Below is a Japan-focused explanation. A key point is that, unlike statutory maternity/child-care leave, fertility-treatment leave (不妊治療休暇) is generally an employer-designed benefit rather than a universally mandated statutory leave entitlement. The Ministry of Health, Labour and Welfare (MHLW) nevertheless strongly promotes dedicated leave and flexible-work arrangements and has incorporated fertility-treatment support into the Kurumin Plus certification framework.

Fertility Treatment Leave Policy Implementation in Japan

1. Meaning and purpose

A fertility-treatment leave policy is an internal employment policy allowing employees to take time away from work for fertility-related medical treatment, including:

• fertility examinations;
• ovulation-induction treatment;
• artificial insemination;
• IVF/ICSI;
• egg or sperm retrieval;
• embryo transfer;
• medical consultations and follow-up appointments;
• procedures that require recovery time.

The policy should ideally be available irrespective of gender or employment status, subject to clearly defined eligibility rules. MHLW's model rules specifically contemplate fertility-treatment leave and recommend making the system available to workers regardless of gender or employment type.

The practical need is significant. MHLW's 2023 survey found that only 26.5% of surveyed companies had support systems for employees undergoing fertility treatment, while 10.9% of people who had undergone fertility treatment reported leaving employment because they could not balance treatment and work.

2. Is fertility-treatment leave legally mandatory?

This distinction is extremely important.

Statutory position

Japan does not generally impose a universal statutory fertility-treatment leave entitlement equivalent to childcare leave or family-care leave.

MHLW's model employment rules expressly state that fertility-treatment leave is not a leave that must be provided under the work-related legislation, and that employers should establish appropriate details according to their circumstances.

Therefore, an employer may voluntarily create:

1. paid fertility-treatment leave;
2. unpaid fertility-treatment leave;
3. special leave separate from annual paid leave;
4. fertility-treatment leave combined with annual leave;
5. short-term treatment leave;
6. longer treatment-related leave of absence;
7. hourly or half-day leave;
8. flexible working hours;
9. flextime;
10. telework;
11. reduced working hours.

MHLW specifically identifies annual paid leave in hourly or half-day units, flextime, telework and other flexible arrangements as useful mechanisms for balancing treatment and employment.

3. What should the policy contain?

A properly drafted Japanese fertility-treatment policy should answer at least the following questions.

A. Who is eligible?

The policy should define whether eligibility extends to:

• permanent employees;
• fixed-term employees;
• part-time employees;
• dispatched workers, where appropriate through coordination with the dispatching employer;
• male employees;
• female employees;
• employees accompanying a spouse/partner for treatment, if the employer chooses to provide it.

A gender-neutral policy is preferable from an implementation perspective because fertility treatment can involve both partners.

B. What treatments qualify?

The employer should avoid requiring employees to disclose unnecessarily detailed medical information.

A broad definition could cover:

Medical examination, consultation, treatment, procedures and recovery reasonably connected with infertility or fertility treatment.

The policy can identify qualifying treatment categories without requiring the employee to disclose the precise diagnosis.

C. How much leave?

There is no single statutory number of fertility-treatment leave days applicable to all employers.

An employer can establish, for example:

• X days per fiscal year;
• X hours per year;
• X days per treatment cycle;
• monthly entitlement;
• annual entitlement with limited carryover;
• a combination of short leave and longer unpaid leave.

MHLW's model rules provide examples ranging from a specified number of days per year to a longer period of leave over several fiscal years.

4. Paid or unpaid?

The policy should clearly state whether fertility-treatment leave is:

Paid

Advantages include:

• employees do not have to choose between treatment and income;
• reduced incentive to conceal treatment;
• easier employee uptake;
• greater practical effectiveness.

Unpaid

The policy should specify:

• whether salary stops completely;
• how partial-day absence is calculated;
• whether bonuses are affected;
• whether retirement-benefit calculations are affected;
• whether social-insurance treatment changes.

Hybrid model

A particularly practical design is:

Paid short-duration treatment leave + unpaid extended treatment leave + flexible work arrangements.

This recognizes that fertility treatment can require repeated short appointments rather than one continuous period away from work.

5. Interaction with annual paid leave

Fertility-treatment leave should normally be designed in addition to ordinary annual paid leave if the employer wants it to be a meaningful standalone benefit.

Japanese annual paid leave is a statutory entitlement under the Labour Standards Act. The Supreme Court has held that the entitlement arises when the statutory conditions are satisfied and is not dependent on employer "approval."

The Konoha Telephone Exchange Office Case (最高裁昭和57年3月18日判決) is particularly relevant to the administration of annual leave: an employer may exercise the statutory timing-change power only within the statutory framework, including where the requested timing would interfere with normal business operations.

Consequently, an employer should not create a fertility-treatment policy that effectively forces employees to exhaust their statutory annual leave before accessing the company's separate fertility-treatment benefit unless the policy clearly establishes that structure.

6. Notice and documentation requirements

The policy should establish a simple application procedure.

A good system might require:

1. employee request;
2. approximate treatment date;
3. expected duration;
4. leave category requested;
5. certification where genuinely necessary;
6. HR approval/recording.

