Japan, Islands of Infertility

ツジセイゴウ

At Medical Center of Toto University Hospital, Outpatient Department for Infertility

“I think it would be very difficult….”

The doctor explains mercilessly the result of tests. Kazuki is hearing it with trembling his shoulders. Kazuki Yamamoto, 33 years old, is a journalist of Hounichi News Paper and working hard every day.

Three years have passed since his marriage, but still no sign of pregnancy for his wife. Recently in Japan cases of male’s infertility are increasing and today Kazuki have a test of reproduction ability.

“Number of sperms is only 5 million and its motility ratio is also very bad. At this level natural insemination would be impossible. You need artificial insemination if you want a baby.”

Doctor’s explanation is continuing.

Normal adult has about 100 million sperms per 1 cc semen, but for Kazuki’s case it is only 5 million and most of them are dead. Kazuki upset very hard and lost his word. Why me and what is the cause?

“Let’s start from AIH (Artificial Insemination by Husband). But in your case AID (Artificial Insemination by Donor) or ISI (Intracytoplasmic Sperm Injection) might be appropriate. Anyhow take your time and talk with your wife at first. It is very important issue.”

AIH, AID, ISI…, many difficult medical words which are unable to understand for Kazuki. Kazuki got out of the Consultation Room and wandered the corridor to the waiting room.

“Kazuki, are you OK? How about the result?”

It is Akane, his wife, who is 2 years younger than him.

“It is me. The number of sperm is too little for natural insemination. It might be difficult to have a baby like now.”

Kazuki explained the result with big disappointment. Akane was a little shocked but soon answered with hesitant smile

“It’s OK. Don’t mind. I, I would like to continue my work still more.”

But she could not hide her small tear in her eyes.

Almost same time.

At the Pharmaceutical Department of Toto Unveristy. Phd. Dr. Shinohara’s room.

“It has been long time, Miss Tsuyama. You seem very happy.”

“Thank you so much, Professor Shinohara, and apologize my long absence.

Keiko Tsuyama, 31 years old, had graduated from Toto University and now works for Takezawa Pharmaceutical Corporation as one of research staff. She had studied under Dr. Shinohara during her university period.

“I have heard your reputable activities. You are now one of senior researcher in the infertility studies. I am proud of you as one of my student.”

“Are you joking? You had been always good at compliment.”

“No, no. I am serious.”

“It is my turn to say congratulation, Professor. I have heard you will take office as the General Manager for the Pharmaceutical Research Institution.”

The Pharmaceutical Research Institution is the biggest and the most famous organization in Japan. It is leading more than 100 senior researchers and had produced the Novel Prize Scientist before.

“No, no. It is not my business. Annoying post. Everyday communicating with government officers and others. It would be the last post for old aged professor.”

“Ok, Ok, I understood.”

Keiko was laughing.

“Well, to be honest, the reason I ask you to come here today is related to this Institution. Miss Tsuyama, won’t you come and work with us in this Institution? I need a reliable staff.”

Keiko was astonished. The Institution is too famous to belong for such young researchers like Keiko.

“Well, it is my greatest honor, but is there any other more suitable person? For example, Mr. Issiki.”

Keiko brought his face into her mind. Shuuya Issiki had been studying with her under Phd. Shinohara. His ability was the very best by far. He graduated at the top of top results and went into the University Laboratory.

“Mr. Issiki? No, he is not. He had entered into wrong way as a scientist.”

“Something wrong”

“Yes, we are now arguing his study in the Ethics Committee.”

Keiko felt something but would not go ahead any more.

“Professor Shinohara, thank you very much for your special offer. But please give me a time for thinking. Because I am now involved in a big project in Takezawa. I can never give up it soon.”

“Ok, ok. I understood. You are now precious for Takezawa. I am sorry for asking you too much.”

“I am sorry I cannot come up to your expectation.”

“Don’t mind. But, please remind, if you have any problem, you will always be welcome for us at any time.”

One year later

New year’s day at Kazuki’s home.

“Aha, Mr. and Mrs. Suzuki had a new baby last year. It is so cute.”

Akane looked at a picture printed on a new year’s card. It was sent from their old friend Suzuki. Akane passed the card to Kazuki.

“Well, Akane, shall we try ISI (Intracytoplasmic Sperm Injection) this year? It is difficult by AIH (Artificial Insemination by Husband).”

Kazuki said a little irritated.

They had been trying AIH for one year since that consultation.

AIH is done by artificial injection of sperm. Usually a husband must take his own semen by masturbation. Collected semen is washed and stocked by several times and injected into wife’s vagina by syringe. A couple is required to avoid intercourse during this medication to collect semen as much as possible.

In spite of this hard work, actual insemination succeeding ratio would be at most 10 percent or so. Getting a baby or not is still up to the God.

“I wouldn’t like it.”

“But, we have already tried AIH 6 times but nothing. We must hurry because we are getting old every year. It would be more difficult to have a baby.”

“I am fearful. Because ISI is to inject a sperm forcibly into an egg cell. If we do such thing, the God will get angry and something evil will occur.”

“Don’t worry, we can do anything with the current modern medical technology. There is nothing impossible.”

“No, I do not. I hate it.”

Akane got angry and turned away. Only Kazuki was a little trembling with stress.

Further half a year later

At the Boardroom of Takezawa Pharmaceutical Corporation.

A board meeting was held in serious atmosphere. Mr. Okada, the Chief Research Officer, was continuing his presentation. On the projection screen a shocking data was indicated.

“As the graph shows, Japanese population had started decrease steeply. Approximately 0.4 percent annually. Main reason is sub-replacement fertility namely too small number of newly born babies. Furthermore this pace is now accelerating. If this will continue, Japanese population on 2100 is expected under 50 million, less than half of present level.”

At this moment CEO Mr. Takezawa questioned.

“Wait a minute. I believe this problem is mainly because of social reasons. Change of lifestyle, economical reason and so on. The White Paper of the Government has also pointed out as such. What is this related to our business?”

Mr. Okada changed the screen to the next page.

“Yes, you are correct. However, according to our study, as a cause of Infertility natural reasons could be much bigger than social reasons. As the graph shows, the number of average Japanese male’s sperm had been steeply decreasing for this decade. We estimate approximately one third of young couples need artificial insemination to make a baby. It is apparently extraordinary. We had better give warning to all Japanese citizens immediately and start to develop new medicines for male infertility.”

“Wait, wait, Mr. Okada. It’s not our issue. We should leave such matter to the Government. We are only one private company. We should concentrate on our own business.”

“I feel sorry but we cannot expect so much from the Government. They always insisted on social reasons and neglected scientific analysis. If we do not move now, it will lead to serious result for Japan’s future.”

But Mr. Takezawa dose never make any concession to his suggestion.

“Mr. Okada. Enough. Stop your presentation now. We have nothing discuss anymore.”

Mr. Takezawa declared close of the meeting. And all the content of this presentation and studies were sealed and put under strict confidence.

To be continued