Fertility Treatment and Insurance Coverage in Japan

Fertility treatment insurance coverage in Japan began in April 2022: timing therapy, artificial insemination, IVF, and ICSI are now billed to public health insurance at the standard 30 percent copay, for couples who are married or in a de facto partnership and, for IVF and ICSI, where the woman is under 43 when treatment starts (as of June 2026).¹²³ What a couple actually pays still depends on self-pay add-ons, the monthly high-cost cap, local subsidies, and legal limits that insurance does not touch.

Confirm current details with official sources

Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (厚生労働省) site. This article is general information, not medical advice; for your specific case, consult a licensed physician, specifically a reproductive medicine specialist (生殖医療専門医) or an obstetrician-gynecologist at a fertility clinic.

Overview

Insured fertility care in Japan runs on the national medical fee schedule (診療報酬, shinryō hōshū), the price list that sets what every insurer pays for every procedure.² Because the rules live in that schedule, the covered menu, the age limit, and the transfer caps are the same everywhere in the country and under every public insurer.¹²

Subsidies are a different matter. Prefectures and municipalities run their own top-up programmes on top of insurance, and those differ from one jurisdiction to the next.⁴⁵

What changed in April 2022

Until March 2022, IVF and ICSI were outside health insurance. Couples paid the full price and could claim a national per-attempt grant under a programme that called IVF and ICSI 特定不妊治療 (tokutei funin chiryō, "specified infertility treatment").²

From April 2022, both general infertility care and assisted reproduction became insured.¹² The patient pays 30 percent of the insured fee at the clinic window, the same rate as other insured care for working-age adults.¹⁶

Older English-language sources often describe an income limit of ¥7.3 million. That cap belonged to the old subsidy: it originally required the couple's prior-year income to be under ¥7.3 million and legal marriage, and an expansion decided in December 2020 abolished the income cap, admitted de facto couples, and raised the grant to ¥300,000 per attempt.²⁷

The insurance regime has no income test. The MHLW leaflet lists only age and count requirements for insured IVF and ICSI, and states that these mirror the limits of the subsidy that ran through fiscal 2021.¹ Transfers paid for under the old subsidy do not count toward the insurance cap.¹

General infertility care vs. assisted reproduction

MHLW divides insured fertility care into two tiers.¹²

Term	Reading	Meaning	What it includes
一般不妊治療	ippan funin chiryō	General infertility care	Timing method (タイミング法), artificial insemination (人工授精, jinkō jusei, IUI)
生殖補助医療	seishoku hojo iryō	Assisted reproductive technology (ART)	Egg and sperm retrieval, IVF (体外受精, taigai jusei), ICSI (顕微授精, kenbi jusei), embryo culture, embryo freezing, embryo transfer (胚移植, hai ishoku)

Diagnostic tests for the cause of infertility, and treatment of underlying conditions such as obstructive azoospermia, endometriosis adhesions, or ovulation disorders, were already insured before April 2022.²

The age and count limits apply to the ART tier only.¹ The fee-schedule items for general infertility care, the management fee and artificial insemination, carry no age or count condition in their text (as of June 2026; confirm current figures with MHLW).⁸⁹ MHLW does not state in so many words that general care has no age limit, so ask the clinic how it applies the rule to your case.

Insured artificial insemination uses sperm collected from the patient's partner (as of June 2026).⁹

Who is covered

Coverage attaches to enrolment in Japanese public health insurance, whether employee health insurance (Kyokai Kenpo or a health insurance society) or National Health Insurance (NHI). Neither the MHLW leaflet nor the fee-schedule conditions contain any nationality requirement.¹³

Foreign residents are obliged to enrol in public health insurance. The NHI exclusions turn on a stay of under three months and on specific statuses such as Temporary Visitor, not on nationality.⁶ The background is covered in How Japan's Universal-Coverage System Works.

Treatment must take place at an insurance medical institution that has filed the relevant facility notification with its Regional Bureau of Health and Welfare. The regional health bureaus (part of MHLW) publish the lists of these institutions.¹¹⁰¹¹

Eligibility for insured treatment

Four conditions decide whether IVF or ICSI is insured: the woman's age, the number of transfers already used, the couple's relationship, and a signed treatment plan.¹³

Age at the start of treatment

For IVF and ICSI, the woman must be under 43 at the start of treatment (as of June 2026; confirm current figures with MHLW).¹³ This limit is set in the fee-schedule notices, not in statute, so it can change at a fee-schedule revision.³

"Start of treatment" has two different anchors, and they do different jobs:

• For the under-43 test, the age that counts is the age on the day the treatment plan (治療計画, chiryō keikaku) for that embryo transfer was created (as of June 2026).¹²
• For the transfer-cap tier (6 or 3 transfers, below), the age that counts is the age on the day the couple's first-ever embryo-transfer treatment plan was created (as of June 2026).¹²

Turning 43 partway through a treatment plan

If a woman starts a treatment at 42 and turns 43 during it, the one treatment that includes her 43rd birthday can be completed under insurance (as of January 2023).¹³ If the plan needs to be reviewed after she has turned 43, the care that follows is outside insurance (as of January 2023).¹³

A "treatment" here means the series of care under one treatment plan aimed at an embryo transfer.¹³

Embryo-transfer limits per child

The cap counts embryo transfers, not egg retrievals or "rounds." The fee-schedule limit is written on the embryo-transfer item (胚移植術), and egg retrieval can be repeated within a plan when medically necessary, for example when a retrieval yields no eggs.¹¹²

Woman's age at first treatment-plan start	Insured transfers per child	As of
Under 40	6	2026-06112
40–42	3	2026-06112
43 or over	Not insured	2026-06113

After a pregnancy achieved through embryo transfer ends in a birth (出産), transfers for the next child receive a fresh allowance of 6 or 3, depending on the woman's age when that next plan starts (as of June 2026).¹²

Only transfers made under insurance count. Past self-pay transfers and subsidy-era transfers are not added.¹ If insured care is paused and later resumed, transfers of frozen embryos made under insurance still count, including those made before the pause (as of January 2023).¹³

At each new treatment plan, the clinic must confirm the cumulative transfer count to date, record it in the chart, and enter it with the confirmation date on the insurance claim (as of June 2026).³ MHLW asks patients to tell the doctor their previous fertility treatment history and which clinics they used.¹

Marriage or de facto partnership

At the first billing of the management fee, the clinic must confirm one of two things: that the patient and partner are married, or that they intend to legally acknowledge (認知, ninchi, "legal acknowledgment of paternity") any child born of the treatment (as of June 2026).³⁸ A de facto couple (事実婚, jijitsukon) is covered on the same basis as under the old subsidy, and the clinic may confirm the relationship or ask for documents.¹

The documents themselves are left to clinic practice. One Tokyo clinic, for example, asks unmarried couples for insurance cards, a 戸籍謄本 (koseki tōhon, "family register extract") or equivalent proving each partner is unmarried, a juminhyo (residence certificate) showing a shared address, both issued within three months, and attendance by both partners at the first visit.¹⁴ Other clinics may ask for different documents.

