By Suvendrini Kakuchi
TOKYO, Jun 1 2001 (IPS)

Kazuko Iwatsuki, 53, has suffered depression for years due to feelings of inferiority stemming from her inability to bear a child.

“I suffer from a loss of self-esteem and feel an outcast when I meet my in-laws. I feel guilty and lonely because I do not have my own children,” says the home-maker, who has been married for the past 26 years.

When Iwatsuki married, there was intense pressure from her in- laws to produce a child. “My husband was the eldest child of the family and so it was natural that we should have an heir,” she adds.

But getting pregnant has not easy for Iwatsuki — and many others like her and her husband. National surveys in Japan reveal that an estimated one in 10 couples suffers from infertility.

It afflicts not only the women, say doctors, who point out that low sperm counts in men have now become a problem too. The ‘Yomuiri Shimbun’ newspaper reports that 40 percent of infertility in couples is attributed to men.

But infertile couples are resorting to treatment in order to have children and fit into the societal image of what one expert called an ideal family — “a father, a mother and two smiling children”.

Indeed, doctors say the strong social pressure on Japanese couples to have children has resulted in a demand for infertility treatment in Japan, a country with one of the biggest proportions of elderly populations in the world and a women’s fertility rate of just 1.4 percent.

In mid-May, Japan reported its first case of in-vitro fertilisation under which a woman gave birth to her sister’s baby. In this process, the ovum and sperm were taken from the couple and the fertilised egg implanted in the womb of the surrogate mother.

The biological mother sought help because she knew she could no longer bear a child after her uterus was surgically removed due to complications from a miscarriage.

Dr Yahiro Netsu, who conducted the procedure, said he planned to assist more couples who want to have children this way.

The news provoked a nationwide debate in Japan where in-vitro fertilisation, or external fertilisation process, is not banned. But last year, a panel of experts from the Health, Labour and Welfare Ministry called for a prohibition on the procedure, calling it “the use of humans as a tool for reproduction”.

But Iwatsuki supports surrogate motherhood. “Being a mother is what a woman dreams of. It is also a passport to being respected in Japan,” she says.

Reports say more than 11,000 babies were born via infertility techniques between 1998 and 2000. They add that one in every 100 women is under external fertilisation treatment.

In a survey conducted last year, only 0.3 percent of 350 couples who received infertility treatment that did not work sought the adoption of children.

But despite the uproar over the news of surrogacy, Dr Tomoko Saotomo, a gynaecologist at NTT East Kanto Teishin Hospital, hopes laws will soon be passed to support surrogate motherhood.

“The debate should not be on whether the technology is moral or not. The focus should be on the intense desire of the couple for a child,” she explains.

Saotomo points out the decision to resort to surrogate delivery stems from a deep desire among women to have children. “There are a lot of women out there who are desperate when they realise they cannot have children. They need a choice,” she says.

Reports say more than 10 babies have been born in the United States since 1991 to Japanese couples who asked Asian women living there to be surrogate mothers.

The increasing number of women resorting to artificial birth methods has made infertility treatment a growing business in Japan.

High income levels have made such treatment accessible to the average couple, explains Dr Shigeru Mashko, who runs his own clinic for women.

Japanese media report that infertile couples spend around 300,000 yen or 2,800 U.S. dollars per month on treatment which is not covered by national health insurance schemes.

Saotomo adds that the rise in the number of women seeking treatment for late pregnancies, the dieting fad and stressful lifestyles that have also seen a surge in endometritis in women. (Endometritis is the inflammation of the mucous membrane lining the womb.)

Surveys show that more women in Tokyo are having their first child at 35 years, more than 10 years later than women in early post-war Japan.

“Young Japanese women prefer to emphasise career or personal satisfaction before having children, a major contrast to their mothers who believed children were their first happiness,” explains Saotomo. “They panic when they realise later that it is difficult to get pregnant.”

Doctors are also helping older women have children. and providing counselling to help them cope with changes in their lives.

“Japanese women with problems are too shy to seek proper care about their problems. We need to help them to talk out and understand options,” says Saotomo.

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