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厚生労働省が紹介する、不妊治療をサポートする企業の仕組みとは?

厚生労働省が紹介する、不妊治療をサポートする企業の仕組みとは?

不妊治療をしながら仕事を続ける難しさが問題なっている今、この問題に直面している夫婦は年々増加しています。国としても問題視し、少しでも治療と仕事を両立できる支援をしていこうと取り組みを始めている企業も増えています。では、詳しくご紹介します。

 

日本の不妊治療について


「不妊症」という言葉からどんなイメージが思い浮かぶでしょうか。
1980年代ころまでは、多くの女性が20歳代で結婚・出産を経験しており、その頃の不妊症の原因としては、生殖機能に何かしらの問題がある場合がほとんどでした。
しかし、現在は晩婚化に伴い、高齢でも妊娠を希望する人の増加により、疾患ではなく、加齢による自然な妊娠力の低下によって不妊に悩む人が増えています。
今では、全国約4人に1人、最も多い東京都では3人に1人が35歳以上の出産と言われています。いわゆる、現状は高齢出産が多いのです。
2015年に日本では51,001人が生殖補助医療(体外受精、顕微授精、凍結胚(卵)を用いた治療)により誕生しており、全出生児(1,008,000人)の5.1%に当たります。
(生殖補助医療による出生児数:日本産科婦人科学会「ARTデータブック(2015年)」、
全出生児数:厚生労働省「平成27年(2015)人口動態統計の年間推計」による)
つまり、約20人に1人の割合で不妊治療によりできた赤ちゃんを出産しているのです。
また日本では、実際に不妊の検査や治療を受けたことがある(または現在受けている)夫婦は、全体で18.2%、子どものいない夫婦では28.2%です。
(国立社会保障・人口問題研究所「2015年社会保障・人口問題基本調査」による)
つまり、5.5組に1組が上記の対象となるというわけです。

 

なぜ不妊治療をしていると仕事をするのが難しいのか?


それは、不妊治療のスケジュールと大きく関係してきます。
不妊治療に要する通院日数の目安はこちらです。

・一般不妊治療
(女性)
・診察時間1回30分程度の通院が月4日~7日必要になります。
・人工授精を行う場合は、診察時間が1回2時間程度の通院が月1日~のスケジュールが追加されます。
(男性)
・月0~半日
※手術を行う場合は1日

・生殖補助医療
(女性)
・診察時間が1回1~2時間程度の通院が月4日~10日
かつ診察時間が1回半日~1日程度の通院が月2日必要になります。
(男性)
・月0~1日
※手術を行う場合は1日

上記のスケジュールを見てお分かりいただける通り、女性の方が圧倒的に通院する回数、時間は多く必要になります。
しかし、あくまでの女性の体調や周期を考慮した上で行わなければならないスケジュールなので、変動したり、急に診察へ行かなくてはならない、なんてこともあります。
さらには、診察時間以外にも長時間の待ち時間が発生します。一般的には2~3時間の待ち時間があるため、仕事を半日休んだとしても、その日の患者さんが多ければ、待ち時間が非常に多く半日では足りないなんてこともあるのです。
となると、仕事を休まなくてはならない日が多くなったり、周期に合わせて急な診察が必要になり急な休みをもらったりしなくてはならないため、仕事に穴をあけてしまいます。
休みばかりもらってしまうと、同僚や上司から良く思われなかったり、自分でも申し訳なく思ってしまい、どんどん居心地が悪くなります。それが心のストレスとなってしまい、仕事を辞めざるを得ないことになってしまうのです。

 

労働者アンケートからわかる日本企業の取り組み


厚生労働省が日本企業の労働者に対して「仕事と不妊治療の両立支援について」というテーマでアンケートを行いました。
不妊治療をしたことがある人は13%、または近い将来治療を予定している人は2%という回答がありました。
そのうち、
・仕事と不妊治療を両立している人は141人回答のうち、女性が74人、男性が67名
・両立できず仕事を辞めた人は42人回答のうち、女性が40人、男性が2人
・両立できずに不妊治療をやめた人は29人回答のうち、女性が17人、男性が12人
・両立ができず雇用形態を変えた人は21人回答のうち、女性が18人、男性が3人

