Japan: Fertility Treatment Covered by Public Health Insurance — IUI, IVF and ICSI (April 2022)
Source material is a Japanese government announcement (in Japanese); this page is a summary.
In Japan, from April 2022, "general fertility treatment" such as intrauterine insemination and "assisted reproductive technology" such as IVF and ICSI became covered by public health insurance. For assisted reproductive technology, the whole series of basic treatment from egg retrieval through embryo transfer is insured, and treatments that may be added depending on your situation can be combined with insured care if they are designated as advanced medical care. That said, Ministry of Health, Labour and Welfare materials state that age and frequency limits and facility standards for egg retrieval are the same as under the previous subsidy, and the Ministry advises checking the official notifications for details such as billing requirements — so it is best to confirm what applies to you at the medical institution where you receive care.
Key facts
| In effect | April 2022 (Reiwa 4) — decided at the Central Social Insurance Medical Council on 9 February 2022 |
|---|---|
| Newly covered scope | "General fertility treatment" such as intrauterine insemination, and "assisted reproductive technology" such as IVF and ICSI (before this, testing and treatment of underlying conditions were covered) |
| Scope of ART coverage | The entire series of basic treatment from egg retrieval through embryo transfer is insured. Treatments that may additionally be performed and are designated as advanced medical care may be combined with insured treatment |
| Age and frequency | Ministry materials state under "egg retrieval" that "age and frequency limits, facility standards and so on are the same as for the subsidy". The subsidy applied to couples where the wife was under 43 on the first day of the treatment period, with a total of 6 cycles if under 40 and 3 cycles if 40 or over but under 43 (per child) |
| Outside insurance coverage | Intrauterine insemination using third-party donor sperm (AID), third-party egg or embryo donation, and surrogacy |
At the Central Social Insurance Medical Council (中央社会保険医療協議会) meeting on 9 February 2022 (Reiwa 4), it was decided that "general fertility treatment" (一般不妊治療) such as intrauterine insemination, and "assisted reproductive technology" (生殖補助医療) such as in vitro fertilisation and intracytoplasmic sperm injection, would newly become covered by public health insurance from April of that year. This reflected the reproductive medicine guidelines compiled by the Japan Society for Reproductive Medicine, which evaluated the level of evidence, including effectiveness, for each medical technique used in assisted reproductive technology and general fertility treatment in Japan. For assisted reproductive technology, the entire series of basic treatment from egg retrieval (採卵) through embryo transfer (胚移植) is covered by insurance, and among treatments that may additionally be performed depending on the patient's condition, those designated as advanced medical care (先進医療) may be used in combination with insured treatment. Ministry of Health, Labour and Welfare materials state that for egg retrieval, "age and frequency limits, facility standards and so on are the same as for the subsidy", and assisted reproductive technology using third-party sperm or eggs was set out as being outside the scope of insurance coverage. The Ministry advises checking the official notifications and circulars to be issued subsequently for details such as billing requirements and facility standards.
Background — why this change
The "Policy on Social Security Reform for All Generations" (Cabinet decision of 15 December 2020) stated that the details would be determined during fiscal 2021 (Reiwa 3) and that insurance coverage for fertility treatment would be implemented from the start of fiscal 2022 (Reiwa 4). Until coverage began, the existing fertility treatment subsidy scheme was expanded on the premise of widening eligibility, including abolishing the income cap and raising the subsidy amount (300,000 yen per cycle). In addition, the fiscal 2021 supplementary budget enacted on 20 December 2021 included 6.7 billion yen for "support for a smooth transition to insurance coverage of fertility treatment", and treating a single course of treatment spanning two fiscal years as eligible for the subsidy as a transitional measure was under consideration so that treatment plans during the transition period would not be disrupted.
Summaries below are factual notes based on government announcements and primary sources — not evaluations or opinions.
Summaries reflect national-level programs. Municipal (city/ward/town) programs may differ — confirm with the official desk before applying.
FAQ
Which treatments are covered by insurance?
"General fertility treatment" such as intrauterine insemination and "assisted reproductive technology" such as IVF and ICSI newly became covered from April 2022. For assisted reproductive technology, the entire series of basic treatment from egg retrieval through embryo transfer is insured. Testing (to identify causes) and treatment of underlying conditions were already covered before March 2022 (Ministry of Health, Labour and Welfare).
Are there age or frequency limits?
Ministry of Health, Labour and Welfare materials state that for egg retrieval, "age and frequency limits, facility standards and so on are the same as for the subsidy". The subsidy scheme applied to couples where the wife was under 43 on the first day of the treatment period, and the total number of cycles was up to 6 if the wife was under 40 on the first day of the treatment period when the subsidy was first received, or up to 3 if she was 40 or over but under 43 (per child). The Ministry advises checking the official notifications and circulars to be issued for details such as billing requirements and facility standards.
What happens with treatments that are not covered?
Among treatments that may additionally be performed depending on the patient's condition, those designated as advanced medical care may be combined with insured treatment. Under the advanced medical care system, insurance applies to the basic portion shared with general care, such as the basic hospitalisation fee, while the advanced medical care portion is paid by the patient. On the other hand, assisted reproductive technology using third-party sperm or eggs (intrauterine insemination using third-party donor sperm, third-party egg or embryo donation, and surrogacy) is outside insurance coverage.