Insured treatment uses the couple's own sperm and eggs. Treatment with third-party sperm, eggs, or embryos, and surrogacy, are outside insurance.²

The fee schedule does not say in terms that coverage is for heterosexual couples. In practice, the own-gametes rule and the 認知 route mean a same-sex couple cannot use insured treatment; see Good to know below.²³

Infertility diagnosis, treatment plan, and joint consent

The ART management fee applies to patients diagnosed with infertility who are undergoing, or preparing for, ART (as of June 2026).³ JSOG (日本産科婦人科学会, Japan Society of Obstetrics and Gynecology) guidance describes IVF as in principle for cases where pregnancy is judged very unlikely through other treatment, and ICSI as in principle for male-factor infertility or fertilization failure.¹⁵

The clinic must create a treatment plan, explain it in writing to both partners, hand it over, and obtain written consent (as of June 2026).³ At least once every six months, the clinic must reconfirm consent with both partners and revise the plan as needed (as of June 2026).³

The initial explanation is in principle given with both partners present. Where that is difficult, the clinic records the reason and explains to the absent partner at a later visit, and a video-call explanation is allowed with ID verification and written consent (as of January 2023).¹³

The cycle of plan, consent, and review looks like this.¹³¹³

What insurance covers and what stays self-pay

The insured menu now covers almost every standard step of IVF and ICSI. The main exceptions are newer techniques still under evaluation, care outside the age or count limits, and anything involving third-party gametes.¹²

Covered procedures

The table below lists the insured items (as of the dates shown; confirm current figures with MHLW).¹²¹²⁹ Coverage items are revised with each biennial fee-schedule revision.

Procedure	Tier	Insured	As of
Diagnostic tests for cause of infertility	Already insured before 2022	Yes	2022-042
Timing method	General care	Yes (within the management fee)	2022-042
Artificial insemination (IUI)	General care	Yes	2026-069
Egg retrieval	ART	Yes	2022-0412
AMH test (once per 6 months)	ART	Yes	2022-042
IVF and ICSI (including split insemination)	ART	Yes	2022-042
Egg activation (卵子活性化処理)	ART add-on	Yes	2022-042
Embryo culture to cleavage stage or blastocyst	ART	Yes	2022-042
Embryo freezing and storage	ART	Yes	2022-042
Fresh and frozen-thawed embryo transfer	ART	Yes	2026-0612
Assisted hatching; hyaluronan-enriched transfer medium	Transfer add-on	Yes	2022-042
Y-chromosome microdeletion test; TESE, including micro-TESE	Male factor	Yes	2022-042
Third-party sperm, eggs, or embryos; surrogacy	n/a	No	2022-042

Senshin iryo add-ons

先進医療 (senshin iryō, "advanced medical care") is a category of techniques not yet insured but approved for combination with insured care. Insurance pays for the common part of the treatment, and the patient pays the senshin iryo part in full.² It is one type of 評価療養 (hyōka ryōyō, "evaluation-track care") under the system that permits combining insured and uninsured care.²

Clinics must explain the content and cost in advance, obtain consent, and post the content and fees in the clinic. Each technique may only be offered at institutions that have notified their Regional Bureau of Health and Welfare.² Patients need no special procedure beyond consenting, and which senshin iryo a clinic offers varies.¹

Confirm an add-on is registered senshin iryo

Only add-ons registered as senshin iryo at that clinic can be combined with an insured cycle. Ask the clinic whether an add-on is registered senshin iryo there before agreeing to it; an unregistered self-pay option can take the whole treatment out of insurance (see Good to know).²¹⁴

Senshin iryo costs fall outside the high-cost medical expense cap, which applies only to insured costs.¹⁶

Tokyo's subsidy list, which follows the MHLW register, includes the following fertility-related senshin iryo techniques (as of March 2026).⁴ New techniques may be added at any time, and none of the peripheral fertility senshin iryo had moved into insurance (as of December 2025).¹¹⁷

• SEET method (SEET法)
• Time-lapse embryo imaging (タイムラプス)
• Endometrial scratching (子宮内膜スクラッチ)
• PICSI
• Endometrial receptivity testing (ERA/ERPeak)
• Uterine microbiome testing, EMMA/ALICE (子宮内細菌叢検査)
• Uterine microbiome testing, uterine flora test (子宮内フローラ検査)
• IMSI
• Two-step embryo transfer (二段階胚移植法)
• Microfluidic sperm sorting (膜構造を用いた生理学的精子選択術)
• Preimplantation genetic testing for aneuploidy, PGT-A (着床前胚異数性検査)

PGT-A status

PGT-A is not insured (as of July 2026).¹⁴ Its status otherwise rests on news and analyst reporting rather than an MHLW register that could be checked, so treat the details below as reported.

It has been handled as 先進医療B (senshin iryō B), a research-track category, only at designated sites. An Osaka University-led programme approved in March 2023 has reportedly completed its planned cases and ended (as of December 2025).¹⁷¹⁸ A Tokushima University Hospital-led application was judged appropriate as 先進医療B in January 2025 and was reported as still in preparation in December 2025 (as of December 2025).¹⁹¹⁷

Outside designated sites, PGT-A is self-pay, and clinic guidance says adding it to a cycle takes the whole treatment self-pay.¹⁴ Its appearance on Tokyo's subsidy list does not mean general availability; it applies only where PGT-A is performed as registered senshin iryo.⁴

Fully self-pay treatment

Care falls outside insurance when the woman is 43 or over at treatment start, when the transfer cap is used up, or when treatment involves third-party gametes or surrogacy (as of June 2026).¹²¹³ Freezing unfertilized eggs is also absent from the insured menu, although freezing embryos is covered (as of April 2022).²

Frozen embryos created under insurance generally cannot be used for later self-pay treatment, and a plan made with self-pay use in mind is not allowed (as of January 2023).¹³ The exception: embryos still in storage when the age or count limit is reached may be kept and used in later self-pay care.¹³ Starting a fresh self-pay course from retrieval, when medically judged necessary, is permitted.¹³

Current self-pay prices are hard to pin down from public sources. An MHLW-commissioned survey for fiscal 2020, before insurance, put the average cost of IVF at about ¥500,000 per attempt (as of 2020).²⁰

One Tokyo clinic lists self-pay add-on prices of ¥35,000–50,000 for time-lapse imaging, ¥150,000 for ERA, and ¥50,000–80,000 per embryo for PGT-A (as of October 2026).²¹ Prices at other clinics differ.

