NPO Fine is an advocacy organization that supports persons with infertility experience in the past, present and future.
August 2015
To the press and whom it may concern
Announcement

Research Report on the “Questionnaire Survey on Work-Treatment Balance”
Based on the voices of 2,265 respondents, only 6% answered “there is a support system for fertility treatment
in workplace” and 92% found “difficulty in balancing work and treatment.”
NPO Fine (Fertility Information Network) http://j-fine.jp/

NPO Fine is a self-support group for infertility patients and those who are suffering from infertility by the peoplewho have had the experience of infertility. Fine carried out the “Questionnaire Survey on Work-Treatment Balance”
which was answered by 2,265 respondents. We report that the result showed many working women who are going
through a treatment found it difficult to gain support and maintain work-treatment balance.

The actual situation surrounding the respondents clarified in this research shall be disseminated for educational
purpose on infertility and lobbying the government as materials for the submission of our demand statements to theMHLW. We sincerely request that the survey results are featured by your medium for raising awareness in society
at large. More detailed questionnaire survey results will be released on our website.

Summary of survey results● Of those who have received fertility treatment while working, 91.9% found “difficulty in balancing work andtreatment” (Q4), of which 42.3% changed their work forms, including retirement (Q5).
● Only 5.9% answered “there is a support system for fertility treatment in workplace” (Q12). Systems forholiday/temporary retirement and flexible working and employment are required (Q17).
● Including the above, this survey results showed that many of fertility treatment patients continue to work in orderto squeeze out a heavy cost of fertility treatment, accompanying an extreme difficulty in balancing work andfertility treatment, that these people are caught in a dilemma. In addition, while the government and companies areworking to promote women’s social advancement, the reality shows that supporting systems are still in adequate. In
the declining birthrate and aging society, the development of flexible employment and work forms, not only infertility treatment, but also in child care and long-term care, and the organization and societal culture that allows
their use without hesitation are critical, which, we believe, should be supported by society as a whole.

Survey Outline◆Survey objectives◆“Questionnaire Survey on the Financial Burden of Fertility Treatment Part 2" conducted by NPO Fine in 2012 (No.
of respondents = 1,993) revealed the reality of “financial burden” in fertility treatment. Many voiced that, although
they are willing to continue their “work” in order to squeeze out the treatment cost, balancing fertility treatment andwork accompanies a considerable difficulty. Therefore, this survey focused on the "balance between work and1/8

NPO Fine is an advocacy organization that supports persons with infertility experience in the past, present and future.
fertility treatment" and delved into the causes of the difficulty in balancing work and fertility treatment. In order toconsider the needed support for maintaining the balance, we have assessed the present situation, as well as to gather
opinions from a broader population.
◆Survey method◆
Setting the questionnaire form on NPO Fine’s website. Announcement to a broader population including Finemembers. In a total of 35 questions, 20 questions addressed the work-treatment balance and support in theworkplace and other questions covered treatment cost, attributes of respondents, and so forth.
Note) The questionnaire adopted multiple-choice and open-ended questions. As the percentages in the texts and graphs are calculated by rounding a
number with 2 decimal places, there may be a slight gap.

◆Scope of the survey◆
2,265 persons who are interested in fertility treatment (of which 95.0% have the experienced of fertility treatment)◆Survey period◆
May 15, 2014 - January 5, 2015

Excerpts from the survey results
Q2: Please select your current employment form.

Q2. Employment forms of working respondents (N = 1,566)
18, 1.2%

546, 34.9%

914, 58.3%
Regularemployees

Non-regular employees (part-timers, contract andtemporary employees)

Self-employed,
freelance

88, 5.6%
OtherThe survey result showed that approximately 60% of those who are currently not working retired for the reason oftreatment and approximately 90% of the total have worked and received treatment in the past.
Q4: Have you ever felt difficulty in balancing work and treatment?
Of 2,152 respondents who have the experience of fertility treatment, 1,978 (91.9%) answered that they “feltdifficulty in balancing work and treatment.”

