A federal program to help injured veterans and their spouses conceive children through in vitro fertilization is being hobbled by anti-abortion forces that oppose how the process can lead to embryos being destroyed.
Since 2012, Democrats in Congress have repeatedly championed legislation permanently extending IVF benefits to veterans whose injuries in the line of duty have left them unable to conceive children otherwise.
But those bills have fizzled in the face of opposition from Catholic bishops and others in favor of a temporary program that must be reauthorized every year, complicating efforts by eligible veterans to begin or extend their families. The benefit is further limited to exclude veterans who are not married, straight, able to produce their own sperm and eggs and, if they're female, able to carry the baby in their own uterus.
Those limitations have been a problem for couples like Jacob and Ashley Lyerla, who needed to use donor sperm and eggs to create viable embryos after three heart-wrenching rounds of IVF using their own genetic material failed. The Milroy, Indiana, couple has spent about $35,000 out of pocket to continue the expensive procedure with donor material, despite Jake being rendered a paraplegic at 19 by an IED blast in Afghanistan.
Ashley Lyerla, not a veteran herself, said IVF gives them and other couples trying to conceive the ability to bond with their babies as soon as physically possible, unlike alternatives such as adoption and surrogacy.
"By using donor embryos, you have all those memories, you have all those firsts," she said. "You're not having to make yet more sacrifices, more compromises."
Fertility treatments using IVF involve combining extracted eggs and sperm in a lab. The process involves producing multiple embryos and transferring them all into the woman's womb, in hopes one would implant and cause a pregnancy. Today, many embryos are usually frozen, as couples opt to transfer the most viable one at a time to avoid multiple births. Unused embryos may be stored indefinitely, donated to science or destroyed — a prospect opponents see as tantamount to abortion and a key sticking point in their opposition to this military program.
Restrictions imposed on the program closely mirror views the nation's most influential anti-abortion groups have espoused for years. Many of those views focus on life starting at conception, including these embryos, and the groups want to make sure they're never destroyed.
Focus on the Family, a group promoting Christian values, supports keeping IVF "within marriage," which it understands as a legal male-female union. The U.S. Conference of Catholic Bishops teaches that God desires "a loving, sexual union" when creating children, which precludes using donor eggs or sperm or creating embryos in a lab. Students for Life, like dozens of other anti-abortion groups, opposes IVF because of the excess fertilized embryos created. The bishops' group did not return messages seeking comment.
Brittany Raymer, an analyst with Focus on the Family, said the organization is hesitant to support legislation extending and making permanent the benefit, despite having "immense compassion for those military couples who are struggling to conceive due to an injury received while serving our country."
"We have numerous ethical and moral concerns relative to both IVF and surrogacy," she said in an emailed statement, including using taxpayer dollars to create embryos that might be left in a state of limbo or destroyed. The VA said it was working to provide The Associated Press with information on how much the IVF benefit costs taxpayers.
Heather Ansley, head of government relations and advocacy for Paralyzed Veterans of America, is among backers of the permanent benefit for veterans and their families.
"We have a responsibility as a society to make them whole and, certainly, for many people, being a parent is part of that," she said.
In Crystal Wilson's opinion, limiting access to a permanent IVF benefit harms the families of disabled veterans who are trying to have babies. Wilson has conceived two IVF babies through the VA benefit with her husband, Tyler, who was paralyzed from the waist down when struck by a bullet in Afghanistan in 2005.
The Wilsons' difficult journey to parenthood — they have a 2-year-old son, and a baby on the way — has led them to champion federal legislation expanding and making permanent the IVF benefit on behalf of other military families.
"IVF is pro-life, because we're all looking to build a family and bring children into this world, and then build them into amazing, incredible citizens of the world," Wilson said.
A total of 1,549 U.S. service members sustained groin-area injuries, 599 categorized as severe, from 2001 to 2018, according to figures from the Department of Defense Trauma Registry.
Those high numbers were a factor as Congress voted to authorize IVF coverage for veterans in September 2016 for the first time, extending a benefit already available to active-duty service members. The vote lifted, at least temporarily, an earlier ban on IVF benefits for veterans secured by anti-abortion lawmakers in 1992.
U.S. Rep. Andy Harris, a Maryland Republican, physician and abortion opponent, advanced what he viewed as a compromise in 2016, calling for all the fertilized embryos created under the VA IVF benefit to be stored indefinitely, erasing any "ethical dilemma" for veterans over destroying them.
The proposal ultimately failed, in part due to concerns its language might have prevented use of frozen embryos for conception and its potential to put decisions about their fate in the hands of the government — even years after the death of those who created them.
VA spokesman Terrence Hayes said the government is not tracking how many babies have been successfully conceived or born through the program. What is known is that fertility needs are high among recent military veterans, with rates nearly twice as high as the civilian population, according to a 2013 study by the Department of Veterans Affairs. It found nearly 14 percent of men and almost 16 percent of women who served in Iraq and Afghanistan reported infertility.
The National Health Study for a New Generation of U.S. Veterans found female veterans were more likely to seek care for infertility than their male counterparts. The VA says 567 eligible military families have received the IVF benefit since it was first authorized in 2016.
Organizations that work with wounded veterans say dozens, if not hundreds, more could be helped through a more robust, permanent program.
The Bob Woodruff Foundation has provided 32 grants totaling $150,000 to veterans ineligible for the government benefit. That can include same-sex married couples, single female veterans and those with catastrophic injuries that destroyed their reproductive organs.
"We thought that once the VA picked that up, we could happily go out of business on that front," said Margaret Harrell, the foundation's program director. "As it turns out, we've not been able to do so because, although it is fabulous that the VA is currently providing IVF services, they have limited eligibility rules."