Costs and the monthly cap

Three layers decide the bill for an insured cycle: the 30 percent copay, the monthly high-cost cap, and, for some insurers, an extra in-house refund.¹¹⁶²²

The 30 percent copay in practice

Fee-schedule points are worth ¥10 each (as of June 2026; confirm current figures with MHLW).²³ The patient pays 30 percent of the resulting fee at the window.¹

The table below converts the insured points into the window copay (as of the dates shown). The copay column is this article's own arithmetic (points × ¥10 × 30 percent), not a figure quoted by MHLW. Rows dated 2022-04 come from the original 2022 schedule and may since have been revised.^21238924

Item	Points	30% copay (calculated)	As of
General infertility care management fee (once per 3 months)	2508	¥750	2026-06
Artificial insemination	1,8209	¥5,460	2026-06
ART management fee (monthly)	300 or 2503	¥900 or ¥750	2026-06
Egg retrieval	3,200 + 2,400–7,200 by eggs retrieved2	¥16,800–31,200	2022-04
IVF / ICSI	3,200 / 3,800–11,80024	¥9,600 / ¥11,400–35,400	2026-06
Embryo culture	4,500–10,500, plus 1,500–3,000 for blastocyst2	¥13,500–31,500, plus ¥4,500–9,000	2022-04
Embryo freezing (start / annual storage)	5,000–13,000 / 3,5002	¥15,000–39,000 / ¥10,500	2022-04
Fresh / frozen-thawed embryo transfer	7,500 / 12,00012	¥22,500 / ¥36,000	2026-06
TESE (simple / microsurgical)	12,400 / 24,6002	¥37,200 / ¥73,800	2022-04

The table excludes medication, consultations, routine tests, and point add-ons such as the fresh-sperm add-on for IVF or ICSI, egg activation, and assisted hatching (1,000 points each, as of June 2026).¹²²⁴ Several items scale with the number of eggs retrieved or embryos cultured and frozen, so two cycles at the same clinic can cost quite differently.²

One Tokyo clinic estimates the insured out-of-pocket cost for a cycle from retrieval to first transfer at about ¥140,000–250,000 before any high-cost refund or subsidy (as of October 2026).²¹ That is a single clinic's estimate, not a national figure.

High-cost medical expense benefit and the limit certificate

The 高額療養費 (kōgaku ryōyōhi, "high-cost medical expense benefit") refunds insured copays above an income-banded monthly cap. The month is the calendar month, from the 1st to the last day.¹⁶

Meals, private-room charges, and uninsured care, including senshin iryo, are excluded.¹⁶ The full mechanics are in The High-Cost-Catch (Kogaku Ryoyohi) System.

Term	Reading	Meaning
高額療養費	kōgaku ryōyōhi	High-cost medical expense benefit25
限度額適用認定証	gendogaku tekiyō nintei-shō	Limit-application certificate25
多数回該当	tasūkai gaitō	Multiple-month reduction25
年間上限	nenkan jōgen	Annual cap, new from August 202625

The caps changed in August 2026. Monthly caps rose, and a new annual cap (年間上限, nenkan jōgen) was introduced, counted over a year running from August to the following July (as of July 2026).²⁵²⁶

Annual income (approx., under 70)	Monthly cap from 2026-08	Multiple-month cap (多数回該当)	Annual cap from 2026-08	Monthly cap to 2026-07	As of
~¥11.6M or more	¥270,300 + 1%	¥140,100	¥1,680,000	¥252,600 + 1%	2026-0826
~¥7.7M–11.6M	¥179,100 + 1%	¥93,000	¥1,110,000	¥167,400 + 1%	2026-0826
~¥3.7M–7.7M	¥85,800 + 1%	¥44,400	¥530,000	¥80,100 + 1%	2026-0826
Up to ~¥3.7M	¥61,500	¥44,400	¥530,000 (¥410,000 for ~¥2M or less, refunded from 2027-08)	¥57,600	2026-0826
Resident-tax exempt	¥36,900	¥24,600	¥290,000	¥35,400	2026-0826

"+ 1%" means 1 percent of total medical costs above a threshold for that band.²⁶ The multiple-month cap applies from the fourth month once the cap has been reached in three or more months within the last 12.²⁵ A second stage from August 2027 splits the upper bands further, for example into ~¥3.7M–5.1M at ¥85,800 + 1%, ~¥5.1M–6.5M at ¥98,100 + 1%, and ~¥6.5M–7.7M at ¥110,400 + 1% (as of August 2026).²⁶

MHLW's own example: a person under 70 with an income of about ¥3.7M–5.1M who runs up ¥1,000,000 in insured costs in one month pays about ¥93,000 from August 2026 (as of July 2026).²⁵ For people under 70, copays of ¥21,000 or more per institution can also be combined within the household.¹⁶

To pay only up to the cap at the window instead of claiming a refund later, use the My Number Card as your insurance card (マイナ保険証, Maina hokenshō) or obtain a 限度額適用認定証 (gendogaku tekiyō nintei-shō, "limit-application certificate") from your insurer in advance.²⁵ NHI members apply at their municipal office; everyone else applies to their insurer.¹

Extra benefits from employer insurers

Some insurers pay 付加給付 (fuka kyūfu, "additional benefits") on top of the high-cost benefit, under their own rules and names such as 医療付加金 (iryō fukakin, "medical supplementary benefit"). One example pays back everything above ¥25,000 a month (as of March 2023).²² Check your own insurer's current rules.

Health insurance societies (健康保険組合), mutual aid associations (共済組合), and occupational NHI societies (国民健康保険組合) may offer it. Municipal NHI, Kyokai Kenpo, and Seamen's Insurance do not (as of March 2023).²² The difference is explained in Health Insurance Society vs. Kyokai Kenpo.

