Military Fertility in the Era of Egg-Freezing

In December of 2015, Defense Secretary Ash Carter announced that the New Year would bring an end to restrictions on women in the US military serving in combat positions. This move has opened as many as 220,000 jobs previously off limits to female soldiers. The most recent data indicates that 15 percent of active duty service members are now women, and this number is sure to increase by the end of 2016.

As part of an initiative to make military service more appealing to younger people, particularly women, Carter has instituted a pilot program that will cover the cost of freezing reproductive cells. The goal is to provide peace of mind in the event that soldiers are injured (hundreds of veterans suffered injuries to their reproductive organs in Iraq and Afghanistan); they will still be able to have children.

The program is also designed to encourage women to stay in the military during their 20s and 30s. The proposal was mentioned in a speech at the beginning of February, along with other initiatives to make it easier for troops to start families. These initiatives include extending paid maternity leave and subsidized childcare and allowing service members to stay at stations for “family reasons.”

Of the 15 percent of service members that are female, 97 percent are of childbearing age. This is a problem for the military, which wants to retain young troops. Women who reach 10 years of service — which Secretary Carter called their “peak years for starting a family” — have a military retention rate that is 30 percent lower than their male peers. Freezing their eggs, in theory, allows women to remain deployed overseas or otherwise pursue their careers while putting off having children. The image of the military — especially as a career option for young people — remains mutually exclusive with conceptions of a thriving family life. Carter’s program hopes to mitigate that.

Only the most progressive companies offer such services, which have a tendency to be quite expensive. By announcing this program, the Pentagon — one of the largest employers in the US — is placing itself at the forefront of this new issue and joining the likes of Facebook and Apple. These companies have offered to cover the cost of freezing eggs (which can run up to $10,000) as a means of recruiting female candidates, and the Pentagon hopes to do the same.

Although this is an exciting and progressive move for such a large employer, the initiative raises legal and ethical questions that the Department of Defense has failed to address, especially in conjunction with debate surrounding the addition of women to the military draft. Opening the draft to women is not yet a reality, but the top officers in both the Army and the Marine Corps think it should become one. These comments are new to the Defense Department, which had previously agreed that the issue would be researched only after all jobs in the military were open to women. After Ashton Carter’s historic decision in December, this question became relevant again. Even Hillary Clinton seemed open to the idea in a town hall. If women are added to the draft, the military will play an essential role in the fertility of a generation of women facing compulsory military service.

The freezing of reproductive cells has the potential to be a fair solution to this problem, but unfortunately, it does not function equally well for both sexes.

Freezing eggs is a difficult and complicated procedure. Despite the marketing of this program as an “insurance policy” for young women in the military, there isn’t enough research to prove how well it works. Unlike freezing sperm, which has been done regularly for the past thirty years, this procedure is so new that the majority of women who have frozen their eggs haven’t gone back to attempt a pregnancy with them. Consequently, it is hard to tell whether these children will have any genetic or developmental problems. It is also difficult to determine the success rate of pregnancy. Once eggs are frozen, the mother (or surrogate) is eventually impregnated via in vitro fertilization (IVF). This means that egg freezing only works as well as IVF, which is hardly foolproof. IVF has about a 40 percent success rate, and by age 42, that rate drops below 5 percent.

There is also the issue of deciding how the eggs are to be used. If a couple splits up, who keeps the eggs? If a woman is severely cognitively damaged in combat, can her eggs be used without her knowledge? If women are added to the draft, these issues with egg freezing will take on new weight. Egg freezing will shift from a rare reproductive option offered to only the richest professionals to a military expectation, and the inconsistencies of the procedure make that shift empirically irresponsible.

Electing to take this reproductive risk because of perceived life trajectory is one thing, but compelling women to military service (via the draft) and then giving them the “option” to freeze their eggs is another. It raises questions about whether compulsory military service could pressure American women to put their fertility on hold using an invasive and risky procedure. “Options” can quickly turn into expectations when they are presented by an institution as powerful — and one in which group mentality plays such a major role — as the US military.

Men who serve in the military also risk their chances of having a family, but many of them are not on the same timeline as female soldiers. Male veterans who leave the military in their mid-to-late 30s still have plenty of time to have kids. Female veterans face a different battle. The freezing of reproductive cells has the potential to be a fair solution to this problem, but unfortunately, it does not function equally well for both sexes.

If the military were interested in retaining young female soldiers, there are alternative policy changes that could turn it into a more attractive employer. The issue of military rape, for example, has met constant scrutiny over the past few years, but an effective policy has yet to be introduced. Rapists are still being tried in military tribunals accused of bias and victims are often outcasts in their tight-knit communities. According to a Department of Defense survey, three out of every four service members do not trust the military tribunal system enough to report their assaults. According to the same survey, one in seven military sexual assault survivors reported that their assailant was someone in their chain of command. Just last year, Senator Kirsten Gillibrand’s (D-NY) proposed military sexual assault reform fell short of the 60 votes needed to pass in the senate. For the second year in a row, Gillibrand’s bipartisan amendment — which would have removed sexual assault cases from the military chain of command and established a separate justice system to handle those crimes — did not pass.

Then there’s the issue of contraception — a much more effective way than egg freezing for women to control their fertility. Rates of unintended pregnancy in the military are 50 percent higher than those of women in the general population. Tricare — the military health care plan for more than nine million active and retired members of the military — covers most contraceptive methods approved by the FDA, but all of these methods are not available at every hospital and clinic worldwide. For example, a woman stationed in Afghanistan may have difficulty receiving her brand of birth control and may therefore experience gaps in her contraception. On US military bases, general contraceptive use ranges from 50 to 88 percent. Upon deployment, utilization rates drop to between 39 and 77 percent.

Further, due to strict federal rules, Tricare does not generally cover abortions. It is available at military facilities but only covered by military healthcare if a woman’s life is in danger or if the pregnancy is the result of incest or rape. Women who need an abortion in other circumstances must use nonmilitary healthcare providers and pay for the procedure out of pocket—something very few soldiers can afford to do. The intermittent access to contraception makes abortion services particularly necessary, especially since these options are often not even available to female soldiers deployed overseas.  Some advocates have argued that even something as small as pre-deployment counseling that specifically addresses women’s contraceptive needs could help counter confusion and ensure that women have access to the birth control methods they need.

The Pentagon estimates that an egg-freezing program would cost $150 million over five years. Why not direct some of this money toward offering reproductive options that have been proven to work? Why not start offering pre-deployment contraceptive counseling so women can choose when to have a child? These changes could arguably be deemed progressive, but from a purely capitalistic standpoint, they save the military a great deal of money and labor. The military may be able to achieve its goals of higher troop retention if they make these simple changes. If women are added to the draft, they could be compelled by an institution that strips them of their reproductive freedoms — an institution that will instead offer them an “insurance policy” that has not yet proven to be effective. What does that mean for the future of women’s reproductive rights in this country?