May 20, 2025
TOKYO – About 70% of major local governments across Japan are providing financial assistance to people undergoing fertility treatment, according to a Yomiuri Shimbun survey.
Such treatment has been covered by the nation’s public health insurance program since 2022, but many local governments are providing additional support because this insurance has not sufficiently reduced the cost burden for people struggling to conceive.
A growing number of people are turning to fertility treatments including in vitro fertilization, in which eggs fertilized outside the body are returned to the uterus, and artificial insemination, in which semen is placed directly into the uterus. About 10% of babies in Japan are born through IVF.
According to survey results announced by the Health, Labor and Welfare Ministry in 2021, the average cost for one round of artificial insemination was about ¥30,000, and that for IVF was about ¥500,000.
Since April 2022, the government has allowed artificial insemination and IVF to be covered by the public health insurance system to combat the chronically low birthrate. As a result, out-of-pocket expenses for receiving these fertility treatments are capped at 30% of the costs, in principle.
However, the number of IVF cycles and the age at which a woman can receive insurance coverage are limited. A woman aged under 40 when she starts IVF treatment is covered for six rounds, and women aged 40 to 42 are limited to three rounds. In addition, some people opt to receive “advanced medical care” that is not covered by insurance, such as preimplantation testing to check for chromosomal abnormalities in fertilized eggs produced through IVF, and time-lapse imaging that observes fertilized eggs in an incubator to determine the optimal time to return them to the uterus.
Because fertility treatments often involve multiple attempts and span a long period, the heavy financial cost of undergoing such treatments has been a pressing issue, even after insurance coverage was introduced.
The Yomiuri Shimbun surveyed 90 major local governments – the governments of the nation’s prefectures and ordinance-designated cities, and Tokyo’s 23 wards – in December 2024. All 47 prefectural governments, 19 ordinance-designated city governments and 22 ward governments responded to this survey. In total, 62 of the 88 responding governments said they provided financial assistance to people undergoing advanced medical care and other fertility treatments.
According to the survey, 41 local governments subsidized the out-of-pocket portion of advanced medical care procedures; 18 governments subsidized the out-of-pocket portion of costs incurred after insurance coverage had been applied; and nine subsidized people who had to pay full treatment costs because they were not covered by insurance due to exceeding the limits on age or rounds of treatment. Some governments provided more than one of those three assistance types.
Among the local governments that responded, there were calls for the central government to expand the scope of the public health insurance program, and to reduce the economic burden on everyone who wants to undergo fertility treatment, including in cases that fall outside those currently covered by insurance.