When Maiko Okada visited a fertility clinic in Tokyo for the first time five years ago, she was totally unprepared for the roller-coaster ride of emotions she would subsequently experience.

“I visited the clinic casually to see if I had any problems getting pregnant,” Okada, 42, recalls during an interview at a Tokyo cafe recently. “However, the doctor told me that I didn’t have any time to waste, and so I was shunted along a ‘production line’ of fertility treatment without sufficiently consulting my husband or thinking hard enough about how far we wanted to go.”

Okada was to discover first-hand that fertility treatment takes a huge physical, psychological and financial toll on couples.

A 2011 survey by the National Institute of Population and Social Security Research shows infertility afflicts 1 in 6 couples nationwide. Yet experts say the stigma surrounding fertility treatment remains strong, with the public generally viewing the process as something that is either embarrassing or unethical.

Okada, who lives in Saitama Prefecture, says she first attempted the calendar rhythm method on the advice of her doctor for about a year.

When that failed to work, she started an artificial insemination program for another 12 months before eventually moving on to an in vitro fertilization program for 1½ years.

Her medical bills totalled around ¥4 million, including the “alternative” options such as herbal medicine and acupuncture that she tried on her own. And as the therapy dragged on, the emotional pain began to take its toll.

“I saw my friends conceive naturally without having to visit a clinic or spend the same amount of money that I was spending and felt extremely jealous,” says Okada, who is now the mother of a 2½-year-old boy. “I imagined how other people were spending the same amount of money — raising children, buying homes or going traveling — and I hated myself for feeling that way.”

Some women become so distressed that they are duped into buying food products and other goods claiming to boost their ability to conceive, says Atsuko Kawamura, a mother of two who underwent fertility therapy herself for years.

Kawamura, who runs an acupuncture and moxibustion clinic for women with fertility issues in Tokyo’s Suginami Ward, says women who go through therapy face so many obstacles, with every step along the way presenting new emotional challenges.

“A woman’s eggs might have problems fertilizing or retrieving egg cells from her ovary might prove difficult,” she says. “A woman might have empty egg cells or her eggs might not have matured in the first place. … As I became obsessed with my therapy, I found myself unable to keep my eyes off pregnant women and babies on the streets. I also felt as if I couldn’t share my problems with anyone — not even my husband.”

The situation is slowly changing, however, thanks to a growing network of people helping couples to communicate their needs with wider sectors of society.

Nonprofit organization Fine is a self-support group staffed entirely by people who have been, or will be, involved in fertility treatment. Founded in 2004, the group aims to destigmatize infertility so that people can talk about the issue more openly, says Akiko Matsumoto, co-founder of the group and chairwoman of the board of directors.

The group has held various workshops and symposiums that have included doctors, clinical psychologists and infertile couples offering their thoughts on their experiences and advice. Fine has also developed a yearlong course through which people can be certified as peer counselors for infertile couples. A total of 84 people, including one man, have been accredited by the group so far.

Fine, which now has more than 1,500 members, seeks more public and corporate support for women undergoing fertility therapy, arguing that such women are important assets in a rapidly depopulating nation. The women, many of whom are in their 30s and 40s, make up the most productive group of workers and should be allowed to balance therapy and jobs, Matsumoto said.

“Businesses are not keen to support women visiting fertility clinics because, deep down, they don’t want women to get pregnant and take maternity leave,” she says. “That’s sad. There are so many people who want to have children. I really hope society will embrace the choices of women.”

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