Original Article Self-Reported Infertility Among Male and Female Veterans Serving During Operation Enduring Freedom/Operation Iraqi Freedom Jodie Katon, PhD, MS, 1,2,3 Yasmin Cypel, PhD, MS, 4 Mubashra Raza, MD, MPH, 4 Laurie Zephyrin, MD, MPH, MBA, FACOG, 1,5 Gayle Reiber, PhD, MPH, 2,3,6 Elizabeth M Yano, PhD, MSPH, 7,8 Shannon Barth, MPH, 4 and Aaron Schneiderman, PhD 4 Abstract Background: Infertility is associated with psychosocial distress and is a growing public health concern. Our objective was to report the prevalence of lifetime history of infertility among men and women Veterans. Methods: We used data from the U.S. Department of Veterans Affairs National Health Study for a New Generation of U.S. Veterans, a nationally representative survey of Veterans serving during Operation Enduring Freedom/ Operation Iraqi Freedom (OEF/OIF). The primary dependent variables were self-reported lifetime history of infertility among Veterans and their partners, defined as trying unsuccessfully to become pregnant for at least 12 months, and seeking medical help for infertility. Multiple logistic regression was used to determine whether gender was associated with lifetime history of infertility or seeking medical help for infertility, after adjusting for sociodemographic and military characteristics. All analyses were weighted to account for the complex survey design and nonresponse. Results: Among the 20,370 Veterans (16,056 men; 4,314 women) in our final analytic sample, the prevalence of lifetime history of infertility was 15.8% for women and 13.8% for men. After adjusting for age, ever married, education, race/ethnicity, component, branch of service, and deployment to OEF/OIF, compared with men, women Veterans had similar odds of lifetime history of infertility (odds ratio [OR] 1.07; 95% confidence interval [CI] 0.94, 1.20), but increased odds of seeking medical help for infertility (OR 1.35; 95% CI 1.06, 1.72). Conclusions: Women Veterans are more likely than their male counterparts to seek care for infertility, and given their increasing numbers, the demand for infertility evaluation and care within Veteran’s Affairs may increase. Introduction I nfertility is associated with reduced quality of life and psychosocial distress and can be a major source of stress for both partners in a relationship. 1–4 Infertility may also be a cause or indicator of chronic disease including malignancies, cardiovascular disease, and type 2 diabetes. 5–8 There is in- creasing recognition that infertility is a public health concern. 9 While some still perceive infertility as a quality of life issue the American Society for Reproductive Medicine now defines infertility as a disease. 10 In 1998, the United States (U.S.) Su- preme Court issued an opinion confirming that reproduction is a major life activity and that conditions interfering with reproduction should be regarded as disabilities in accordance with the Americans with Disabilities Act. 11 The prevalence of infertility among couples in the United States ranges from 8% to 20% depending on the definition of infertility, the study population, and study design. 12,13 Socioeconomic and racial 1 Office of Women’s Health Services, Department Veteran’s Affairs (VA) Central Office, Washington, DC. 2 Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington. Departments of 3 Health Services and 6 Epidemiology, University of Washington School of Public Health, Seattle, Washington. 4 Post Deployment Health Strategic Healthcare Group, VA Office of Public Health, Washington, DC. 5 New York Harbor VA Healthcare System, New York, New York. 7 Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California. 8 Jonathan and Karin Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, Los Angeles, California. JOURNAL OF WOMEN’S HEALTH Volume 00, Number 0, 2013 ª Mary Ann Liebert, Inc. DOI: 10.1089/jwh.2013.4468 1