The Military Health System offers service members and their families contraceptive care services—including access to all forms of medical and surgical contraception—for men and women.
Taking care of the male and female reproductive systems is "vitally important for overall health during all life stages," said U.S. Army Lt. Col. (Dr.) Matthew Banti, a urologic oncologist at Tripler Army Medical Center, in Honolulu.
"However, in the military, we often put the mission ahead of ourselves," said U.S. Air Force Lt. Col. (Dr.) Meghan Ozcan, a reproductive endocrinology and infertility specialist at 88th Medical Group - Wright-Patterson Air Force Base, in Ohio.
And "part of building resiliency and a strong force is ensuring we meet out personal goals," she said.
MHS reproductive health care services include preventative care, gynecologic treatment, and urologic treatment, said Ozcan.
The services "can help people planning to conceive start out their fertility journey with a healthy foundation," she said.
Women can also get a range of services, from birth control pills, IUDs, hormonal shots, and slow-release hormonal rods, which go under the skin, and permanent surgical sterilization (this is available for men, too).
And TRICARE patients who are referred to civilian providers will no longer have to pay cost-shares or copayments for any TRICARE-covered reversible medical contraceptives, she added.
The MHS provides diagnostic evaluation for infertility in men and women, said Ozcan. It also undertakes procedures to terminate a pregnancy in cases of rape, incest, or when the pregnancy is an eminent threat to the mother’s life, she added.
Military hospitals and clinics can also offer vasectomy as a surgical option for male beneficiaries who wish to avoid pregnancy with their partner, said Banti. Urology providers can reverse prior vasectomies as well as extract sperm from the testicles to be used for advanced reproductive techniques, he added.
"Vasectomy is a safe, highly effective surgical form of permanent male contraception that is performed in an office environment with minimal recovery time required," explained Banti.
Likewise, MHS fertility treatment providers can provide surgical correction, if appropriate, such as for blockages, said the experts. They can also correct hormone imbalances and provide medications to manage diseases and to improve ovulation, they said.
"Nothing is more personal than building a family," said Ozcan. "That family can look different for everyone but making deliberate choices about reproductive health can help us reach those long-term goals."
Yet, "many service members aim to work in competitive occupations or attend military schools, and family planning may have to be adjusted to achieve these career goals," said Banti.
Preconception counseling is available to all service members and their dependents, said Ozcan. Service members experiencing setbacks during their fertility journey, with lack of conception after one year of regular intercourse, should first see their general gynecologist or urologist to be evaluated for infertility, recommended Ozcan. Both specialists can provide some treatment for infertility.
However, "specialty fertility care, such as IVF and intrauterine insemination, is limited to larger military hospitals and clinics," she said. "At Wright-Patterson, we partner with a civilian center in the Ohio area to provide comparable prices even though our local MHS facility does not have an embryology lab."
Given the cost of treatment for infertility in the civilian sector, these six MHS facilities provide IVF services at a reduced cost:
Education is Key
It's important "service members educate themselves about how environmental exposures, sexually transmitted diseases, and other health problems—such as cardiovascular disease and depression—can negatively impact the reproductive system and hormonal functions in men and women," he added.
This knowledge can allow you to make deliberate decisions about your health that can help you proactively plan for the life and career you want to successfully achieve your goals.
As such, "understanding the breadth of birth control options available for MHS beneficiaries allows service members to select the right method for their own family planning," said Banti.
Maximizing Your Health
MHS health care services allow MHS beneficiaries, particularly those in active-duty service, to maximize their operational readiness and performance by proactively taking control of their health.
Ozcan explained that for women, this can include:
- Deciding to use reliable contraceptives to prevent pregnancy.
- Taking care of your body through regular check-ups, immunizations, and screening tests.
- Optimizing your health, nutrition, and stress level prior to getting pregnant.
- Planning pregnancy when you're likely to have a high chance of success. (Fertility drops slowly in a woman's 30s with a sharper decline after 37 and a sharp drop off at 40.)
- Considering permanent contraception options like a tubal ligation or removal if you're certain you don't desire any further children, or long-term reversible contraception like IUDs or implants if you're not planning to have children and desire menstrual control.
For men, it can include:
- Utilizing condoms as a matter of fact to avoid sexually transmitted infections and pregnancy.
- Supporting a partner in decisions regarding hormonal and non-hormonal contraception.
- Considering a vasectomy if you're certain you don't desire any further children.
- Planning pregnancies prior to age 45, when male fertility rates drop and complications go up.
"Serving in the military is physically and mentally rigorous and service members should prioritize their medical readiness by avoiding sexually transmitted diseases and exposures that can degrade their reproductive health," said Banti. "Using reproductive health care can aid service members in balancing their professional and personal aspirations."
For more information, contact your health care provider.