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WASHINGTON (AP) — The roadside bomb that exploded outside Andrew Robinson's Humvee in Iraq six years ago broke the Marine staff sergeant's neck and left him without use of his legs. It also cast doubt on his ability to father a child, a gnawing emotional wound for a then-23-year-old who had planned to start a family with his wife of less than two years.

The catastrophic spinal cord injury meant the couple's best hope for children was in vitro fertilization, an expensive and time-consuming medical procedure whose cost isn't covered by the Department of Veterans Affairs. Robinson and his wife were forced to pay out of pocket, with help from a doctor's discount and drugs donated by other patients.

A bill being considered in the Senate would expand the VA's medical benefits package so other veterans, and their spouses or surrogates, don't have to bear the same expense. The department currently covers a range of medical treatment for veterans, including some infertility care, but the legislation specifically authorizes the VA to cover IVF and to pay for procedures now provided for some critically injured active-duty soldiers.

The bill's meant to help wounded veterans start families as they return home from war and to address a harrowing consequence of combat that can radically change a couple's marriage but receives less attention than post-traumatic stress disorder and brain injuries.

"It's common sense: a male veteran cannot have a kid by himself. It doesn't happen. They need obviously to have it with their wife or a partner," said Robinson, of Florence, N.J., who is now 29 and was injured in a 2006 explosion in Al Anbar province. "So for the VA to say, 'Oh, we can only cover this part of it,' it just kind of doesn't make sense."

In vitro fertilization, the process of mixing sperm and eggs in a laboratory dish and transferring the resulting embryo into a woman's uterus, costs thousands of dollars and each cycle can take weeks. It's physically taxing too, requiring hormone injections and other invasive steps, and can take multiple tries to produce a viable pregnancy. For many wounded veterans, it represents the most promising option.

More than 1,830 veterans of the wars in Iraq and Afghanistan have suffered pelvic fractures and genitourinary injuries since 2003 that could affect their abilities to reproduce, according to Pentagon figures provided to Sen. Patty Murray, the bill's sponsor and chairwoman of the Senate Veterans Affairs Committee.

"Because they served our country, they now can't have a family, which is part of their dream," said the Washington state Democrat, who hopes the committee will act on the bill after returning from August recess. "I think we now have a responsibility to not take that dream away."

Combat injuries can dampen a soldier's ability to have children in any number of ways, said Mark Edney, a Maryland urologist and Army reservist who treats veterans. For men, a blast to the genitalia can harm sperm-producing testicles, while a spinal cord injury can cause erectile dysfunction or ejaculatory problems. For women, shrapnel can injure the pelvis and fallopian tubes, preventing fertilization.

Although expertise exists to help them become parents, Edney said veterans with fertility problems form a "relatively small subset of patients that are just forgotten in terms of policy."

The legislation would likely have helped spouses like Brenda Isaacson, who said the VA's insurance plan covered the cost of recovering sperm from her husband, Chuck — an Army staff sergeant paralyzed by a 2007 helicopter crash in Afghanistan — but not the more than half-dozen IVF attempts the couple underwent before finally having a daughter nearly a year and a half ago. She bristled at being told by officials that infertility services were not medically or psychologically necessary.

"You tell that to a man who's just been wounded — that it's not psychologically necessary to have children — when that's all we'd talked about, having babies," she said.

The proposal comes as technological improvements have made IVF a more common — and reliably successful — way to have children, with the number of births as a result of it and similar procedures rising in the past decade. It's more openly discussed in popular culture, too, from television talk shows to celebrity magazines. And the VA is becoming more sensitive to family health concerns as it encounters younger veterans trying to start post-war lives, said Patty Hayes, the agency's chief consultant for women's veterans' health.

"The culture has changed. There's a lot more veterans who need this," she said, adding that the VA was looking closely at expanding infertility treatment options.

The VA says it already covers some fertility services, including counseling, diagnostic tests and intrauterine insemination — a method of artificial insemination — for the veteran. But that leaves out many veterans and their spouses whose best hope for pregnancy is the more physically rigorous, but also more reliable, IVF process, where the average cycle costs $12,400, according to the American Society for Reproductive Medicine.