という回答でした。
仕事と不妊治療を両立している人もいる中、どちらかをあきらめざるを得ない人もいます。
そして、今不妊治療と仕事を両立している人の中で、両立が難しいと感じたことのある理由として多いのが…

・通院回数が多い
・精神面で負担が大きい
・待ち時間など通院にかかる時間が読めない、医師から告げられた通院日に外せない仕事が入るなど、仕事の日程調整が難しい
・体調、体力面で負担が大きい
・仕事がストレスとなり不妊治療に影響が出る
などでした。

・仕事と不妊治療を両立するための制度
仕事と不妊治療を両立するためには、やはり企業側の理解、また同僚の理解が何よりも必要なのです。
最近では、上記のような問題に対して、不妊治療の人のために企業として制度を設けているところもあります。

・失効年休の積み立て休暇制度
失効した年次有給休暇を積み立て、不妊治療等のために特別休暇(有給休暇)として利用できる制度。1日単位/半日単位で利用可能。

・半日単位・時間単位の年次有給休暇制度
年次有給休暇の半日単位付与:労働者が希望し、使用者が同意した場合、年次有給休暇を半日単位で与えることが可能。
年次有給休暇の時間単位付与:労使協定により、年次有給休暇について5 日の範囲内で時間を単位として与えることが可能。
このように会社の制度としてあると、取得しやすくはなります。しかし、制度を作るだけでは意味がありません。その制度を使えないと意味がなく、使いにくい環境であれば誰も取得しようともしません。
まずは、同僚、上司の理解への取り組みが一番の課題なのかもしれません。

・治療費の援助制度
不妊治療を受けるには、高額な費用も必要となります。
からだ、心、費用などあらゆる面で負担が掛かってくる不妊治療ですが、それらの負担を少しでも少なくするためには、少しでも若いうちに不妊治療を始めておくことが良いでしょう。
不妊治療は、高額な費用がかかるものだけとは限りません。保険の対象となる「タイミング法」もあります。30歳代半ばくらいまでであれば、タイミング法によって妊娠できる人が大半と言われています。
タイミング法が無理であれば、「人工授精」が提案されますが、1回につき1万~3万、
「体外受精」だと1回30万~80万円と高額になってしまいます。
厚生労働省は、体外受精など高度な生殖補助医療を「特定不妊治療」とし、2004年から公的補助金の制度を設けました。
しかし、これには「1年度あたり1回15万円、2回まで、そして通算5年の支給」となっているうえ、「夫婦の世帯収入730万円未満」という制限が設けられています。
このようなことから、十分な治療を受けられないケースもたくさんあるのです。
そんな問題に対して企業側も対応し、不妊治療費を援助する助成制度を独自で設ける企業も増えてきました。

・不妊治療貸付制度
体外受精・顕微授精・精巣内精子生検採取法などに要する費用を貸し付け、給与天引きの形で返済する制度。

・共済補助金制度
不妊治療に要した費用が5万円を超えた場合に、5万円まで共済会が拠出する制度。
利用は1年度内に1回限り。

 

今後の課題とは


不妊治療が受けやすくなり、実際に妊娠できる人も増えてほしいですよね。
女性は30代後半、男性が5歳年上(つまり40歳以上)の場合、妊娠率が低下すると言われています。
「年齢」がポイントとなる高齢出産世代の夫婦は、結婚が決まったタイミングで出産の人生設計を立てるのが良いかと思います。
まずは、日本の社会環境が不妊治療の現状を、本人、そして治療に協力する夫、家族、女性を雇用する会社が理解してあげることが大切ではないでしょうか。

一覧に戻る

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