“Expansion of insurance application for infertility treatment” is … Welcome voice, pointing out the issues

“Expansion of insurance application for infertility treatment” is … Welcome voice: September 17, 18:39

There has been a welcome call from parties and other parties about Prime Minister Kan’s call for an expansion of insurance for infertility treatment. It is expected that consideration will proceed in the future, but some people are pointing out issues.
Prime Minister Naoto Kan has called for the expansion of insurance for infertility treatment as part of measures to reduce the birthrate.

Of the infertility treatments, insurance is currently applied only in part of the initial stage of treatment, and advanced treatments such as “in vitro fertilization”, which is expensive to treat, are, in principle, self-paying.

According to a survey by Fine, a non-profit organization that assists men and women during treatment, in vitro fertilization often costs more than 500,000 yen for a single treatment.
(Source: NPO Fine “Questionnaire on Fertility Treatment and Economic Burden 2018”)

As for the expansion of insurance applications, Akiko Matsumoto, president of the NPO, said, “There are many people who give up treatment for economic reasons, so we welcome the progress of our efforts on this issue.”

On the other hand, according to NPOs, various other issues remain.

Because the method of treatment varies greatly from person to person, such as the frequency of going to the hospital, the amount of medicine, and the type of treatment, the probability of getting pregnant may decrease if a single treatment is performed according to the conditions at the time of insurance application.

In addition, since the disclosure of the pregnancy success rate for each clinic has not progressed, it is that there is little judgment material to choose a medical institution.

In addition, he points out that it is necessary to support people who want to become pregnant in society as a whole, such as the development of an environment that makes it easy to balance work and treatment.

In addition, since children born with artificial insemination using third-party sperm are widely recognized, such as requesting disclosure of information about sperm providers, it is said that ethical issues should be solved by promoting the development of laws.

Mr. Matsumoto said, “It is a good story to eliminate the economic burden, but it is strange that the discussion proceeds so prominently. We should also improve the social environment and laws so that other issues can be solved together.”

Infertility testing and treatment About one in six couples experienced

“Infertility” is defined by the Japanese Society of Obstetrics and Gynecology, in which healthy couples who wish to become pregnant do not become pregnant after one year.

Interest in infertility treatment is increasing year by year, and according to a survey conducted five years ago by the National Institute of Population and Social Security Research, approximately one in six couples, 18% of couples have experienced infertility testing and treatment.

What are the specific treatment methods?

In infertility treatment, the male and female tests are performed first to determine the cause of infertility. If the test finds a symptom that causes infertility, medication or surgical treatment is performed.

On the other hand, if symptoms leading to infertility are not found, treatment to assist fertilization is carried out step by step.
In general, the first thing to do is to
“Timing method” to predict the ovulation date and to teach the timing of sexual intercourse,
“Ovulation induction method” is taken to promote ovulation by drugs and injections.

In addition, if infertility continues,
“Artificial insemination” is performed in which semen is collected, good sperm is taken out, and injected into the uterus at a time when it is easy to become pregnant.
If it still has no effect,
In vitro fertilization is performed in which sperm and eggs are fertilized in vitro to return the fertilized egg to the uterus.

Application of public insurance limited to some treatments

Of these, public insurance is applied to
In addition to the inspection,
Treatment with drugs and surgery,
“Timing method” and
“Ovulation induction method” and so on.

Limited to some treatments, the stage has progressed
“Artificial insemination” and
“In vitro fertilization” is not applicable.

It is not possible to continue treatment because of the financial burden, and there are not a few people who give up pregnancy.

In addition, since the number of visits to the hospital is increased, and the burden is placed on the mind and body, balancing with work has become a major issue.

According to a survey conducted by the Ministry of Health, Labour and Welfare in 2017, about 16 percent of those who experienced infertility treatment quit their jobs because of infertility treatment.

Some local governments have their own support system.

Among infertility treatments, in vitro fertilization, which is expensive, has a national subsidy system, including “microinsemination,” in which sperm is injected into an egg using a microscope.
In addition to the age at which the wife is under 43 years of age,
Income is limited to less than 7.3 million yen for married couples.

Under these circumstances, financial support is being given to local governments on a per-unit basis.
Of these, in Tokyo, since last year,
In addition to the increase in the income limit to less than 9.05 million yen,
It is also for factued marriage.
According to the Tokyo Metropolitan Government, the number of grants in the last fiscal year increased by approximately 5% compared to the previous fiscal year.

In addition, Tokyo Minato Ward provides subsidies as a ward without establishing income restrictions.

In addition, Saitama Prefecture
In addition to the second and subsequent grants,
We are promoting our own support system by subsidizing up to 100,000 yen for early infertility treatment under the age of 35.

Expectations from those who have experience in infertility treatment

Mr. Abe, who lives in Kanagawa Prefecture, became pregnant and gave birth five years ago after about three years of infertility treatment, including artificial insemination and in vitro fertilization, while working as a dentist.

In addition to the cost of in vitro fertilization, 350,000 yen, as well as examination and medical expenses, the total cost of treatment was more than 1 million yen.

Based on his own experience of became physically and mentally unstable because of his impatience with whether or not he would become pregnant and financial concerns, he said he welcomed the policy of expanding insurance for infertility treatment.

Mr. Abe said, “At that time, it was hard mentally because I couldn’t get pregnant easily. In addition to sadness and impatience, expensive medical expenses. It was difficult for me to take time off from work just because my body was in fertility treatment, and I thought about quitting, but there was a current situation where I couldn’t quit my job because of financial concerns about how long fertility treatment would last. I think some people have given up treatment because of the high cost of treatment, so I think insurance is a very good thing in the sense that there are more opportunities.”

On the other hand, Mr. Abe
In addition to improving the current situation where information on hospitals and treatment methods is insufficient,
Understanding the workplace for infertility treatment so that it is easy to take a vacation,
He said that there are many other issues to be solved besides insurance.

Research to grasp the actual situation of the Ministry of Health, Labour and Welfare

Reducing the burden of infertility treatment has been a challenge that the government has set up in the past.

The government’s Guidelines for Measures to Address the Declining Birthrate, which was compiled in May, also includes the application of public health insurance to fertility treatment.

In light of this, the Ministry of Health, Labour and Welfare is considering expanding insurance applications for treatments that are clearly effective, in addition to the subsidies currently being subsidized.

The Ministry of Health, Labour and Welfare has already conducted research to understand the actual situation prior to the study, and is investigating the number and cost of treatment for medical institutions nationwide that are undergoing infertility treatment.

Based on the results of the survey to be gathered during this fiscal year, we have decided to start a concrete study, but it has been pointed out that the content of “infertility” varies from person to person, and it is necessary to sort out the extent to which it is regarded as the treatment of disease. Such considerations and initiatives are expected to accelerate in response to Prime Minister Kan’s policy.

Health, Labour and Welfare Minister Tamura “Efforts to apply insurance as soon as possible”

After meeting with Prime Minister Naoto Kan, Minister of Health, Labour and Welfare Tamura said at a press conference, “With regard to infertility treatment, Prime Minister Kan said, “I would like to see a significant increase in the current subsidy system,” so after considering it as soon as possible, I would like to proceed so that the burden can be reduced even before insurance is applied. In order to apply insurance, we need to carefully discuss what methods and other applications we will apply to, but we would like to make an effort to apply insurance as soon as possible.”