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Japan occupies a unique position in the world of fertility treatment. It is one of the most experienced IVF nations on earth — with the first Japanese IVF baby born at Tōhoku University back in 1983, and over 850,000 IVF babies born since. It also performs more IVF cycles per capita than almost any other country in the world. And since April 2022, Japan became one of the few large economies to bring IVF under national health insurance — a landmark shift that changed the financial landscape for couples across the country. Yet despite all of this, the cost of IVF in Japan remains a subject of significant confusion. Insurance covers some things but not others. Local government subsidies exist in some cities but not all. Advanced procedures sit entirely outside the insurance system. And for foreigners, the picture is even less clear.