The process can be especially vexing for military couples coping with life after a catastrophic injury and trying to establish a new normal, said Barbara Cohoon, deputy director of government relations for the National Military Family Association, a nonprofit advocacy group.

"When someone has an injury and they're paralyzed from the waist down, being able to reconnect emotionally and physically as a couple is part of the therapy," she said.

The Defense Department recently made IVF a covered benefit for active-duty service members who are either seriously ill or catastrophically injured, with a policy that allows for coverage of three completed IVF cycles for the soldier's spouse, said spokeswoman Cynthia Smith. She said artificial insemination using donated sperm or eggs is excluded under its policy.

Robinson, the now-29-year-old Marine who suffered the broken neck, said he started exploring ways to have children — something he and his wife had always discussed — during an extensive rehabilitation process.

They tried artificial insemination, which didn't work because of poor sperm quality resulting from his injury. They spent $6,000 of their own money on IVF and got pregnant on the first try — and now have 8-month-old twins Collin and Leah.

"Everyone deserves to have a chance at a family. We were able to save the money and stuff like that. But maybe for someone who isn't able to do that, I would hate to see that they don't have that option," he said.

Tracy Keil used IVF to conceive her twins after her husband, Matt, was shot in the neck in Iraq in 2007 and rendered a quadriplegic, six weeks after they wed. The couple was able to save the thousands of dollars needed for treatment because they live mortgage-free in a custom-made home designed by a nonprofit that builds houses for disabled veterans and their families. She's since become a leading advocate for the legislation, testifying on it this summer before a Senate committee.

"I agree with the fact that they had other hurdles to get over first, especially with PTSD and suicide and traumatic brain injury. They had other things that were just plain more important," Keil said of the VA. "But now we're at the point where those programs are in place and it's time to address this issue."

Follow Eric Tucker on Twitter at http://twitter.com/etuckerAP

Editor's Note: This story is the latest installment in a joint initiative by The Associated Press and Associated Press Media Editors taking a closer look at this latest generation of war veterans as they return to civilian life, and the effect this is having on them, their families and American society.

NASHVILLE, Tenn. (AP) — Faced with tighter budgets after the Iraq War but still in charge of treating tens of thousands of injured troops, the military is getting a hand from a private foundation that is building medical centers specializing in the signature physical and psychological injuries of Iraq and Afghanistan.

The Pentagon has a partnership with the Intrepid Fallen Heroes Fund, which is raising $100 million to build clinics on military bases. The clinics will form a network aimed at treating and researching traumatic brain injury and post-traumatic stress disorder, two areas the military has focused on since roadside bombs became a common weapon in Iraq and Afghanistan.

Army officials say the foundation, which grew out of the philanthropic efforts of the late New York real estate businessman Zachary Fisher, has been highly effective because it can sidestep government bureaucracy on construction projects and provide a financial boost for medical advances that are desperately needed for injured soldiers, Marines, airmen and sailors.

Since 9/11, the charity has built the nation's top specialized hospitals for troops injured in Iraq and Afghanistan: a brain injury center of excellence in Bethesda, Md., and an amputee and burn rehabilitation center in San Antonio, Texas.

"We have felt that buildings often are catalysts for better care and attention," said Marty Edelman, a trustee of the Intrepid Fallen Heroes Fund and a New York-based real estate attorney.

Staff Sgt. Spencer Milo, 27, went to the National Intrepid Center for Excellence in Bethesda to treat persistent symptoms from a concussion he suffered during a suicide bomber blast in southern Afghanistan last year.

"The second you walk into these buildings, you instantly feel calm," he said. "You're in a small group and you really get very, very specific treatment. The first time you get there you sit in a room with every single doctor and you tell them what's going on, so you don't need to repeat yourself. Everyone is consistently on the same page."

