Episode 145: Infertility in the Military: From the Male’s POV

Justin Smith: I was in the U.S. Army for 16 and a half years. I decided to join the Army back in 2003, which, if anybody remembers the height of the Iraq and Afghanistan war, 9/11 had just happened. And so, I joined the Army during that time, as a medic. Immediately, it was a reality shock, as soon as I got to my first assignment, five days later, I was shipped off to Iraq. So, I didn’t really get to experience the regular day-to-day life in a non-combat zone environment. So, my day-to-day was literally learning how to navigate and survive the conflict in Iraq at that point in time. Later in my military career, I was commissioned as a Medical Service Corps officer and from there were bigger roles in health care administration, until I retired at about 16 and a half, almost 17 years in. During my time in the Army, they sent me to grad school. I started an internship at a fertility clinic in San Antonio, Texas. Eventually, I became, from data analyst and business analyst all the way up to regional Chief Operating Officer of the same clinic that changed names and merged with Inception Fertility and Prelude fertility. And then I also have IVF twins from RMA of Texas prior to their change to Aspire Fertility. 

My wife at the time, I am divorced, we had been trying for about seven years to have kids. We were paying out of pocket, and we went through about four IUI cycles, and two IVF cycles that were out of our pocket through the military system. And so, by the time I started my internship, we essentially had come to terms with the fact that we probably just weren’t going to have kids. And I asked my boss at the time, you know, we were talking about it, and he essentially just asked, “Hey, so are you guys thinking about trying again?” He’s like, “If your wife wants to try again, let’s see how much it’s going to actually cost to do it here. And you’re just going to pay what the cost of it is, not the actual sticker price on what we normally charge.” We went through with the cycle. 

Dan Bulger: And that was the round of IVF that worked. 

Justin Smith: You can get coverage for diagnostics from the military, you can get some of the lab work done. However, egg retrieval and embryo transfer are not covered by the military. They do what’s called batching cycles, where they bring in everybody who has been accepted in each of these clinics, only 100 to 150 people per batching cycle. So, if you don’t get accepted into the program, you’re kind of waiting in a holding pattern. You’re coming out of pocket six or seven thousand dollars for this, but what you get with that is you’re not getting any genetic testing or PGT-A. You’re just pretty much a part of the batch. And we’re going to retrieve your eggs and get your embryology work. And then we’re going to turn around, and we’re going to batch all your frozen embryo transfer cycles. 

Dan Bulger: Modern medicine today is more and more about personalized medicine. And this is certainly the case when we talk about fertility treatment at the nation’s best fertility clinics. But that all goes out the window and the system like we just heard about in that system. It’s about the efficiency of the operation, not the efficacy of the treatment. And well, it’s simply not the best way to do things. And all of this can take its toll physically and emotionally. 

Justin Smith: I mean, we did IUI cycles. So, it’s always an up and down roller coaster. And so, you’re managing not only your feelings, but you’re managing your partner’s feelings. And of course, you’re trying to be sensitive to it, because you’re not the one who they’re doing all the poking and prodding with all these needles to. You’re just the one feeling the disappointment you know, if the answer is no.  Again, every single one of these times and at the same time, you’re still trying to figure out is it me? Am I the cause of this? You know, is she the cause of this? There was male factor for infertility on my side. And then she had a lower ovarian reserve at the time.  And so, we were fighting two battles from one side, she had her infertility, I had my infertility, and I didn’t necessarily come to terms with that until we were well into the process. 

Dan Bulger: Active servicemen and women are doing this as a job. It’s a tremendous sacrifice. And it’s something that we should all be very, very grateful for. But it is also a job. And we live in a country where people get their insurance and health care coverage from their job. So yeah, I think the military should add a better benefit for their people, just like I think employers across the country should.  

Justin Smith: I think we’re getting better about it where it’s less taboo. But if you were pregnant, there was no return-to-work policy or you know, maternity care or maternity leave. In the military, it wasn’t generous at all.  Sometimes it was frowned upon that the women were pregnant. Especially during the height of the war. If a woman was pregnant, you couldn’t be in a combat zone, you had to go home. So, the military is all about their numbers. We need enough numbers to show our strength and U.S. combat strength. We just lost somebody to pregnancy? Shame. 

Justin Smith: I was not going to divulge that we did this through IVF, because I still was struggling with that, that we needed assistance, you know, so it took me a while. And finally, as my twins got a little bit older, I understood that this is something that a lot of people go through. And unshared information is useless information. And over the years, the cost has gone down. And you’ve had people like Progyny come in, and kind of reshaped the industry to make care accessible to any regular person nowadays. And I think, as we progress, you’re going to see the costs get lower, but you’re going to see access increase, and employers are starting to realize that it becomes a competitive advantage for them. If they’re able to offer an inclusive benefit that supports family building for their employees. 

Dan Bulger: Justin’s experience with infertility gave him some perspective. So, we asked him as a male partner, someone who was diagnosed with male factor infertility, what would he say to someone who was maybe just now finding themselves in that same position.  

Justin Smith: Even though you’re going through the processes, and some of them may feel embarrassing or overwhelming. Just understand that the more you hold on to that feeling, the more you’re delaying and losing time. You have to understand that you’re not the only one that’s going through this, you know, one in eight couples experience infertility in some shape, form, or fashion. Half of it could be male, half of it could be female, but the sooner you get to the answer, the sooner you’ll get the results you want. So, if you feel like there’s an issue, just tackle it head-on. 

Dan Bulger: Now is a better day to get tested for infertility than tomorrow. And if you can’t do it today then tomorrow is a better day than the next day after that. This is your life. And this is your journey. Just make sure to give yourself the best chance that you can.