More people in Japan are undergoing premarital medical examinations as more couples struggle with infertility due to late marriages.
While many people view such checkups positively, as a way to detect health problems at an early stage, some experts are concerned that reproductive capacity could be used as criteria for selecting marriage partners — eventually leading to a situation akin to eugenics. The types of premarital checkups vary depending on institutions, but packaged services often include blood tests, checks for sexually transmitted diseases, rubella antibody tests and uterine cancer or semen tests. The fees are not covered by national health insurance.
According to Recruit Marketing Partners Co., 59 percent of 187 women surveyed in 2011 were aware of premarital health checkups, and 24 percent actually underwent them. Many cited concerns about their health as reasons for having the examinations. One respondent said the result of a checkup showing no abnormalities provided a sense of relief, while another said the test led to the early discovery of a disease.
Fertility is understood to decline in line with age for men and women, and delayed marriages have pushed up the number of people struggling with infertility.
More than 1 in 3 couples are concerned about potential infertility, according to the National Institute of Population and Social Security Research. The body said the number of couples who have undergone fertility checks or treatment is also on the rise.
Akira Tsujimura, a professor at the urology department at Juntendo University Urayasu Hospital, said that although most people who have premarital health checkups are women, medical tests for men are also drawing attention. “It has come to be widely known that about half of infertility cases are attributable to male partners,” said Tsujimura, who has conducted premarital health checkups for men at an outside clinic.
According to a report compiled by Tsujimura, of 564 men aged between 21 and 66 who underwent semen tests, 25.4 percent had a low sperm count or poor sperm mobility, and 1.8 percent had azoospermia — a medical condition where a man’s semen contains no sperm. “It is better to know (about health issues) in advance because thinking about whether or not you should have children affects your life plan,” he said.
But Jun Murotsuki, the head of the obstetrics department at Miyagi Children’s Hospital, said, “From past examples abroad, we cannot deny the eugenic aspects (of such medical examinations). It is problematic to go through health checkups without being aware of (such issues).”
In France, premarital health checkups were previously mandatory based on a eugenic policy, though they were later abolished. China also scrapped obligatory premarital health examinations.
Murotsuki added that revealing diseases or infertility could create problems, and pointed out that counseling is not readily available in Japan.
“If people want to undergo tests themselves they can do so, but I am concerned about cases in which they are forced by families and partners who make it a condition for marriage,” he said.