[Hot Policy] "Preventing the Frustration of Childbirth Intentions"... Fertility Testing Costs Supported for Both Men and Women

Increase in Infertility Population Due to Late Marriage
Ministry of Health and Welfare Provides Pre-Pregnancy Tests
Support of 130,000 KRW for Women and 50,000 KRW for Men

The population experiencing infertility, despite having a strong will to have children, is increasing every year. The main cause is identified as the clear trend of marrying later. According to the Health Insurance Review and Assessment Service, the number of patients using infertility and assisted reproductive technology treatments increased from 221,272 in 2017 to 252,298 in 2021. Considering that the annual number of births was about 250,000 in 2022 (according to Statistics Korea), this is a comparable figure.

The Ministry of Health and Welfare's 'Pre-pregnancy Health Management (Fertility Testing) Support Project,' which started on the 1st of this month, was launched in response to this reality. Even if there is a will to give birth, as time passes, it becomes more difficult to solve problems, so it was judged that support measures for the reproductive health of the public need to be established. Of course, since aging is the main cause of infertility, it is difficult for the government to urge individuals to give birth quickly. However, to prevent those with the will to give birth from becoming discouraged, it was considered necessary to provide opportunities to check reproductive health as early as possible.

The detailed policy design and meticulous practical work were handled by Soo-bin Lee, a 3-month-tenured officer in the Birth Policy Division of the Ministry of Health and Welfare (66th Administrative Examination). In a recent meeting with Asia Economy, Officer Lee said, “So far, pregnancy and childbirth policies have mainly focused on the perinatal period (from immediately after pregnancy to around childbirth). While local governments have policies supporting health management for men and women of reproductive age, the benefits vary depending on where one lives, so I thought a (uniform) policy at the central government level was necessary.”

The pre-pregnancy health management support project primarily supports the costs of ovarian function tests and semen analysis for couples hoping to conceive (including common-law and prospective couples). The core is that the government supports up to 130,000 KRW for women and up to 50,000 KRW for men for the essential fertility (reproductive health) test, the ovarian function test (AMH). These tests typically cost about 140,000 KRW (ovarian function test and gynecological ultrasound) and 50,000 KRW (semen analysis) at private hospitals, so the government effectively covers most of the testing costs.

Although the big picture of supporting the cost of fertility testing was set, the process of deciding the scope and amount of support during detailed design was a continuous challenge. The final budget approved by the Ministry of Economy and Finance was 6.2 billion KRW. Officer Lee continued to deliberate on setting an effective support amount within this budget. After internal discussions, they succeeded in expanding the support for women's testing costs from 100,000 KRW to 130,000 KRW. Officer Lee said, “I was able to persuade the heads of departments to recognize the need for an increase.”

While 30,000 KRW may not seem like a large amount, considering the total number of couples, it requires a significant budget. The increase was made to raise policy participation. Officer Lee investigated medical institutions one by one and confirmed that gynecological ultrasound costs about 70,000 KRW and ovarian function tests about 70,000 KRW, totaling approximately 140,000 KRW. Officer Lee explained, “If only 100,000 KRW were supported for women's testing, women would have to pay about 50,000 KRW more personally, including consultation fees. Since increasing participation is the most important policy goal, if individuals had to bear an additional 50,000 KRW, participation rates would likely drop.”

To verify whether the increase was financially feasible, Officer Lee conducted a demand survey targeting maternal and child health project managers in local governments. They checked how many newlywed couples and births there were in each region. The detailed survey predicted a demand of about 65,000 couples in 16 local governments excluding Seoul. This was less than the initially expected scale of 82,000 couples, and it was judged that the budget could sufficiently cover the increase.

There were also considerable policy considerations to increase participation among men of reproductive age. Although men account for about 40% of the infertile population, only about 5% of men visit infertility specialty hospitals for testing, compared to 95% of women. Officer Lee said, “Women are relatively familiar with getting tests at obstetrics and gynecology clinics, but men find it unfamiliar to get semen analysis at hospitals. It was found that most men come to infertility specialty hospitals driven by their wives.”

To encourage male participation, they considered supporting costs only when couples get tested together. Officer Lee said, “However, considering that more policy conditions would inconvenience participants, after much deliberation, we finally decided to support testing costs without any specific conditions.”