Some insurers pay automatically from claims, others only on application, and payment often takes two to three months (as of March 2023).²² Subsidy programmes deduct any high-cost benefit and 付加給付 received, so keep the insurer's statements.⁴

Medical expense tax deduction

Infertility treatment and artificial insemination fees paid to a physician count toward the medical expense deduction (医療費控除, iryōhi kōjo) at year-end tax filing.²⁷ The deduction equals the medical costs paid in the calendar year, minus insurance reimbursements, minus ¥100,000 (or 5 percent of total income if that income is under ¥2 million), up to a maximum of ¥2 million (as of April 2026).²⁸ The National Tax Agency publishes the current rules.

Any high-cost benefit received must be subtracted from the costs it relates to.²⁸ Local fertility subsidies are not taxable, but the subsidy amount must also be subtracted when claiming the deduction.²⁹

Prefectural and municipal subsidies

Since insurance began in April 2022, the national IVF and ICSI subsidy no longer carries the load. Prefectures and municipalities run their own programmes on top of insurance; Tokyo's programme from fiscal 2022, for instance, covered only senshin iryo costs.⁴

How the layers stack

In Tokyo, which serves as the example in this section, the order is insurance first, then the Tokyo Metropolitan programme, then a ward top-up. Ward rules on how the layers interact vary; Bunkyo, for example, requires senshin iryo applicants whose treatment started on or after 1 April 2026 to apply to Tokyo first (as of September 2026; confirm current figures with the Tokyo Metropolitan Government and your ward office).⁴⁵

The flow below shows how each layer reduces what is left to pay.^1262245

A typical eligibility pattern, from Tokyo's programme, looks like this: married or de facto from treatment start to application, resident in the jurisdiction over the same period, insured IVF or ICSI, any senshin iryo at a registered institution, and the woman under 43 at treatment start (as of March 2026).⁴ Applications are due after treatment ends, against fiscal-year deadlines.⁴⁵

Other prefectures' programmes differ in amount, eligibility, and deadlines and are not generalized here.

Tokyo as a worked example

Tokyo figures apply only to Tokyo residents

Everything in this subsection describes the Tokyo Metropolitan Government programme and, for the ward layer, Bunkyo Ward. Residents of other prefectures and wards should check their own programmes, which may be smaller, larger, or absent.

For treatment started on or after 1 April 2026, Tokyo subsidizes the self-pay share of insured IVF or ICSI plus any senshin iryo combined with it, up to ¥150,000 per treatment (as of October 2026).^4303132 Applications opened on 1 October 2026 through an online form (as of October 2026).³¹³²

For treatment started before 1 April 2026, only senshin iryo costs are eligible (as of March 2026).⁴³² For treatment started on or after that date, senshin iryo is no longer required: the insured copay alone qualifies, while fully self-pay treatment does not (as of March 2026).⁴

The grant is the lower of ¥150,000 and the insured copay plus senshin iryo cost, minus any high-cost benefit and 付加給付 (as of March 2026).⁴ Tokyo gives these examples:

Insured copay	Senshin iryo	High-cost refund	Eligible amount	As of
¥90,000	¥30,000	None	¥120,000	2026-034
¥120,000	¥90,000	None	¥150,000 (cap)	2026-034
¥200,000	None	¥80,000	¥120,000	2026-034

"One treatment" runs from the treatment plan through the post-transfer pregnancy check, and cannot be split by retrieval or transfer (as of March 2026).⁴³² The age and count rules match insurance: the woman under 43, with a limit of 6 if 39 or under at treatment start and 3 if 40–42; earlier uses of Tokyo's senshin iryo subsidy count toward the limit, while pre-2022 subsidies do not (as of March 2026).⁴

There is no income limit (as of March 2026).⁴ Either spouse must be continuously registered as a Tokyo resident from the first day of treatment to the application, and de facto couples living apart must submit a declaration (as of March 2026).⁴

The deadline is the last day of the fiscal year in which the treatment ended; treatments ending January through March can be applied for until 30 June. Late applications are not accepted for any reason (as of March 2026).⁴ As a fiscal-2026 transitional rule, couples whose treatment ended by 30 September 2026 and who moved out of Tokyo after it ended, also by 30 September, may still apply by the deadline (as of March 2026).⁴

Ward layer: Bunkyo

Bunkyo pays up to ¥50,000 per treatment toward self-paid senshin iryo combined with insured IVF or ICSI, and up to ¥100,000 per treatment where an uninsured element made the whole treatment self-pay (as of September 2026).⁵ For treatment started on or after 1 April 2026, senshin iryo applicants must in principle apply to Tokyo first, and Bunkyo deducts the Tokyo grant from the self-paid amount it subsidizes (as of September 2026).⁵

Couples must be married or de facto, the wife under 43 at treatment start, and either spouse resident in Bunkyo at application; third-party gametes and surrogacy are excluded (as of September 2026).⁵ The deadline follows Tokyo's fiscal-year pattern, and Tokyo-first applicants have one year from the Tokyo decision (as of September 2026).⁵

Layer	What it pays	Cap per treatment	As of
Health insurance	70% of insured fee	n/a	2022-041
High-cost benefit	Copay above monthly cap	Income-banded	2026-0826
付加給付 (some insurers)	Insurer-specific	Insurer-specific	2023-0322
Tokyo Metropolitan	Insured IVF/ICSI copay plus senshin iryo, net of refunds	¥150,000	2026-10431
Bunkyo Ward	Senshin iryo / self-pay remainder	¥50,000 / ¥100,000	2026-095

Egg-freezing subsidies

Tokyo subsidizes non-medical egg freezing for women aged 18–39 on the day of retrieval who live in Tokyo and are freezing out of concern about age-related fertility decline (as of March 2026).³³ The programme started in fiscal 2023.³⁴

The grant is up to ¥200,000 in the year of freezing, then ¥20,000 a year for answering a storage survey through fiscal 2028; women who freeze in fiscal 2026 can receive up to ¥240,000 in total (as of March 2026).³³ Applicants must attend Tokyo's online briefing, register for the survey project, start the procedure within one year of the briefing, and use a registered institution; it is once per person, and those already diagnosed with infertility or covered by cancer-patient programmes are excluded (as of March 2026).³³

