Health ministry to enhance ways to inform infertile couples of fostering, adopting

The Yomiuri Shimbun

December 2, 2021

The welfare ministry will expand the ways to inform couples undergoing infertility treatment of fostering and adopting as an alternative to having children from next spring, when public health insurance coverage for infertility treatment begins.

The Health, Labor and Welfare Ministry plans to draw up guidelines for medical institutions that conduct infertility treatments on how to explain these options to their patients, as infertility treatment does not always result in pregnancy and birth.

The purpose of the foster parenting and special adoption systems is to care for children who have been separated from their parents for reasons such as abuse or poverty. Foster parents raise such children until they reach 18 after being entrusted with them by a local government. In the case of special adoptions, a child under 15, in principle, becomes the legal child of a married couple with whom there is no blood relationship, with the permission of a court.

The guidelines indicate that it is desirable to provide such information before infertility treatment begins. In addition to recommending that the information be provided more than once if desired, the ministry will also offer explanations that take into consideration the delicate feelings of couples, because if a patient is in the middle of treatment or has reached an impasse, they may think they are being urged to give up.

The ministry also plans to include cooperation with child consultation centers and private agencies that work in adoption in the guidelines, as well as the provision of opportunities to talk to those who have given up infertility treatment and adopted children instead.

The number of infertility patients is increasing every year, with about 460,000 rounds of in vitro fertilization conducted in 2019. The number of couples who plan to undergo treatment is expected to increase once it becomes covered by public health insurance next spring. However, there are many cases in which couples are unable to have a child despite treatment.

According to the Japan Society of Obstetrics and Gynecology, about 20% of women in their mid-20s to mid-30s who go through in vitro fertilization give birth, while the percentage drops to about 10% by the age of 40.

It has been said that as treatment becomes prolonged and patients bear more of a physical and mental burden, it becomes necessary for a doctor to propose to stop the treatment and offer other options. The ministry decided to create the guidelines to enhance the way to provide the information, as not all medical institutions are eager to share it with their patients.

There is another challenge, too. The fostering and adoption programs are intended to bring children living in institutions into a home environment where they can be nurtured, not as an alternative to infertility treatment. There is a lack of personnel available to explain the concept and take care of couples who have given up treatment.

Meanwhile, society’s understanding of foster parents and adoption is also poor. About 45,000 children nationwide are unable to live with their parents. Only 22% of them live in foster homes, lower than 82% in the United States and 73% in Britain.

“Enhancing the provision of appropriate information has the potential to connect children in need of a home environment with infertile couples who wish to have children. That is significant,” said Hiroyasu Hayashi, a professor of social welfare at Japan Women’s University.