Many in Japan are willing to try just about anything to reverse their nation’s tanking birth rates
ICSI sperm injection into oocyte. Photo by Ekem via Wikimedia Commons
Late last month, the city of Urayasu, in Japan’s Chiba Prefecture, decided to one-up the nation’s public medical insurance scheme by offering to subsidize egg freezing for local women. Dubbed the Urayasu Oocyte Cryopreservation Program, the plan is an apparent global first by any municipality. The local government has promised to allocate 90 million yen (about $750,000) to the local Juntendo University Hospital to promote research on the process, which involves encouraging local women to utilize the procedure. Normally, including 10 years of storage, egg freezing costs about a million yen ($8,250). The first round of cash from the government will reduce the cost of egg freezing by 70 percent for local women between the ages of 20 and 34 at the time of egg collection and under 45 by the time of egg use.
In part, the Urayasu decision is a laudable move by the local government to afford women more choice in their reproductive options, preserving viable egg cells for use beyond the traditional limits of fertility. At least that’s one way local officials have promoted the grant. But rather than just goodwill or female empowerment, the primary motive behind the decision seems to be the need for women to have more children in the face of Japan’s tanking birthrates. It’s unclear whether the project will actually raise fertility rates, but no matter the impetus, it’s still a unique and appreciable benefit that other governments and organizations may want to emulate.
Urayasu isn’t the first institution in the world to offer egg-freezing services to women. Back in October, Apple and Facebook kicked up a little controversy by offering to pay female employees to freeze their eggs, providing up to $20,000 per individual. Some saw this as a cynical ploy by the companies to encourage women to stay longer before leaving to have children—an implicit guilt trip promoting their own corporate needs over family. But generally it was embraced as a good tool for promoting choice and self-determination.
Original illustration from Reductress, edited by KJ Dell'Antonia, via NYTimes.com
However, despite an ultimately positive consensus, many organizations remain cautious about adding the procedure to their health plans. In part, the hesitancy occurs because egg freezing is a relatively recent technology. First pioneered in the 1980s, it was mainly an experimental treatment for cancer patients until 2012 when it dropped the “experimental” label and started to enter the wider consciousness. Yet we still lack good, long-term data on the effectiveness of the procedure and the possible risks to children and mothers involved. All we know is that shorter freezing periods are better, but, on average, each egg has just a 5 percent chance of retrieval and viability. We also know that most women aren’t freezing their eggs until their 30s, and even then they’re doing so because of a lack of a partner or stability more so than for professional concerns.
So despite all the promotional materials and hype that’s flying around about egg freezing, it’s still not what you’d call surefire or cost effective, which makes it unattractive to insurers. Yet some companies just have the money to spend and the mind to try something less than guaranteed. As for Urayasu, they’re just desperate to try anything to boost their fertility rates, a motivation Mayor Hideki Matsuzaki has openly copped to when discussing the new program.
Last year, Japan’s national birthrate hit an all-time low following four years in which more people in the nation died than were born. Many fear that the current trajectory will dip Japan’s population to 97 million, a decrease of 30 million, by 2050—the loss of working age citizens could lead to spiraling, unsustainable welfare costs, and a fundamental economic crisis. Officials suspect that part of this declining fertility has to do with a trend towards later marriages, when having children seems less viable for salaried Japanese couples. In light of these trends, the nation is increasingly willing to be the proving ground for experimental programs promoting young marriages or increased fertility in older marriages. “The [Urayasu] project is worth undertaking,” says local hospital director Koyo Yoshida, “as it could lead to a clinical study of whether [such subsidies] really contribute to curbing the declining birthrate.”
Urayasu,Chiba, in Japan. Photo by Kamemaru2000 via Wikimedia Commons
Unfortunately, this alone won’t get to the core of Japan’s demographic problems. Recent studies suggest that besides marrying later, Japanese couples are just less interested in sex and relationships. So while pushing the limits of procreation further into the future may be useful to those inclined to wait, egg freezing can’t address a deeper overall reticence to form families in the first place.
Still, given the potentially apocalyptic future they face, many in Japan are willing to try just about anything to reverse their nation’s demographic trends, creating a favorable environment for experiments like the Urayasu cash infusion. And no matter their intentions, the local government has made it easier for women who want to wait to have families to do so. We can only hope that their test yields positive results and that they follow through on citywide aspirations to expand their egg freezing program across the nation. That would be a powerful and instructive precedent for public policy makers worldwide.