No national subsidy for non-medical egg freezing exists. The national programme that does exist supports fertility preservation for cancer patients and similar cases, is run by prefectures, and also helps fund later ART using the preserved eggs, sperm, or embryos.³⁵

That cancer-patient programme is the likely source of claims about a "national ¥200,000 per cycle" egg-freezing grant. Kagawa Prefecture, for example, lists ¥200,000 for unfertilized-egg freezing under it, for women under 43 at freezing (as of September 2022).³⁶ Some local governments have begun subsidizing social egg freezing, and Kanagawa Prefecture notes that views on its merits and drawbacks vary.³⁷

Checking your own municipality

Each prefecture, designated city, and core city runs a 不妊専門相談センター (funin senmon sōdan sentā, "infertility consultation centre") that offers medical and emotional consultation and information on clinics.¹ Your ward or city health centre (保健センター, hoken sentā) page is the other starting point. Rules differ in amount, eligibility, and deadlines.⁴⁵

Useful Japanese search terms are 「不妊治療 助成」 plus your city or ward name, 「先進医療 助成」, 「卵子凍結 助成」, and 「特定不妊治療費助成」.

Applications in Tokyo and Bunkyo typically ask for the following; other municipalities may differ (as of September 2026).²²⁴³²

• A treatment certificate completed by the clinic (受診等証明書; Tokyo's form is downloadable from the TMG site)
• Receipts
• Proof of residence
• Proof of marriage, or a de facto declaration
• The insurer's statement of any high-cost benefit or 付加給付 received

Kyoto City, for example, requires the insurer's statement from anyone who received or will receive such refunds, and may claw back grants if refunds come to light later (as of March 2023).²²

Choosing a clinic and English support

No two clinics offer the same mix of insured care, senshin iryo, and language support, so the choice of clinic shapes both cost and experience.¹

Clinic types and what to compare

When comparing clinics, useful points include the insured and self-pay menus, which senshin iryo the clinic has registered, and how often treatment requires visits.¹ The official records described below show what a clinic is set up to do, not how successful it is.

Facility standards: general care and ART

Each insured fertility fee item can be billed only by a clinic that has notified its Regional Bureau of Health and Welfare (地方厚生局, chihō kōseikyoku) that it meets the 施設基準 (shisetsu kijun, "facility standard") for that item: the staffing and equipment conditions set in the fee schedule.³³⁸ The notifications chain together: insured artificial insemination requires the general-care management fee notification, and insured egg retrieval requires the ART management fee notification (as of April 2022; confirm current figures with MHLW).³⁸

That produces three levels of clinic, summarized below (as of June 2026).

Level	Fee item	Main requirements	As of
General infertility care	一般不妊治療管理料	Obstetrics, gynecology, or urology department; at least 1 full-time physician with 5+ years in obstetrics and gynecology or in urology; at least 1 of them having handled 20 or more infertility cases; its own ART notification or a cooperation arrangement with an ART clinic; cooperation with the national clinic-information project	2026-0639
ART, level 2	生殖補助医療管理料2 (250 points, monthly)	Same departments; a full-time physician with 5+ years in obstetrics and gynecology or urology and 2+ years in ART; a full-time physician with 1+ year of ART at a JSOG-registered facility; a gamete and embryo manager; JSOG IVF registration and online case reporting; dedicated retrieval, culture, and cryopreservation rooms; safety management and mix-up prevention; after-hours emergency arrangements; cooperation with the national clinic-information project	2026-06340
ART, level 1	生殖補助医療管理料1 (300 points, monthly)	Everything in level 2, plus a dedicated staff member, such as a nurse or certified psychologist, to handle patient consultations, and a staff member, such as a social worker, to coordinate with health and welfare services	2026-06340

The general-care 20-case minimum has changed since 2022. The original 2022 standard required the institution to treat 20 or more infertility cases a year, while the current standard requires at least one physician to have handled 20 or more cases, and the 2026 filing form asks for each physician's case count.³⁸³⁹⁴¹

A clinic that has filed only the general-care notification can offer timing and insured artificial insemination, and the rules direct it to refer patients to a cooperating ART clinic when needed (as of April 2022).³⁸ Read against the standard, a clinic billing the level 1 ART fee has consultation staff on site, while a level 2 clinic meets the same clinical and safety standards without that requirement.⁴⁰

Checking a clinic's filing

The regional health bureaus, which are part of MHLW, publish lists of institutions whose facility notifications have been accepted.¹⁰¹¹ Which bureau to check depends on the clinic's prefecture, and list formats differ between bureaus.

The Kanto-Shinetsu bureau, covering Tokyo, Kanagawa, Saitama, Chiba, and six other prefectures, publishes the lists by prefecture in PDF and Excel, alongside its list of institutions approved for senshin iryo (as of September 2026).¹⁰ The Kyushu bureau updates its comprehensive list around the 10th of each month (as of October 2026).¹¹

Search the list for the clinic's prefecture by clinic name, then look for 一般不妊治療管理料 (general care) or 生殖補助医療管理料 (ART) among its accepted items.¹⁰¹¹

The Children and Families Agency clinic search

The Children and Families Agency (こども家庭庁) runs a clinic search on its site 「みんなで知ろう、不妊症不育症のこと」, filterable by prefecture and treatment type (as of October 2026).⁴² Cooperating with this national information project is part of the facility standard for general-care, ART, and TESE clinics (as of August 2024).⁴³

Clinics register facility details, the fee items they have notified, staffing, their treatment menu including senshin iryo, and their treatment policy (as of August 2024).⁴³ They also register results as age-banded counts of procedures performed, plus age-banded safety data on ovarian hyperstimulation syndrome and multiple pregnancy (as of August 2024).⁴³

Procedure counts are not success rates

The results clinics register for the national search are counts of procedures performed by age band, not pregnancy or live-birth rates.⁴³ Use the search to see what a clinic offers and how much it does, not as an official comparison of success rates.