The employer should avoid demanding detailed medical records where a simple medical confirmation is sufficient.

MHLW has developed a Fertility Treatment–Work Coordination Card (不妊治療連絡カード) specifically to facilitate communication between employees receiving fertility treatment and employers.

7. Medical privacy

Fertility treatment is particularly sensitive personal information.

Therefore, the HR process should operate on a minimum-necessary-disclosure principle.

For example, a manager generally needs to know:

"The employee requires approved fertility-treatment leave on 14 October."

The manager ordinarily does not need to know:

• the employee's infertility diagnosis;
• reproductive history;
• IVF results;
• embryo information;
• medication details;
• partner's medical information.

The Supreme Court has recognized privacy interests in personal information. In University Personal Information Disclosure Case (Supreme Court, 2003), the Court considered the tort implications of disclosure of personal information and the individual's privacy interests.

This is not a fertility-treatment case specifically, but it is an important principle when constructing a confidential HR procedure.

8. Protection against retaliation

A fertility-treatment policy is ineffective if employees fear:

• demotion;
• unfavorable transfer;
• reduction of responsibilities;
• negative performance assessments;
• denial of promotion;
• contract non-renewal;
• termination;
• harassment.

The company should therefore expressly prohibit adverse treatment because an employee has legitimately used the fertility-treatment support system.

This principle is strongly reinforced by Japanese case law concerning pregnancy, childcare and family-related workplace rights.

9. Case Law 1 — Hiroshima Central Cooperative Hospital Case

Hiroshima Central Cooperative Hospital Case

Supreme Court, First Petty Bench, October 23, 2014

This is one of the most important Japanese cases for designing fertility-related workplace accommodation.

A pregnant physiotherapist was transferred to lighter duties. At the time of the transfer, she was removed from her position as deputy chief. She was not restored to that position after maternity/childcare leave.

The Supreme Court held that disadvantageous treatment connected with pregnancy-related accommodation is, in principle, prohibited, subject to narrowly defined circumstances.

Relevance to fertility-treatment leave

Although the case concerned pregnancy rather than infertility treatment, the implementation lesson is significant:

An employer should not convert an employee's use of a legally protected or company-created family/health accommodation into an opportunity for adverse personnel action.

HR should therefore separately document:

• leave approval;
• ordinary performance issues;
• personnel changes;
• organizational restructuring.

This helps prevent an allegation that the employee was penalized because she used the accommodation.

10. Case Law 2 — Shuhoku Bus Case

Shuhoku Bus Case

Supreme Court, December 25, 1968

The Supreme Court considered whether an employer could unilaterally change employment conditions through work rules.

The Court recognized that changes to work rules imposing disadvantageous conditions may be effective where the amended rules are reasonable in light of the circumstances, but an employer cannot simply assume unlimited authority to deprive employees of established rights.

Relevance

Once a fertility-treatment leave entitlement is incorporated into employment rules, it becomes important to draft the entitlement precisely.

For example, the employer should specify:

• eligibility;
• number of days;
• pay status;
• application procedure;
• carryover;
• interaction with annual leave;
• treatment during resignation;
• treatment during fixed-term contract expiry.

Ambiguous policies create disputes over whether the employer has actually granted a contractual benefit.

11. Case Law 3 — Takeda System Case

Takeda System Case

Supreme Court, November 25, 1983

This case concerned unilateral alteration of rules concerning menstrual leave.

The Supreme Court examined the reasonableness of changing employment rules by considering factors including:

• the nature of the change;
• necessity;
• degree of disadvantage to employees;
• compensatory measures;
• maintenance of workplace discipline;
• fairness among employees;
• negotiations with the labour union;
• circumstances surrounding the leave system. 

Relevance

This is particularly useful for fertility-treatment leave because both involve special health-related leave.

If an employer later reduces:

10 paid fertility-treatment days → 3 unpaid days,

the employer should not assume that merely changing the work rules resolves the issue.

The reasonableness of the change and its effect on employees may matter.

12. Case Law 4 — Mikuni Hire Case

Mikuni Hire Case

Supreme Court, July 15, 1983

The Supreme Court considered an unfavorable change affecting calculation of retirement benefits and found the change unreasonable where a significant disadvantage was imposed without adequate compensating measures.

Relevance

A fertility-treatment policy should clearly explain whether periods of leave affect:

• bonus calculations;
• seniority;
• retirement benefits;
• attendance-based benefits;
• promotion;
• performance evaluation.

The company should avoid hidden penalties.

For example, stating:

"Fertility-treatment leave is unpaid"

is materially different from:

"Fertility-treatment leave is unpaid and will additionally be treated as unauthorized absence for bonus and promotion purposes."

The second structure creates a substantially different employment consequence and should be expressly addressed.

13. Case Law 5 — Konoha Telephone Exchange Office Case

Konoha Telephone Exchange Office Case

Supreme Court, First Petty Bench, March 18, 1982

The Court addressed the nature of annual paid leave and the employer's timing-change authority. MHLW summarizes the decision as establishing that statutory annual leave does not depend upon employer approval and that the employer's ability to change the requested timing is limited by the statutory framework.

