I Returned From Service Overseas With A Health Problem I Never Anticipated

After multiple tours in Iraq, I returned home with a hidden health battle that would take years to reveal itself

I Returned From Service Overseas With A Health Problem I Never Anticipated

Justin Smith

Image by Justin Smith x mbg creative

August 24, 2024

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My life unfolded just as I expected—high school graduation, college, the birth of my first son, and then enlisting in the U.S. Army.  

But after multiple tours in Iraq, I returned home with a hidden health battle that would take years to reveal itself. It's a concern that rarely gets the attention it deserves when we talk about veterans' health. 

The first sign something was off 

When I got married in 2011, my then-wife and I knew we wanted to have children together. Like any newlyweds, we started trying, understanding that it might not happen right away—it often takes time and effort. But for us, that effort stretched into six long years without success

Almost immediately, we assumed the issue was tied to her fertility—after all, that’s what everyone told us. She was in her 30s, and doctors labeled her as an "older" mother, attributing much of our struggle to that. 

So, we dove into various treatments. She endured countless tests, took a slew of medications to spark a pregnancy, and we even went through several rounds of intrauterine insemination (IUI), all with no success. 

Throughout this process, we leaned on military health care wherever we could—fertility treatments are more expensive than you'd think. But the program didn’t cover everything, and the out-of-pocket costs began to weigh heavily on us. 

Finally, the spotlight was put on me 

After six rounds of IUI, we were finally admitted to the military IVF program—our last hope to change our course. 

One step in this new program was unlike the rest: the doctors finally suggested looking at my sperm—something that, in hindsight, seemed like an afterthought compared to their initial focus on my wife’s fertility. When my sperm was tested, they discovered the real issue: my sperm was compromised, and not just in one way. 

I had low sperm count, low motility, and poor morphology. In simple terms, the structure of my sperm, the quantity, and its ability to move through the reproductive system were all off—and here we were, thinking the problem was solely my wife’s. 

When I got the news, I couldn’t shake the feeling that my time in the military may have played a part. How could I spend years exposed to toxic chemicals, endure severe psychological stress, indulge in more drinking and smoking than I should, and come out unscathed? 

I asked my doctor for confirmation, and my fertility physician agreed—this was most likely the cause. In fact, research shows that chemical exposure1, psychological stress2, smoking3, and increased alcohol consumption4 all decrease the quality or count of sperm—with that considered, it’s no wonder my sperm tests came back so poor.  

He also revealed that I wasn’t alone; this issue is incredibly common among veterans, but it's something that rarely gets discussed. 

The failure we couldn’t bear  

Our first task was to select an embryo, but the military IVF clinic didn’t have the resources to test which embryos were most viable, so we were essentially shooting in the dark. 

While I was taking medication and making significant dietary changes to boost my sperm, it was hard to know what was working without access to genetic embryo testing. 

This entire process had become a financial burden we were close to being unable to bear. After our third attempt at IVF through the military program—not to mention the six years of failed IUI—we had to pause. Our bodies and budget just couldn’t handle it. 

We decided: It’s time for a break 

As much as we didn’t want to admit it, my wife and I were ready to give up. We were getting older, and as her doctors constantly reminded us, her chances of having children were only decreasing with age. So, we took a break. I focused on school, and my wife focused on her military career. 

During a two-year Army sabbatical, I went to grad school and, by a stroke of fate, ended up interning at a small fertility clinic in San Antonio, Texas. They needed someone familiar with the military health care program, so I fit right in. 

Because of my work there, they offered us the opportunity to pay only the base cost of the IVF process—no profit included. Despite our history of failed attempts, we couldn’t pass up the chance. This time, we also had access to genetic testing. 

By this point, my wife was 39, nearing what some might call the “expiration date” for having children—a term I’ve always hated. But we chose to press on against the odds and, following our doctor’s recommendation, inserted two healthy, genetically normal embryos. In all of our previous attempts, transferring one embryo had failed, so why not try two? 

The best day of them all 

While spending Christmas with my wife’s family in New York City, we got the call: we were pregnant—no questions, no hesitations, no “maybes.” Just pregnant. Finally, all of our hard work had paid off. 

Soon after, we went to the clinic for an ultrasound. "You’re having twins," the physician told us. My first thought—after the joy and excitement—was that I was going to have to pay for two of everything, just like my grandparents had with my father and his twin brother. But it was a cost I was more than willing to bear to have two new lives enter the world.  

After a mostly healthy pregnancy, our twins were born. It felt like a miracle had finally graced our lives. 

Seven months later, another miracle came our way: we were pregnant again—this time without reproductive technologies, and with just one baby. 

People often say that a few rounds of good IVF can “kick-start” your fertility, and for us, that turned out to be true.  

Why I shifted my career to help others  

A few years later, it was time for me to retire from the Army. I knew exactly where I wanted to be: in the fertility industry, helping others the way they had helped me. 

So, I followed my passion and my calling. Now, I spend my days working with Progyny, helping others have children despite the odds. Much of my work focuses on helping employers provide top-notch fertility and family-building care for their staff because I know firsthand what it's like to navigate that challenging journey. 

What I want men to know about fertility  

While I share my story countless times at work, I’ve noticed that the conversations online still revolve around women’s fertility, with little focus on men’s fertility. A third of fertility issues are due to male factor. My hope for the future is to see more people—including physicians—talking openly about the possibility of men’s fertility issues, rather than automatically placing the burden on women. 

From my years in the fertility industry, I’ve learned that it’s never too early to start thinking about your reproductive health. If you’re considering having kids, visit your primary care physician and ask for a referral to a urologist. From there, you can go through sperm collection and testing to see where you stand. 

Most importantly, take care of your body. If I could go back, I wouldn’t drink nearly as much as I did, I’d never pick up smoking, and I’d take stress seriously—understanding its impact on our physical health. 

When it comes to military health care and fertility support, I’ll always be an advocate. Too often, men and women are sent overseas without fully understanding the consequences or receiving the support they need when they return, both mentally and physically. 

Now, I have the privilege of helping others experience the same joy I felt when my wife and I learned we were pregnant, and I’ll tell you firsthand: it never gets old.