Military women are 3 times more likely to suffer infertility than civilians, but the Pentagon is forcing nearly all of them to pay for their own treatment

• An advocacy group for female troops and veterans reported in early December that over 30% of women serving or who have served in the armed forces suffer from infertility arising from their service.
• In a survey of nearly 800 women, many respondents say their infertility is linked to known causes of reproductive harm, but the military and veteran health care systems are not providing access to a full range of infertility treatment.
• A Defense Department spokeswoman said the military provides full access to fertility services for military members, and an official report states that in vitro fertilization is provided for service-related infertility.
• TRICARE, the military's health care provider, does not cover in vitro fertilization, forcing troops to pay thousands of dollars out-of-pocket — even when that condition arose from their service.
• Advocates argue that these services should be provided at no cost to the service members when infertility is service-related.

An Army retiree says she was just 21 years old when exposure to a chemical used to strip paint from aircraft parts caused her to become infertile.

Hers is just one of the stories compiled in an alarming report by the Service Women's Action Network (SWAN), an advocacy group for service women and women veterans, that details military women's access to reproductive health care.

Based on a survey of nearly 800 active-duty, reserve, retired, and veteran women, SWAN found that over 30% of women who currently serve or who have served in the armed forces reported infertility. According to the Centers for Disease Control, only 12% of civilian women experience difficulty getting or staying pregnant. It's this disparity that activists found most alarming.

"This data clearly cries out for more research to pinpoint the high levels of infertility," the report says.

Jessica Maxwell, a spokeswoman for the Department of Defense, said the military does collect data about infertility. A September 2013 issue of a monthly medical report showed that over 16,800 service women were diagnosed with infertility during a 13-year surveillance period.

That amounts to fewer than 1% of active-duty women who served during that time, a striking disparity with the findings of the SWAN report, which collected self-reported data. The military's numbers, now over five years old, represented women who "were hospitalized during the surveillance period" and whose hospitalization record showed a particular code for infertility, according to the report reviewed by Business Insider.

In an emailed statement to Business Insider, Maxwell said that military service members who can not conceive within "acceptable clinical guidelines are given full access maternal fetal medicine and advanced fertility services."

The military's report also states that its health care system "does not provide non-coital reproductive therapies ... except for service members who lost their natural reproductive abilities due to illnesses or injuries related to active service."

Many of the women who responded to its survey told SWAN that their infertility is service-connected. One respondent, a retired Army officer who was formerly enlisted, said that her military occupation exposed her to methyl ethyl ketone (MEK), an organic solvent used to strip paint and clean parts. A report compiled by the World Health Organization lists reproductive harm as a possible long-term side effect of MEK exposure.

Another respondent said she was exposed to harmful toxins as a fuel handler; the Centers for Disease Control lists jet fuel as a potential cause of reproductive harm. A third woman said she was exposed to air pollution caused by burn pits; while conclusive data have not yet been compiled, some studies have linked poor air quality to decreased fertility. 

Despite the science linking these hazards to infertility, many women say that military and veteran health care systems are not providing access to treatment. SWAN reports that only five military facilities provide a full range of treatment, and many survey respondents say they had to pay out-of-pocket, sometimes up to $30,000, for care.

Despite the military's insistence that it provides treatment when infertility is related to active service, TRICARE, the military's health care provider, does not cover in vitro fertilization.

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