Mental Health Implications of Infertility

Did you know Veteran infertility rates (16-18%) are higher than those in the general population (12-14%)? Infertility is defined as the inability to conceive after 12 months of regular sexual intercourse without contraception, or more than 6 months for women over the age of 35. Women Veterans diagnosed with infertility are more likely to have a mental health diagnosis, a history of Military Sexual Trauma (MST), and be an ethnic minority, young, or obese. Several studies document an association between lifetime sexual assault and/or MST and infertility in women. Active mental health symptoms stemming from this trauma can indirectly interfere with conceiving. 

Common causes of infertility include problems with ovulation; advanced maternal age (35 years or older); anatomical abnormalities of the cervix, fallopian tubes and uterus; male factor involvement; and genetic abnormalities. In approximately 10% of couples trying to get pregnant, all of the above factors are normal and there is no easily identifiable cause for infertility. When attempting pregnancy is unsuccessful, it is normal to experience a wide range of feelings.

Infertility can be experienced as a threat to a central life goal, a low-control situation, or an invisible loss leading to emotional reactions such as self-blame, depression, tension between partners, and social isolation. It can also reduce a sense of self-efficacy and trust in one’s own body. Going through infertility treatments are at times stressful, increasing the risks of mental health symptom exacerbation and/or recurrence, if left untreated. Some common diagnoses seen in infertility patients include major depression, anxiety disorders, PTSD, and eating disorders. Therefore, it’s important that care providers ensure mental health conditions are detected, diagnosed, and treated.

The VA offers all Veterans, regardless of service connection, sexual orientation, gender identity and expression, or marital status, infertility benefits as part of the medical benefits package as outlined in Directive 1332. Approval for IVF benefits under Directive 1334 is contingent on specific criteria being met and completion of the application process.  Not only do VA Infertility and IVF benefits cover consultation, evaluation, and treatment, these benefits also cover genetic testing & counseling, up to six Intra-Uterine Inseminations (IUI), and if eligible, up to a lifetime maximum of 6- attempts to achieve 3- completed IVF cycles. 

If you are a Veteran struggling with mental health concerns, the VA has a variety of mental health providers here to help. There is also the Veteran’s Crisis Hotline that provides 24/7 confidential crisis support for Veterans and their loved ones. That number is 1-800-273-8255.  For more information, please contact the Women’s Health Infertility/IVF Care Coordinator at ext. 10924.

For more information about the Madison VA Hospital, visit www.madison.va.gov or www.facebook.com/MadisonVAHospital and subscribe to our newsletters.