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1 [1] (May 21, 2026)

handle is hein.crs/govetzb0001 and id is 1 raw text is: a Congressional Research Servic~ informing the legislative debate s~nce 1914 Updated May 21, 2026 Infertility in the Military Over the past two decades, Congress has considered various legislative actions concerning the provision of infertility services and reproductive care for servicemembers and their families. The Department of Defense (DOD), which is using a secondary Department of War designation under Executive Order 14347 dated September 5, 2025, administers a statutory health entitlement (under Title 10, Chapter 55, of the U.S. Code) through the Military Health System (MHS). The MHS offers health care benefits and services through its TRICARE program, which could be a vehicle for providing reproductive services. Federal regulation (32 C.F.R. §199.4(g)(34)) generally prohibits the TRICARE program from paying for certain infertility services for most servicemembers and other TRICARE beneficiaries. Some Members of Congress have offered legislation that would override the regulation, arguing that expanding TRICARE coverage to include fertility services would reduce sacrifices of military service and benefit our troops. Background The U.S. Centers for Disease Control and Prevention (CDC), defines infertility as not being able to get pregnant (conceive) after 1 year (or longer) of unprotected sex. Among females, certain conditions affecting the ovaries, fallopian tubes, or uterus can result in infertility. Among males, hormonal disorders or disruptions to testicular function can cause infertility. Infertility risk factors for all persons can include increased age; smoking; excessive alcohol or drug use; excessive weight gain or loss; excessive physical or emotional stress; physical trauma or heat exposure to the testes; and exposure to testosterone, radiation, some medications, or certain environmental toxins. In 2024, CDC estimated that between 2015 and 2019, 8.5% of married women between age 15 to 49 had infertility and 11.4% of men of the same age range had some type of infertility. In 2024, DOD estimated that between 2013 and 2021, the overall rate of new and preexisting infertility diagnoses (i.e., prevalence rate) among active duty servicemembers was 1.54%. Males accounted for 1.05% of total prevalence and females accounted for 0.49%. In 2025, DOD reported that between 2019 and 2023, the overall rate for new infertility diagnoses (i.e., incidence rate) among active duty females of childbearing potential (ages 17-49) was 77.5 per 10,000 person-years. During this time period, the annual incidence rate decreased from 89.2 per 10,000 in 2019 to 69.5 per 10,000 in 2023 (see Figure 1). Incident infertility rates were highest among servicewomen in certain demographics or military characteristics. These included those who were aged 35-39, were Black non- Hispanic, served in the Army, served in senior officer ranks (0-4 to 0-10, W-4 to W-5), and worked in health care or aviation occupations. The 2025 report did not examine specific infertility rates or common demographics among male servicemembers. Figure l. Annual incidence rates of female infertility diagnoses by type, active component servicewomen of childbearing potential, 2019-2023 Figure is interactive in HTML report version. 120 Incidence rate per 10,000 person-years Any origin - Unspecified origin Other specified origin 40 -Anovulation Tubal origin a Uterine origin 2019 2020 2021 2022 2023 Source: CRS graphic based on Defense Health Agency (DHA) Armed Forces Health Surveillance Branch, Infertility Among Active Component Service Women, U.S. Armed Forces, 2019-2023, Medical Surveillance Monthly Report, vol. 32, no. 5 (May 2025), p. 22. Notes: Person-year is a measure of time a defined population is at risk for infertility. n rt -t Treatment Infertility treatment can include timed intercourse, medications, intrauterine insemination, surgery, or assisted reproductive technology (ART). TRICARE covers medically necessary ... diagnostic and treatment services for male and female infertility, including * correction of physical cause of infertility; * treatment of erectile dysfunction if it has a physical cause; and * diagnostic services (e.g., semen analysis, hormone evaluation, chromosomal studies, immunologic studies, imaging studies, special and sperm function tests, or bacteriologic investigation). In general, TRICARE does not cover ART services, such as: * artificial or intrauterine insemination; * costs related to donors or semen banks; * Cryopreservation; * care for erectile dysfunction from psychological causes including depression, anxiety, and stress; or