B) Pay Attention to the IVF limitations covered by Japanese health insurance
①Insured and uninsured medical treatments cannot be combined.
During the insurance cycle, it is prohibited to utilize uninsured tests or medication. For example, patients who are currently in the insurance cycle are not permitted to undergo reproductive immunology testing which helps identify the cause of IVF implantation failure.
Even though uninsured medications are required to manage the problem identified during reproductive immunology testing, it is not allowed to prescribe these medications during the entire insurance cycle.
In Taiwan, fertility treatments do not distinguish between insured and uninsured. Physicians and patients have the flexibility to combine any necessary tests and medications, enabling them to efficiently and effectively achieve a successful pregnancy.
②Age and IVF attempt limits：
The number of attempts is calculated by the number of embryo transfers conducted.
- Women < 40 years old are allowed a maximum of 6 attempts per child.
- Women aged 40 - 42 years old are allowed a maximum of 3 attempts per child.
- Women ≥ 43 years old are not eligible for insurance coverage.
If the embryo transfer limit is exceeded, insurance for IVF is not available.
⚠️ Note:
The insured IVF program does not normally permit a repeat egg retrieval cycle if you already have insured frozen embryos.
If you already have insured frozen embryos in storage, your next action should be insured embryo transfer and you will not be able to undergo insured egg retrieval again.
If you wish to undergo egg retrieval again in order to obtain higher-quality embryos, you will have to bear the cost yourself as the insurance IVF program does not allow the accumulation of embryos. The embryo transfer cycle using these uninsured embryos will also be at your own expense.
③Examination limitation:
⚡Embryo preimplantation genetic testing (PGT)
Chromosome abnormalities in embryos are the main cause of miscarriages. Unfortunately, Japanese health insurance does not cover genetic testing for embryos. Therefore, if you decide to undergo embryonic genetic testing, you will have to bear the expense of the entire IVF cycle from egg retrieval to embryo transfer on your own.
⚡Reproductive immunology testing
Reproductive immunology testing of the mother aims to identify the root causes of infertility, recurrent miscarriage or repeated failure of IVF.
This type of testing helps detect factors that indicate overactive immune responses targeting the embryos, or blood clotting disorders that may impair placental blood flow, potentially resulting in pregnancy termination.
Unfortunately, Japanese health insurance does not cover this specific screening but you can do it at your own expense outside the insurance cycle.
⚡Ultrasounds and blood tests can only be conducted at a frequency that is eligible for insurance coverage
④Medication limitation:
💊 Insurance coverage does not include immune-related medication that aids in regulating the mother's immune system to safeguard embryos from potential harm, as well as blood thinner shots. If you require these medications, you will need to cover the expenses for the entire IVF cycle by yourself.
💊 Insurance will only cover certain medications and dosages.
💊 Many preventive medications for ovarian hyperstimulation syndrome (OHSS📝) are not covered by insurance. As a result, in insured ovulation inductions, the priority is to reduce the chances of OHSS. This implies placing a cap on the maximum number of eggs that can be collected per egg retrieval cycle.
📝OHSS (Ovarian Hyperstimulation Syndrome)
Typically, during a menstrual cycle, a woman releases just one egg. However, in the case of IVF treatment, hormonal medications are used to stimulate the production of multiple eggs at once. Occasionally, the ovaries can overrespond to these medications, resulting in a condition known as OHSS (Ovarian Hyperstimulation Syndrome).
OHSS is a relatively rare occurrence, affecting less than 5% of individuals undergoing controlled ovarian stimulation for fertility treatment. Severe cases of OHSS are even rarer, happening in less than 1% of people receiving ovarian stimulation.
Mild to moderate OHSS is characterized by symptoms such as abdominal pain, bloating, slight weight gain and nausea. In more severe cases, symptoms can include excessive weight gain, severe nausea and vomiting, severe abdominal swelling, difficulty breathing, blood clots, decreased urination and severe abdominal pain.
Treatment for mild to moderate OHSS typically involves avoiding vigorous physical activity, consuming electrolyte-rich fluids and using pain relievers to alleviate symptoms. However, severe cases of OHSS often require hospitalization for proper management and care.