Q5-Q6: Reasons for the difficulty in balancing work and fertility treatment and theirconsequential actions
Q6: If there was any change to work condition, what was the reason? (N=836, multiple answers)
Depending on the treatment stage, fertility treatment cannot predict when the next consultation will be. Therefore,
many are forced to be late for work, leave early or change their schedule in the last minute for the treatment and2/8

NPO Fine is an advocacy organization that supports persons with infertility experience in the past, present and future.
hospital visits. In addition, there is a serious psychological strain as understanding and support are hard to gain
(Q6).
Q6: What caused to change the work condition?
(N=836, multiple answers)
Treatment requires frequenthospital visits.

568

It takes time to visit hospital andreceive consultation.

534

There is a serious psychologicalstrain.
One cannot assume responsibility
while on treatment.
There is a serious physical strain.
It is hard to gain cooperation andsupport for the treatment inworkplace.
It is hard to gain understanding forthe treatment in workplace.

446
386
335
333
303
54

Other

persons

The result showed that more than 40% changed their work conditions (Q5).
Q5: Have you ever changed the work condition as a result of balancing treatment and work?
Of 1,978 respondents, 836 (42.3%) answered that they have changed the work condition as a result of balancing
treatment and work. Breakdown showed 527 (63.0%) for retirement, 121 (14.5%) for job change, 104 (12.4%) for
temporary retirement and 84 (10.1%) for transfer.
Q9 & Q10: Did you find it difficult to talk about the treatment in your workplace? What was the reason?
Of those who answered that they have talked about the treatment in workplace, 68.8% answered “Yes (that theyfound it difficult to talk about the treatment)” (Q9). The most common reason for not to talk about the treatment
was that they “did not want the others to know about infertility.” Also many voiced that they “did not want to causeinconvenience to others by the treatment” (Q10). These are not just concerns by the respondents, but the severe
reality in workplace, as the following comments show.

Behind the above concerns...
•“Understanding from my colleagues was limited that if I am late, leave early or make other changes in the lastminute, I could hear my colleagues talking behind my back. I was stressed and consequently left the job.”•“When I informed about the IVF treatment, my supervisor said ‘Get on with it and do it right in one go.’Considering there are many who suffer from infertility for many years, I was devastated by such words even before
starting the treatment and the thought that such a harassment would continue every time.”

Q12~17: Fertility treatment support system in workplace
Only 5.9% answered “Yes” for having a fertility treatment support system in their workplaces and 78.9% answered
“No.”
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NPO Fine is an advocacy organization that supports persons with infertility experience in the past, present and future.
Q12: Is there any supporting system, etc. for fertility treatment in your workplace?
(N = 2,265/2,265)
50, 2.2%

110, 4.9%

184, 8.1%
No134, 5.9%

Yes
Not sure
OtherNo response
1,787, 78.9%

Q17: What kind of support is needed in your workplace? (N=1,385, multiple answers)
In addition to financial support, many requested changes to working and employment environment. In particular,voices seeking flexible use of the systems depending on various life events were eminent.

Q17: What kind of support is needed in your workplace?
(N = 1,385/1,385, multiple answers)
Holiday/temporary
retirement system

1,045Work hour system

1,029

Loan and financial
assistance for treatment

659
399

Re-employment system

Employment system forsupporters
Information service andeducational activities

318
285
163

Establishment of counselingoffice29
persons

Other

The following graph shows the “needed support” by age. Respondents in their 30s, who are becoming busy in theirwork and moving onto a higher position, showed greater needs, seeking support for “holidays/temporary
retirement,” “work hours” and others concerning time management.

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Q17: What kind of support is needed in your workplace? (by age)
(N = 1,385, multiple answers)
Persons
1,600
1400

600

Other
Information service and educational
activities
Establishment of counseling office
Loan and financial assistance fortreatment
Holiday/temporary retirement system