At the Intrepid Center, there were no rushed appointments or bouncing from one doctor to the next, Milo said. He also benefited from alternative treatments and therapies that aren't available at other military hospitals, like art therapy, and he was given a service dog to help him in his recovery.

Now the fund is widening its scope beyond the two hospitals with a plan to build between seven and 10 clinics at the nation's largest military installations, with a hub-and-spoke model to channel the latest patient data up to research hubs and push down treatment models to the doctors and therapists.

Clinic groundbreakings have already happened at Fort Belvoir in Virginia and Camp Lejeune in North Carolina and additional clinics will be built at Fort Campbell in Kentucky, Fort Hood and Fort Bliss in Texas, Fort Carson in Colorado, Fort Bragg in North Carolina, and Joint Base Lewis McChord in Washington.

The charity raises the money to build the facilities and once completed, turns over control to the military branches, which are then responsible for staffing and operating the clinics.

"We don't pretend to be doctors," Edelman said. "So we build the best facilities that money can buy and we engage the entire American community to support us."

The foundation has a history of stepping into the gap when the government has been slow to react or respond to the military's neediest families. At the beginning of the wars in Iraq and Afghanistan, the fund provided grants to the families of U.S. service members who were killed until federal legislation substantially increased survivor benefits.

Edelman said the charity doesn't focus on complaints that the military hasn't done enough to adequately treat the signature wounds from Iraq and Afghanistan.

"I can understand people saying, 'How come the government hasn't already done it?'" he said. "... Sometimes it's hard for it to move quickly, but we can. We don't think about as they haven't, we just think about it as we can.

"We are going to help them do it in the time frame and the level of excellence that the American private sector can do," he said.

Col. Nikki Butler, director of the rehabilitation and reintegration division for the office of the Army surgeon general, said the Army is not dependent on the Intrepid Fund but does appreciate the help.

The Army has already been treating soldiers with traumatic brain injury and PTSD at these installations, she said, but the centers will enhance that care with a multidiscipline approach that includes some new types of providers, like acupuncturists to treat chronic pain.

She said the facilities will be very helpful for some of the Army posts that have outgrown existing space, and each new clinic will have staff members tailored to best suit the population at the local installation.

"You want to be able to treat them holistically, in that patient care setting, rather than sending them all over the place," Butler said. "It may require different types of providers, but I think what you get is efficiency and eventually get less demand on the system and better use of the patient's time and the provider's time."

Butler said partnerships with the NFL and public giving campaigns like this one are helping to shed light on concussion care and behavioral health issues.

"Brain injuries are not easy to see and people don't like to talk about the psychological pieces of it. When you have strong partnerships with other big entities, then I think it's much easier to bring it to light in the public venue," she said. "The public is much more aware than they ever were even five, 10 years ago."

Even as the military shrinks in size and overseas obligations, there will continue to be a long-term need to treat these soldiers, Butler said, noting more than 80 percent of all TBI injuries don't occur in a war zone.

The charitable giving comes at a key time for the defense department, which is facing the possibility of severe funding cuts if Congress can't agree on a budget.

Dr. Bret Logan, director of the TBI center at Fort Campbell, Ky., where one of the new clinics will be built later this year, acknowledged that it's a tight financial year for the government, but the military is prioritizing care for the neediest troops.

"What's important is that you don't become a black hole where people are just dumping money into," he said.

Logan said there's always been a constant stream of individuals and groups who want to help these soldiers, but the Intrepid Fund has found a way to streamline public giving.

"It falls to guys like Fisher and the Intrepid Heroes Fund to get the organization together to find these people," he said. "I think everyone is looking for a way, even now, to help. It's a personal thing for people. The easier you make it for people to help, the more they are likely to do so."

Milo, the Army staff sergeant who was treated in Bethesda, said it's refreshing to see a charity step up to help soldiers who are still fighting and dying overseas.

"A lot of times you come back and people want to turn a cold shoulder to you and pretend like it doesn't happen," he said. "It's nice there are people out there like the foundation and others that do care and want to help us when we come back."

Follow Kristin Hall at http://twitter.com/kmhall/