Subsidized fertility treatments

The Health, Labor and Welfare Ministry will introduce an age limit for couples who receive subsidies for fertility treatments. From fiscal 2016, only couples in which the woman is younger than 43 will be eligible for the subsidies.

Since the success rate of infertility treatment goes down while the risks from pregnancy and childbirth increase as a woman ages, the ministry’s decision does seem rational from a medical perspective. But many women may think that the government is forcing them to have a baby at a certain time in their life and thus interfering with their right to make decisions about their own body.

The government must not only prove that this is not the case but also become aware that many women have no other choice than to postpone childbirth because of social and economic reasons. It must take adequate measures to address this problem.

In vitro fertilization and micro-fertilization, in which sperm is implanted into an ovum under a microscope, are not covered by the public health insurance system.

Each round of such treatment costs ¥300,000 to ¥500,000. Currently a couple whose combined annual income is ¥7.5 million or less can be subsidized up to ¥150,000 for each round of infertility treatment received over five years — for up to 10 rounds of treatment. They can undergo up to three rounds of treatment in the first year and up to two rounds annually from the second year.

When the subsidies were introduced in fiscal 2004, some 17,000 people received them. In fiscal 2012, some 135,000 people received them, as the budget for the subsidies reached some ¥20 billion for the central and local governments. In more than 30 percent of the cases, the woman was at least 40 years old.

Under the new policy, a couple can receive subsidies for up to six rounds of treatment if the woman is 39 years old or younger and up to three rounds of treatment if the woman is 40 to 42 years old. A couple can undergo the treatment at any time they choose. Thus a couple can receive multiple rounds of treatment in a short time.

The new policy is based on findings by a ministry research panel. If women are younger than 33, about 20 percent of them become pregnant after one round of treatment. But the rate goes down with advancing age — 7.7 percent for 40-year-old women and 1.3 percent for 44-year-old women.

Many women will view the new policy as pressure on them to have a baby at a young age. There are many cases in which women have become better off financially over the years, but face the problem of infertility when they want to have a baby.

The government at the same time must push social policy to create a society that makes it easier for women to have and rear a child. It also must make sure that medical institutions that give infertility treatment meet a high medical standard.