JSOG registration

Separately from the fee schedule, JSOG members performing IVF or ICSI must register with JSOG and report their cases.⁴⁴¹⁵ Registration is renewed through a strict review every five years, and JSOG deletes a facility that performs no IVF, ICSI, or frozen embryo transfer for three consecutive years, after checking that it holds no frozen embryos.⁴⁵

Registered facilities report each case online, and JSOG compiles and analyses the results by facility every year.⁴⁵ JSOG's registration committee page and patient FAQ do not publish those per-facility results as success rates.⁴⁵⁴⁶

JSOG's online facility search, linked from its website, covers five registration categories: IVF and embryo transfer; freezing and transfer of embryos and eggs; ICSI; medical-indication freezing of eggs, embryos, and ovarian tissue; and donor insemination (as of October 2026).⁴⁶ JSOG notes that the data reflect each facility's five-yearly renewal or change filing, so ask the clinic directly for current information.⁴⁶

Because JSOG IVF registration is itself a condition of the insured ART standard, a clinic billing insured ART should appear both in its regional bureau's list and in JSOG's registry.⁴⁰

How often you will need to visit

MHLW's handbook on combining fertility treatment with work gives a rough guide to visit days per menstrual cycle (as of March 2025).⁴⁷ MHLW notes that the figures can rise or fall with the doctor's judgment, individual circumstances, and physical condition.⁴⁷

Treatment	Women: visits per menstrual cycle	Men	As of
General infertility care	2–6 days, about 1–2 hours each	None to half a day (1 day if surgery)	2025-0347
ART	4–10 days of 1–3 hours each, plus 1–2 days of half a day to a full day each	None to half a day (1 day if surgery)	2025-0347

Visits follow the ovulation cycle and, in ART, the ovaries' response to stimulation drugs, so dates can be hard to fix in advance (as of March 2025).⁴⁷ One IVF attempt, from tests through stimulation, retrieval, freezing, and transfer, takes about 3 months at minimum and about 6 months typically (as of March 2025).⁴⁷

Schedules differ between facilities, though each facility's own schedule is usually fairly fixed, so ask about consultation hours and visit patterns when comparing clinics (as of March 2025).⁴⁷ In an MHLW survey for fiscal 2023, 49.3 percent of workers who could not combine treatment with work cited unpredictable visit times or being unable to take time off on doctor-specified days (as of March 2025).⁴⁷

Finding English-language support

In Tokyo, the Tokyo Metropolitan Health and Medical Information Center "Himawari" (ひまわり) runs a foreign-language line at 03-5285-8181 in English, Chinese, Korean, Thai, and Spanish, from 9:00 to 20:00 daily (as of May 2026). It is free apart from call charges and directs callers to institutions offering their language.⁴⁸

The AMDA International Medical Information Center (0120-339-266) offers phone interpretation for medical visits in several languages, with availability varying by weekday (as of May 2026).⁴⁸ Nationwide, the Immigration Services Agency points to MHLW's Medical Information Net (NAVII) and JNTO's search for institutions that accept foreign patients.⁶

Treatment plans and consent are written documents, so ask the clinic in advance what language support it provides for them.³ More general guidance is in Finding an English-Speaking Provider.

Legal limits on egg freezing, donor conception, and surrogacy

Much of what is permitted in this area rests on JSOG's professional guidelines rather than statute. Only one law, the 2020 parentage act, is in force.¹⁵⁴⁹

Egg and sperm freezing

JSOG's guideline permits freezing unfertilized eggs, embryos, or ovarian tissue for women whose fertility is expected to be lost through cancer treatment, at JSOG-registered ART facilities, with written consent.¹⁵ This medical-indication freezing is supported by the national, prefecture-run fertility-preservation programme described above.³⁵

For non-medical ("social") egg freezing, JSOG's list of ethics guidelines contains no view (as of June 2026; confirm current guidance with JSOG).⁴⁴ The Japan Society for Reproductive Medicine (日本生殖医学会) issued a guideline on social egg freezing in 2013, and states that the guideline does not recommend egg freezing or postponing pregnancy and birth.³⁷

Unfertilized egg freezing is not on the insured menu (as of April 2022).²

Donor sperm and donor eggs

Insurance excludes all treatment with third-party sperm, eggs, or embryos.² JSOG's guideline on donor insemination (提供精子を用いた人工授精, AID) limits it to legally married couples, in principle for azoospermia, with anonymous donors, no more than 10 children per donor, and no payment for donation.¹⁵

That married-only rule is professional self-regulation, not law. As of October 2026, no statute governs who may donate or receive sperm or eggs in Japan.^1549505152

The 2020 parentage act (in force)

Act No. 76 of 2020, the "Act on Assisted Reproductive Technology Offering and the Special Provisions of the Civil Code Related to the Parent-Child Relationship," was promulgated on 11 December 2020, with its parentage provisions taking effect one year later.⁴⁹ It does three things that matter here:

• Basic principles (Art. 3): ART must be properly conducted, with necessary and appropriate explanations and the sufficient understanding of those involved.⁴⁹
• Mother (Art. 9): a woman who conceives and gives birth using another woman's eggs is the child's mother.⁴⁹
• Father (Art. 10): a husband who consented to his wife's treatment with another man's sperm cannot later deny paternity.⁴⁹

The act does not regulate who may donate or receive gametes. Its supplementary provisions called for a review of that question in roughly two years, and the legislation meant to follow has not been enacted.⁴⁹⁵⁰

The Specified Assisted Reproductive Medicine Bill (not law)

Two versions of a donor-conception bill exist, and they differ on who would be eligible. Neither is law.⁵⁰⁵³

Neither donor-conception bill version is law

The 2025 bill lapsed without a vote, and the 2026 revision has only been reported as a draft. Until a bill is passed, JSOG guidelines and the 2020 parentage act are the only framework.⁵⁰⁵⁴⁵³

The 2025 bill (lapsed). The 特定生殖補助医療に関する法律案 (tokutei seishoku hojo iryō, "specified assisted reproductive medicine," meaning treatment with sperm or eggs from a third party other than the spouse) was submitted to the House of Councillors on 5 February 2025 as a member's bill and referred to the Cabinet Committee on 30 May 2025.⁵⁰⁵⁵ It was never voted on and lapsed (審議未了, shingi miryō, "deliberation not completed") when the session closed, and JSOG expressed regret at that outcome.⁵⁰⁵⁴

As described by a sponsoring party's newspaper, the 2025 bill would have limited donor conception to legally married couples and excluded surrogacy. It would also have let children aged 18 or over obtain non-identifying donor information such as height, blood type, and age, held for 100 years at the National Center for Child Health and Development (国立成育医療研究センター), and banned payment for donation.⁵⁵

The 2026 revised draft (reported only). Kyodo News reported on 14 May 2026 that the cross-party group behind the bill had revised the draft to delete the legally-married-only provision, leaving a route for de facto couples (as of May 2026).⁵³ The 100-year retention and the right to request donor information from age 18 (出自を知る権利, shutsuji o shiru kenri, "right to know one's origins") were kept; the report did not describe how the draft treats surrogacy.⁵³