Relevance

A fertility-treatment policy should distinguish:

Statutory annual leave

from

Company-created fertility-treatment leave.

Otherwise HR managers may incorrectly treat fertility-treatment requests as ordinary discretionary leave applications.

14. Case Law 6 — Dentsu Case

Dentsu Case

Supreme Court, March 24, 2000

The Supreme Court recognized employer liability in a case involving prolonged excessive work and an employee's resulting mental health deterioration and suicide. The judgment emphasized the employer's responsibility in relation to working conditions and employee health.

Relevance to fertility-treatment policy

Fertility treatment can involve:

• repeated medical appointments;
• medication;
• physical procedures;
• recovery;
• emotional stress;
• unpredictable treatment schedules.

Therefore, employers should not design a leave system that technically exists but is practically impossible to use because of excessive workloads or staffing expectations.

A policy should be integrated with:

• workload management;
• overtime management;
• manager training;
• confidential HR support;
• flexible scheduling.

15. An important qualification regarding the six cases

There is currently limited reported Japanese case law specifically deciding disputes over a standalone fertility-treatment leave policy.

Therefore, the six cases above should not be presented as six direct fertility-treatment precedents.

They are analogous Japanese employment-law authorities dealing with the legal principles most relevant to implementing such a policy:

16. Anti-harassment requirements

The policy should expressly prohibit:

• jokes about infertility;
• questioning an employee about pregnancy plans;
• asking why the employee is undergoing IVF;
• disclosing treatment information;
• pressuring an employee to resign;
• suggesting that treatment demonstrates lack of commitment;
• penalizing treatment-related absences;
• hostile comments from supervisors;
• retaliation after HR complaints.

MHLW expressly promotes workplaces free from harassment relating to fertility treatment and provides employers with materials for building such workplaces.

17. Manager training

Implementation should not stop at writing the policy.

Managers should be trained that:

They should say:

"Please coordinate the required dates with HR. Your medical details do not need to be shared with the team."

They should not say:

"Why do you need so many hospital appointments?"

or:

"This will affect your career if you keep taking time off."

Manager training should cover:

• confidentiality;
• non-discrimination;
• leave administration;
• flexible scheduling;
• appropriate communication;
• workload redistribution;
• avoiding retaliation;
• escalation to HR.

MHLW itself identifies employee education/training and awareness-building as part of an effective fertility-treatment/work support framework.

18. Work-rule implementation

If the employer creates a formal fertility-treatment leave system applicable to employees generally, the provisions should be incorporated into the relevant employment rules.

The policy should address:

Article 1 — Purpose

To enable employees receiving fertility treatment to balance treatment and employment.

Article 2 — Eligibility

Specify covered employees.

Article 3 — Qualifying treatment

Define fertility treatment sufficiently broadly.

Article 4 — Leave entitlement

Specify days/hours and applicable period.

Article 5 — Pay

State whether leave is paid, partially paid or unpaid.

Article 6 — Application

Specify notice and documentation requirements.

Article 7 — Confidentiality

Restrict access to medical information.

Article 8 — Flexible working

Provide flextime, staggered hours, telework or reduced hours where appropriate.

Article 9 — Non-retaliation

Prohibit disadvantageous treatment connected with legitimate use.

Article 10 — Return to work

Specify restoration of ordinary duties and treatment of longer absences.

19. Interaction with Kurumin Plus

Fertility-treatment support has also been incorporated into Japan's Kurumin Plus certification framework.

Among the requirements, employers seeking the relevant certification must establish:

1. a fertility-treatment leave system; and
2. at least one additional mechanism such as:
   • half-day/hourly annual leave;
   • overtime-work limitation;
   • staggered working hours;
   • flextime;
   • shortened working hours; or
   • telework.

The employer must also communicate its policy, provide training/awareness measures and appoint a person responsible for fertility-treatment/work-balance consultation.

Thus, a leave-only policy is weaker than an integrated flexibility framework.

20. Recommended implementation model

For a Japanese employer, a practical structure would be:

Fertility-treatment leave
→ paid short-duration leave

+

Hourly/half-day annual leave
→ appointments

+

Flextime/staggered hours
→ unpredictable treatment schedules

+

Telework
→ where the job permits

+

Shortened working hours
→ periods of intensive treatment

+

Confidential HR contact
→ controlled disclosure

+

Anti-retaliation rule
→ protection against adverse treatment

+

Manager training
→ consistent implementation.

This structure is broadly consistent with the mechanisms identified by MHLW for balancing fertility treatment and employment.

21. Compliance checklist

Conclusion

In Japan, fertility-treatment leave is principally a company-created employment benefit rather than a universally mandated statutory leave entitlement. The legally safer implementation is therefore to create a clear written entitlement rather than relying on informal managerial discretion. MHLW expressly recommends fertility-treatment leave and complementary flexible-working arrangements and provides model rules and implementation resources.

The major legal risks are not simply whether the employer provides leave, but how the policy is administered: discriminatory treatment, retaliation, excessive documentation, privacy breaches, unreasonable work-rule changes, and personnel decisions connected with the employee's use of the system. The Japanese cases above provide useful principles for controlling those risks.