In-Vitro Fertilisation

Author's Notes
As part of a special issue of Being A Broad about pregnancy and childbirth, I researched the hows and whys of In-Vitro Fertilisation. While I wrote the original version (and the majority) of this article, sections of it were modified after my submission to reflect changes from the publisher. For more information, please feel free to contact me.

As Japan inches towards workplace equality, the number of women who settle down with the intent of focusing on their careers has been steadily increasing over the past few years. Working full-time, these women hardly have time to focus on child-rearing, and by the time they decide they want a child, they have passed the so-called "prime" age of fertilisation, occasionally making natural conception difficult.

Thirty-six-year-old Jennifer (name changed to protect privacy) is one such woman. Hailing from the United States and currently residing in Tokyo, she gave birth to her three-month-old son in August 2010 after working full-time for a number of years. "I didn't want to have a child until later, but time passed quickly and I didn't end up having time until I was 36 years old," she explained. "My husband and I tried naturally, but it didn't work, probably due to my age."

After extensively researching her options and consulting with her parents back home, she decided she would try to conceive through in vitro fertilisation—more popularly known as IVF. After visiting two clinics, she decided on the English-friendly Kato Ladies Clinic in Shinjuku, which specialises in providing natural, hormone-free IVF. Having learned that she had fewer eggs than most women her age, Jennifer admitted that she had been a bit worried about the possibility of successfully completing an IVF, but added that the Kato Ladies Clinic had reassured her they would be able to complete the procedure normally. "I had fewer eggs, but they were of high quality," she said. "They took out one egg and implanted it without any problems."

Had Jennifer and her husband encountered anything to hinder the completion of a full IVF procedure, she would not have been charged full price and would have been able to try again. "It's cheaper the first time, anyway," she said, adding that the clinic maintains a strict privacy policy in which they call people by number rather than name in public areas.

After successfully extracting the egg and mating it with her husband's sperm, Jennifer waited three months and had multiple weekly checkups. "We had to wait for my cycle to come, which is why it took so long," she explained.

Six weeks in, Jennifer and her husband began looking at prospective hospitals for her to give birth in. She settled on the English-friendly Aiku Hospital in Hiroo and explaining that, "we had to focus on places that would handle older-age pregnancies, but the fact that I had conceived through IVF didn't make any difference."

Amber (not her real name) shared the same sentiments about hospital attitudes towards IVF in Japan. "It is more of the hospital's business how the baby was conceived," she stated in an email, adding that she had completed the majority of her IVF procedures between 2006 and 2008 after separating from her husband years before. According to Amber, while single women are not necessarily encouraged to undergo IVF, it is not illegal for unmarried women to have IVFs done. "There are very few rules pertaining to assistive reproductive technology in Japan," Amber explained, but stated that she did not feel comfortable informing her doctors of her marital status. "None of the doctors knew that I was single, otherwise I would likely have been refused treatment." She added that there are certain clinics in Tokyo that are more sympathetic to single women, but others require prospective participants to sign special permission forms.

Jennifer said she was not required to sign a special permission form before having her IVF, but instead needed to obtain an introduction letter to present to the Kato Ladies' Clinic at her first visit. She explained that the letter aimed to "introduce the previous doctor and clinic in case the new clinic or hospital needed to contact them." Because of Jennifer's enrollment in an insurance program, the costs of her multiple checkups at the clinic were reimbursed by her local government office.

This is common in Japan, according to Amber: "If you are under the national health insurance plan, there may be some incentives, depending on (your) district and infertility diagnosis." She added that by her calculations, a typical IVF procedure costs around three to five hundred thousand yen in Japan. Though it takes longer and may cost more, there are several reasons a woman may try to conceive via IVF.

Age plays a key role in a woman's ability to conceive a child, and once she reaches a certain age, it may be hard to conceive naturally. This is what happened in Jennifer's case. "I knew exactly when my baby was going to be due," she said. "More importantly, I realised that when I got older, I wouldn't have to give up. My husband and I were very happy overall with our decision to go for IVF and feel we were very lucky to be in Japan, where we could take advantage f the unique methods offered and not have to worry too much about the costs."

IVF is also one of the most successful ways to conceive as a single mother. "I had done several IUIs (Intra-Uterine Insemination) with donor sperm before moving to IVF," Amber stated. "I was already over 40 years old, so I needed to use the best technology with the best success rates."