Julie believes in breaking the chains of shame and embarrassment that these topics carry and instead empowering others to share their journeys and advocate for the next generation. In 2022, she was named AFI Fort Leavenworth Spouse of the Year for her awareness, advocacy and leadership in infertility and military family building.
Related: Fertility Benefits for Active-Duty Service Members
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