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Changes to reproductive health

DOD amends assisted reproductive services policy for severely ill and injured active duty service members

Navy Lt. Cmdr. Megan King, a certified nurse-midwife, uses a tape measure to determine fetal height on a maternity patient at Naval Hospital Jacksonville, Fla., Sept. 18, 2023. Photo credit: U.S. Navy photo

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The Defense Department has amended its policy covering assisted reproductive technology services to expand access for severely ill and injured active duty service members.

Under the amended policy, active duty service members with a qualifying illness or injury may now access this extended benefit regardless of their marital status, and they may now use donor gametes (sperm, egg, or both) and embryos, when procured at their own expense.  

Kimberly Lahm, a program director in Office of the Deputy Assistant Secretary of Defense for Health Affairs for Health Services Policy and Oversight, said the changes to the policy reflect the department's commitment toward ensuring equity of access to reproductive health care for those who serve. 

"We continue identify ways to lean forward as much as we can in support of equity of access to reproductive health care for our service members," Lahm said.  

In general, the department is not authorized to provide these services, and they are excluded from TRICARE coverage, except in the provision of these services for severely ill and injured active duty service members.  

Under the amended policy, qualifying active-duty service members are no longer required to be married to access assisted reproductive technology services, allowing qualifying service members who are single or in unmarried partnerships utilize the benefit.  

The amended policy also allows for coverage of assisted reproductive technology services for a qualifying active duty service members' spouse, unmarried partner, or third party surrogate, so long as these parties are enrolled in TRICARE. While the amended policy no longer prohibits the use of a surrogate, paid surrogacy arrangements continued to be excluded.  

Another key change to this policy is the removal of the ban on the use of donor gametes (egg, sperm, or both). Therefore, qualifying service members may now use donated eggs, sperm or donor embryos when procured at the service member's expense.  

Lahm said the adjustments to the existing policy are specifically targeted to help more qualifying active-duty service members who have suffered severe injury or illness realize their family planning goals, in accordance with DOD authority to provide this benefit.  

Since taking office, Secretary of Defense Lloyd J. Austin III has prioritized efforts to strengthen support for DOD personnel and family members under his "Taking Care of Our Service Members and Families" campaign.? 

Those efforts include key initiatives to improve the lives of service members and their families through access to quality and affordable child care and easing the burden of relocation for military families, among other things. ?   

Lahm said women's health policy and access to reproductive care are important areas of focus, within the broader initiative to take care of military families. 

That includes Austin's October 2022 directive ensuring access to reproductive health care and expanding contraceptive access through walk-in contraception services at all major military medical treatment facilities, among other initiatives.  

Lahm said ensuring access to reproductive health care gives service members the resources needed to support their family planning goals and is important to overall quality of life.  

"We're doing what we can to support our service members in making the reproductive health decisions that align with their family planning goals," Lahm said. "That is just one example of how we're supporting Secretary Austin's 'taking care of our people' initiative."

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