400

Re-employment system

200

Employment system for supporters

1200
1000
800

0Work hour system~2425~29

30~34

35~39

40~44

45~49

50~

OtherAgeOn the other hand, some said they do not seek support from their workplaces. Comments are excerpted below.
Intention for “not seeking support from workplace”• “It is not that I am ill, and the treatment is for my personal reason, so I do not want any preferentialtreatment. It would help me if my employment form is changed to a part-timer temporarily, based on
the premise that I will be reinstated as a regular employee...”• “I believe the system where reduced work hour and other options can be freely selected depending on
lifestyle would be helpful, but not in the pretext of a support to fertility treatment. I hope that such
system can be also used for pregnancy, child caring and long-term care.”◆Findings from the survey results◆
Number of children who are born by ART such as IVF and micro fertilization in Japan was 37,953 in 2012 andshows that approximately 1 in 27 live births is born by ART. Furthermore, live births by ART accumulates to341,750 in Japan (Note 1). Having a child by fertility treatment is by no means uncommon now.
However, the advanced treatment requires high cost. According to the results from NPO Fine’s “Questionnaire
Survey on the Financial Burden of Fertility Treatment" conducted in 2010, one cycle of IVF or micro fertilization
costs between 300,000 to 500,000 yen. By repeating the treatments, the cost becomes high. The subsidy programsby the national and local governments benefit 150,000 yen per treatment (75,000 yen depending on the content oftreatment) with restrictions on the frequency and the combined income of the couple, as well as the age of a wife.
Therefore, the treatment cost cannot be covered by a subsidy alone. In order to raise the money for the treatment
cost, the environment that ensures work-treatment balance becomes essential for the patients receiving fertility
treatment.
Companies that provide a supporting system for the treatment are extremely rare, and the survey result showed
only 5.9% answered “Yes” for the question on the existence of any supporting system in workplace (Q12).
Furthermore, it is a reality that more than 40% had to change their work form, including retirement (Q5).
Understanding and support from companies and the national and local governments are required so that women areable to enjoy pregnancy, childbirth, child caring and fertility treatment while working.
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NPO Fine is an advocacy organization that supports persons with infertility experience in the past, present and future.
Some comments are introduced from open-ended answers.

•If I let go of my regular employee status and my treatment is unsuccessful, I would have lost everything. So I feel I cannot
commit myself to leave my work.

•Although I would like to reduce my work hours, that would reduce my salary and I could not afford the fertility treatment cost.
It is difficult to return to office as a regular employee once you become a non-regular employee.

•If you cannot gain understanding of colleagues in your workplace, it is difficult as you cannot take a day-off.

•As women are often taking care of housework, balancing work, housework and treatment was extremely tough. Even my work
hours were reduced, physical and psychological burden was too much.

What are the specific systems needed by the respondents to maintain the balance?
Many requested for flexible work and employment environment, such as reduced work hours, flextime systemand other temporary change of employment form. For this open-ended question, there were over 400 comments.
Among them were voices for improving the current work environment where “paid leaves, reduced work hour andflextime system can be used” and “long-hour labor is reduced,” rather than seeking a “new system” in order tomaintain the balance. We believe these comments are overarching requests that not only apply to the “balance
between fertility treatment and work,” but also to childcare and long-term care.

While it is important that companies establish a supporting system, the survey result showed that a majority ofrespondents have not used the system even though they are entitled to. Therefore, we believe there is a need forunderstanding and cooperation for infertility and the fertility treatment in the company and to change the soft
aspect of corporate culture that supports reinstatement after pregnancy, childbirth and child caring. Some
comments are introduced below.
•Local government employees are known to be entitled to rich welfare package, however, actually benefiting from it often receives
criticism from others and is not easy.

•I hope the company would understand a sudden day-off can happen. There are many who wish to properly perform their duties.
For those who hold that strong sense of responsibility, it truly becomes psychologically hard to accept the reality.

•Understanding of a supervisor. Understanding of the workplace will make a great difference in psychological burden of fertility
treatment that extends for a long period of time. I was heartily grateful for my supervisor’s understanding in my workplace.

•The reality is that people rarely have accurate knowledge on the fertility treatment. I hope that companies, and society, would
conduct training to promote understanding of infertility.

•Promote diversification of work styles. Improve operational efficiency and reduce unnecessary overtime work. Change thementality that overtime work is a virtue. Promote the diverse work styles, such as telecommuting. Not only in the case of fertility
treatment, ensure that all employees are able to enjoy their holidays by firmly legislating the upper limit of the statutory work
hours to eliminate the long work hours. By doing so, more women would be able to have a child when they are young without thefertility treatment through prevention of pregnancy in the older age.