The group aimed to submit the draft in the session then sitting, but the outlook was unclear. No such bill appears on the House of Councillors bill list for the 221st Diet session (February to July 2026), or on the list for the 222nd session that convened on 5 October 2026, as of 9 October 2026.⁵¹⁵²

The sequence so far, with nothing in it yet enacted beyond the 2020 act, is below.^4950535152

Insurance does not cover donor eggs, and no statute regulates their use.²⁴⁹⁵⁰

Surrogacy and treatment abroad

JSOG prohibits surrogacy (代理懐胎, dairi kaitai): members must not perform ART for surrogacy, be involved in it, or broker it, whether paid or unpaid.¹⁵ Insurance excludes it.² The lapsed 2025 bill would also have excluded surrogacy by statute, but it did not pass.⁵⁰⁵⁵

Under Article 9 of the 2020 act, the woman who gives birth is the legal mother.⁴⁹ That rule bears directly on parentage, and potentially on the child's nationality, when couples pursue egg donation or surrogacy abroad, so take advice from a lawyer before starting treatment outside Japan.

Good to know

Adding an unapproved self-pay option can make the whole cycle self-pay

Japan permits combining insured and uninsured care only within a defined framework that includes senshin iryo.² Clinic guidance treats retrieval through transfer as one treatment, so adding any self-pay item that is not approved senshin iryo counts as mixed billing (混合診療, kongō shinryō) and makes the whole treatment self-pay.¹⁴

The same logic blocks using insured frozen embryos for a planned self-pay course (as of January 2023; confirm current figures with MHLW).¹³ Fully self-pay treatment is also excluded from Tokyo's subsidy (as of March 2026), so the loss can be larger than the add-on itself.⁴

Documenting a marriage without a koseki

The fee schedule requires the clinic to confirm marriage or an intent to acknowledge the child, but leaves the documents to clinic practice (as of June 2026).³ Clinics may ask for documents to confirm a de facto relationship.¹

A heterosexual de facto couple can have their relationship recorded on the juminhyo as 夫（未届） or 妻（未届）, "husband (unregistered)" or "wife (unregistered)."⁵⁶ Couples without a koseki, including two foreign nationals, should ask the clinic before the first visit which documents it accepts. Marriage Between Two Foreigners in Japan covers the marriage process itself.

Same-sex couples and municipal partnership certificates

Insurance excludes third-party gametes, which a same-sex couple would need, and JSOG's donor-insemination guideline is limited to legally married couples.²¹⁵ Reporting by Cronkite News describes same-sex couples as unable to use insured fertility treatment.⁵⁷

Shinagawa Ward, for example, began recording same-sex partners as 夫（未届） or 妻（未届） on copies of the juminhyo from October 2025, for holders of a Tokyo Partnership Oath certificate. The ward states that this notation has no legal effect, and that the relationship is still reported to other agencies as 同居人 (dōkyonin, "cohabitant") (as of September 2025).⁵⁶ The wider legal picture is in Same-Sex Marriage Status in Japan.

The My Number insurance card replaces the limit certificate

Presenting the My Number Card as your insurance card at the clinic window has the same effect as a limit-application certificate: you pay only up to the monthly cap.²⁵ That avoids paying a full retrieval month up front and waiting for a refund. Maina-Hokensho: Health Insurance Card Going Digital explains the card.

Changing jobs or insurers mid-treatment

The transfer cap is counted per patient, not per insurer: at every new treatment plan, the clinic confirms and records the cumulative transfer count (as of June 2026).³ Tell any new clinic your full history and previous clinics, as MHLW asks.¹

If you change insurers, the limit certificate comes from the new insurer (or, for NHI, from your municipal office), so apply again or use the My Number Card as your insurance card.¹²⁵

Plan transfers around the calendar month

The high-cost cap applies per calendar month. Costs that fall in one month are capped once, while the same costs split across two months can each reach the cap.¹⁶²² Discuss with the clinic whether retrieval and transfer can be scheduled with this in mind.

Since August 2026, an annual cap running from August to July also limits total insured copays over the year (as of July 2026).²⁵²⁶

After pregnancy is confirmed

Once pregnancy is confirmed, you must notify your municipality promptly, and the municipality issues the 母子健康手帳 (boshi kenkō techō, maternal and child health handbook).⁵⁸ Ask the fertility clinic when and to whom it will refer you for ongoing pregnancy care. The ward-office steps are in Confirming Pregnancy and Registering at the Ward Office.

See also

• What Insurance Doesn't Cover
• Health Insurance When Changing Jobs in Japan
• Prenatal Checkup Vouchers and Subsidies
• Childbirth Lump-Sum Benefit (Shussan Ikuji Ichijikin)
• Medical Japanese: Intake and Symptom Description

References

Footnotes

1. 厚生労働省 (MHLW). 「令和4年4月から、不妊治療が保険適用されています。」 patient leaflet, with reverse-side 「不妊治療の保険適用に関するQ&A」 (R4.11.1). Hosted by こども家庭庁 (Children and Families Agency) on its 不妊治療に関する取組 page (2023-04-01 version). https://www.cfa.go.jp/assets/contents/node/basic_page/field_ref_resources/bef0ee9a-c14d-4203-b02b-051adf80f495/cf3a6623/20230401_policies_boshihoken_funin_01.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶ ↩²⁷ ↩²⁸ ↩²⁹ ↩³⁰ ↩³¹ ↩³² ↩³³ ↩³⁴ ↩³⁵ ↩³⁶ ↩³⁷

2. 厚生労働省保険局医療課. 「令和4年度診療報酬改定の概要 不妊I（概要、先進医療、医薬品、移行措置）」 (令和4年3月4日版), slides 4–12. https://www.mhlw.go.jp/content/12400000/000911818.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶ ↩²⁷ ↩²⁸ ↩²⁹ ↩³⁰ ↩³¹ ↩³² ↩³³ ↩³⁴ ↩³⁵ ↩³⁶ ↩³⁷ ↩³⁸ ↩³⁹ ↩⁴⁰ ↩⁴¹

3. Knowlety. 「B001n33 生殖補助医療管理料」, 令和8年度診療報酬改定 (updated 2026-06-09). https://knowlety.jp/ika/b001n33/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰

4. 東京都福祉局. 「不妊治療費助成制度Q&A」 (2026-03). https://www.fukushi.metro.tokyo.lg.jp/documents/d/fukushi/-202603qa-2- ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶

5. 文京区. 「不妊治療費（先進医療及び自由診療）の一部助成について」 (updated 2026-09-30). https://www.city.bunkyo.lg.jp/b027/p001534.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

6. 出入国在留管理庁 (Immigration Services Agency). "Guidebook on Living and Working," Chapter 6 "Medical Services." https://www.moj.go.jp/isa/content/001453600.pdf ↩ ↩² ↩³

7. 岐阜県. 予算要求資料 「不妊治療助成事業費」 (令和2年度3月補正予算). https://www.pref.gifu.lg.jp/uploaded/attachment/230593.pdf ↩

8. Knowlety. 「B001n32 一般不妊治療管理料」, 令和8年度診療報酬改定 (updated 2026-06-09). https://knowlety.jp/ika/b001n32/ ↩ ↩² ↩³ ↩⁴

9. Knowlety. 「K884-2 人工授精」, 令和8年度診療報酬改定 (updated 2026-06-09). https://knowlety.jp/ika/k884-2/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

10. 関東信越厚生局. 「保険医療機関・保険薬局の施設基準の届出受理状況及び保険外併用療養費医療機関一覧」 (updated 2026-09-15; data as of 2026-08-01). https://kouseikyoku.mhlw.go.jp/kantoshinetsu/chousa/kijyun.html ↩ ↩² ↩³ ↩⁴

11. 九州厚生局. 「届出受理医療機関名簿」 (data as of 2026-10-01). https://kouseikyoku.mhlw.go.jp/kyushu/gyomu/gyomu/hoken_kikan/index_00007.html ↩ ↩² ↩³ ↩⁴

12. Knowlety (medical fee-schedule database reproducing MHLW 告示 and 通知). 「K884-3 胚移植術」, 令和8年度診療報酬改定 (updated 2026-06-09). https://knowlety.jp/ika/k884-3/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹

13. 厚生労働省保険局医療課. 「疑義解釈資料の送付について（その37）」 事務連絡 (令和5年1月12日), 別添 不妊-1 to 不妊-5 (republished by 東海北陸厚生局). https://kouseikyoku.mhlw.go.jp/tokaihokuriku/iryo_hoken/gigi/000263564.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹²

14. 医療法人社団 原レディースクリニック (宮﨑薫 監修). 「体外受精の保険適用｜何歳まで・何回まで？条件と先進医療・高額療養費【2026年最新】」 (updated 2026-07-28). https://www.haramedical.or.jp/column/insurance_coverage.html ↩ ↩² ↩³ ↩⁴ ↩⁵

15. 日本産科婦人科学会. 見解・指針 collection, 日産婦誌78巻8号 (2026-08): 「体外受精/顕微授精・胚移植に関する見解・指針」 (p.1056), 「医学的適応による未受精卵子，受精胚および卵巣組織の凍結・保存に関する見解・指針」 (p.1057), 「提供精子を用いた人工授精に関する見解・指針」 (p.1060), 「代理懐胎に関する見解・指針」 (p.1081). https://fa.kyorin.co.jp/jsog/readPDF.php?file=78/8/078081051.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

16. 全国健康保険協会 (Kyokai Kenpo). 「高額な医療費を支払ったとき（高額療養費）」 FAQ. https://www.kyoukaikenpo.or.jp/faq/benefit/004/index.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

17. 第一生命経済研究所 (重原正明). 「2024～2025年の先進医療は不妊治療関係中心に増加」 (2025-12-18). https://www.dlri.co.jp/report/ld/556120.html ↩ ↩² ↩³

18. 第一生命経済研究所 (重原正明). PGT-A 先進医療B 了承 report (2023-03-16). https://www.dlri.co.jp/report/ld/236667.html ↩

19. 日刊薬業 (nk.jiho.jp). 「着床前胚異数性検査を『適』　先進医療B」 (2025-01-10). https://nk.jiho.jp/article/195817 ↩

20. 公益財団法人 生命保険文化センター. 「不妊治療の保険適用」 (ライフイベント解説). https://www.jili.or.jp/lifeplan/lifeevent/792.html ↩

21. よしひろウィメンズクリニック. 「【最新】不妊治療・体外受精の料金完全ガイド2026」 (updated 2026-10-02). https://yoshihiro-womens.clinic/blog/taigaijusei/in_vitro_fertilization_costs/ ↩ ↩²

22. 京都市. 「高額療養費や付加給付について」 (令和5年3月現在), fertility-subsidy applicant handout. https://www.city.kyoto.lg.jp/hagukumi/cmsfiles/contents/0000173/173095/kougaku_chirashi.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

23. 厚生労働省. 「診療報酬の算定方法」 (平成20年3月5日厚生労働省告示第59号; current text reflecting 令和8年3月5日厚生労働省告示第69号, applied from 2026-06-01), 法令等データベース. https://www.mhlw.go.jp/web/t_doc?dataId=84aa9729&dataType=0&pageNo=1 ↩

24. Knowlety. 「K917 体外受精・顕微授精管理料」, 令和8年度診療報酬改定 (updated 2026-06-09). https://knowlety.jp/ika/k917/ ↩ ↩² ↩³

25. 厚生労働省. 「高額療養費制度を利用される皆さまへ」 (updated 2026-07-31). https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/iryouhoken/juuyou/kougakuiryou/index.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹

26. 厚生労働省. 「（参考）高額療養費制度の見直しについて」 (table: 現行 / R8.8～ / R9.8～). https://www.mhlw.go.jp/content/12400000/001661792.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹

27. 国税庁 確定申告書等作成コーナー. 「不妊症の治療費や人工授精の費用」. https://www.keisan.nta.go.jp/r3yokuaru/cat2/cat22/cat221/ocat324/cid077.html ↩

28. 国税庁 (NTA). 「No.1120 医療費を支払ったとき（医療費控除）」 (令和8年4月1日現在法令等). https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1120.htm ↩ ↩²

29. 国税庁 質疑応答事例. 「不妊治療費助成金に係る所得税の取扱いについて」. https://www.nta.go.jp/law/shitsugi/shotoku/01/08.htm ↩

30. 東京都. 「不妊治療費の助成拡大について」 press release (2026-03-27). https://www.metro.tokyo.lg.jp/information/press/2026/03/2026032713 ↩

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