Before her son was born, Amber Bohlman went to three fertility clinics, took hormones for five years, traveled out of state to meet with specialists and tried a variety of treatments.
"It got to the point where my hair was starting to fall out," Bohlman, a Marine Corps veteran, said about the hormones' effects. "It was just really hard on my body, continuing to do this."
But Bohlman and her long-term partner, Peter Folsom, were limited in the kinds of fertility treatments they could try. The VA wouldn't pay for the treatment that doctors kept recommending.
"Every step of the way, my doctors were like, 'We suggest IVF. You should be doing IVF.' I was like, 'OK, but that's not covered.'"
For decades, the Department of Veterans Affairs did not cover in vitro fertilization for unmarried, single and LGBTQ veterans.
Bohlman and Folsom crunched the numbers and estimated that IVF would cost them more than $20,000 out of pocket. It's a complicated and lengthy protocol with no guarantee. Bohlman decided to stick with hormone therapy, despite the toll it was taking on her body.
That’s when she got a surprise.
"We got the hormones in the mail," Bohlman said. "I took a month off because obviously those hormones were horrific and I really just needed a month to not be on them. And that's when we got pregnant."
Her son is now 2 months old.
In March, the VA reversed its rule so that more veterans can access IVF, including those who aren't legally married. But Bohlman and Folsom have another obstacle. The VA will only pay for IVF if a veteran's fertility problems are from a service-related injury.
In Bohlman's case, doctors can't determine the cause.
"Unexplained infertility," Bohlman said, quoting her doctors. "They could not tell me why I wasn't getting pregnant or what was wrong. They couldn’t pinpoint anything."
The National Organization for Women in New York City has sued the VA in federal court to remove the restrictions.
"Almost all of the members of NOW NYC [that we represent] are harmed by the service connection piece," said Grace Sullivan of the Reproductive Rights and Justice Project at Yale University Law School, which represents NOW NYC.
"Some members were previously excluded, because they were in a same-sex relationship or unmarried. And now they're still excluded because, even though those barriers have been removed, they still can't prove they have a service-connected disability."
Sullivan called the service connection requirement "insurmountable." In court documents, NOW NYC alleges infertility can be caused by post-traumatic stress disorder, toxic exposure and other factors.
"Fifteen percent or more of infertility is unexplainable," Sullivan said. "And not to mention the fact that infertility is caused by things that are certainly related to service, like age — when you're able to start having a family after getting out after many years of service — but that's not necessarily going to be something that a doctor will call 'service connected' for infertility."
A 2018 survey by the Service Women's Action Network found female service members grappled with infertility at more than four times the national average, but the research is scarce on why.
Bohlman said she's grateful she was able to access a host of fertility treatments through the VA even though IVF was not an option.
"I'm really happy that they removed that marriage requirement," Bohlman said. "Because it did feel like if for some reason we did find a loophole to qualify for IVF, that we were going to be forced to get married if we wanted to use it."
For now, Bohlman said she’d like to get pregnant again within the next two years. By that time, she'll be 38 and hopes they'll be a family of four.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans.
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