Almost every respondent answered to the open-ended question, “Do you feel support outside your Company isneeded for work-treatment balance?” Many commented on “their husband’s participation in housework andunderstanding and cooperation for the treatment.” In addition, many voiced to seek opportunities for manager
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NPO Fine is an advocacy organization that supports persons with infertility experience in the past, present and future.
training and company-wide training to deepen understanding for infertility and the treatment.
The research survey showed a difficulty in balancing work and treatment, a lack of understanding for infertility
in workplace and home, gaps between the existing systems and requests and many other situations surrounding therespondents. First, it is essential to acknowledge the reality and advocate in order to solve the problems.
There are more intriguing results from other numerous questions, including those on the Subsidy Program. Moredetailed results will also be released on our website in the near future. For inquiries and opinions regarding thesurvey results, please feel free to contact the following.
*1 Japan Society of Obstetrics and Gynecology, “Number of live births by age”
MHLW, “FY2012 Vital Statistics”

http://plaza.umin.ac.jp/~jsog-art/data.htm

http://www.mhlw.go.jp/toukei/saikin/hw/jinkou/kakutei12/dl/03_h1.pdf*For the past questionnaire survey results and all of the present survey questions, please access below. http://j-fine.jp/activity/enquate/index.html------- Examples of NPO Fine’s activities and performances -------◎ First in Japan! Petitions to the Diet were submitted by those who are suffering from infertility.
For the first time as an advocacy organization representing people who are suffering from infertility, seeking to reduce the economic burden ofinfertility patients, we submitted our first petition to the Diet in 2007. In May 2011, the fourth petition to the Diet, signed by approximately 20,500people, was adopted by the House of Representatives for the first time and sent to the Cabinet. *Reference URL ：http://j-fine.jp/activity/act/message.html◎ Submission of various demand papers
We have submitted demand papers on approval of new drugs and re-consideration for the reduction in the Subsidy Program for Specific Fertility
Treatments to the MHLW, and the addition of "correct knowledge and education about pregnancy and child birth" to the curriculum in theguidelines for junior and senior high schools to the MEXT. *Reference URL：http://j-fine.jp/activity/act/index.html◎ Media
Asahi Shimbun, Yomiuri Shimbun, Mainichi Shimbun, Nihon Keizai Shimbun, Sankei Shimbun, Tokyo Shimbun, Hokkaido Shimbun, Shinano
Mainichi Shinbun, Chunichi Shimbun, Kyoto Shimbun, Nishinippon Shimbun, Kumamoto Nichinichi Shimbun, Kobe Shimbun, Shizuoka Shimbun,
Sanyo Shimbun, Hokuriku Chunichi Shimbun, Nihonkai Shimbun, Kyodo News, Jiji Press and others, NHK "Close-up Gendai," "Metropolitan Area
Networks," "Morning Market (Asaichi)," NTV "Today's Event," Nippon TV G+ "Healthcare Renaissance," Fuji TV "Tokudane!," "Speak,” TBS TV“Hanamaru Market," "Ippuku!," "Weekly Asahi,” “AERA,” “AERA with BABY,” “I Want a Baby,” “Bungeishunju,” “Domani,” "Fujinkoron,”"Weekly Gendai,” “Weekly Bunshun,” “GLOW," “VERY,” “WEDGE,” “Ninkatsu Premo” and others.

◎ Number of Fine members is approximately 1,650 and we have started the SNS! Number of registrants: Approximately 1,600 (as of August 2015)------- Future activities of NPO Fine (excerpt) (as of July 1, 2015) -------◎ “Fine Festival 2015: Country-wide Talk Event Special”
This year’s Fine Festival 2015 lands on Tohoku for the first time!

Organized in Sapporo, Sendai, Tokyo, Nagoya and Osaka.

* Reference URL: http://j-fine.jp/matsuri/2015/matsuri.html

NPO Fine http://j-fine.jp/
6-11-5-201, Kiba, Koto-ku, Tokyo, 135-0042 TEL 03-5665-1605

FAX 03-5665-1606*We would appreciate if you could e-mail us for any inquiries as the office is not attended at all times.
E-mail for NPO Fine PR contact：finekouhou@j-fine.jp

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