Academic journal article International Journal of Men's Health

"My Husband's Sperm Is Triple A": Male Infertility and Assisted Reproductive Technologies in Contemporary Japan

Academic journal article International Journal of Men's Health

"My Husband's Sperm Is Triple A": Male Infertility and Assisted Reproductive Technologies in Contemporary Japan

Article excerpt

Below I discuss data from a larger research project on intimacy and reproduction in Japan, a nation in the middle of a "crisis of ultra-low fertility rates" (Jones, Straughan, & Chan, 2009), a crisis aggravated by delayed marriages (bankon) and late-in-life pregnancies (körei shussan). Fertility rates have dropped "below the population replacement level of 2.11 in 1974, after which the rate took a downturn and reached the lowest record of 1.26 in 2005" (Ministry of Health Labor and Welfare, 2010, p. 1). Delayed marriages are evidenced by the mean ages of first marriage for men and women of 30.9 and 29.3 respectively, with a mean age of mothers at first birth of 30.4 (Ministry of Health Labor and Welfare, 2014). Yet in spite of the global decrease, fertility actually rose among women aged between 15 and 19 as well as 35 and over (Ministry of Health Labor and Welfare, 2014). Late-in-life pregnancies have become conspicuous in Japan, and women who experienced their first delivery at 35 years of age or over accounted for about 27 percent of the national rate of newborn babies in 2013 (Ministry of Health Labor and Welfare, 2014).

Pronatalist policies have been the main strategy deployed to reverse the demographic trends. The 1990 Angel Plan encompassed the first official attempt to deal with "the problem of low birth rate", a controversial issue attracting a great deal of governmental and media attention (Roberts, 2002). The plan was originally designed as a ten-year strategy, whose three main objectives were to improve child-care facilities, encourage parental leave from work, and provide support for working mothers. To date, pronatalism has included several initiatives and the 2004 "New-New Angel Plan" or "Child Care Support Plan" marked the most recent attempt to encourage childbearing. The efficacy of these policies, however, remains elusive, as no contrasting control scenario in which the plans were not implemented was orchestrated (Coulmas, 2007). As a result, demographers and stakeholders predict that population replacement is implausible.

Subsidies for assisted reproductive technologies (ARTs) could have an impact on current population trends. Nonetheless they have never been an integral element of pronatalism. In the Japanese context, ARTs are not restricted to a particular form of knowledge; rather they convey "a curious mixture of social practice, folk beliefs and medical advice" (Seaman, 2011, p. 157). ARTs thus include natural and holistic treatments (NHT)-beverages, food, clothes, even good-luck charms that could enhance fertility, traditional Chinese herbal medicine (TCHM), and the timing method (TA; also known to some as "fertility awareness" or "natural family planning")-calculations of women's infertile and fertile intervals based on ovulation periods. Delayed marriage and late-in-life childbearing, however, has triggered the need for biomedical interventions more than ever: artificial insemination (AI), in-vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI). IVF and ICSI in particular have "already become indispensable treatments for infertility" (Yanagida, 2009, p. 29).

A review of the past ten years of ARTs-related media reports indicates a general public concern with the need for specific counselling services and financial support for IVF and ICSI (Asahi Shukan, 2004), in view of a growing number of married women who postpone childbirth and find in ARTs the best option to conceive. Childless couples refuse a "life without children" (Shükan Asahi, 2002) and struggle with the "sorrow of infertility" (Mainichi Shimbun, 2004), the major consequences of which are serious psychological stress and heavy economic burdens.

The government has established centers to provide specialized counselling for infertility along with a special scheme of financial support for ARTs. Japanese married couples are entitled to as much as 100,000 JPY for two years to cover the expenses of IVF or ICSI, if they have an annual income below 7,300,000 JPY and a physician who recommends it (Ministry of Health Labor and Welfare, 2007). …

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