You can’t tell women in Japan when to have a baby…

Kyoto Medical University professor and infertility expert Nobuhiko Suganuma gets bashed for telling the public when best to have a baby. The Japan Today article below (scroll down to read) sure touched a raw nerve (as have previous political comments noted in news articles 1 | 2) and generated a furious debate over what has been in recent years an emotional and sensitive issue for women (read the comments/furore here). Women obviously both like telling others what to do, and at the same time, abhor being told what and when to do it!  I personally didn’t have a problem with an expert on infertility basically stating the statistics/probabilities and suggesting that more people walk into the”baby” package thing with their eyes open to the risks… the way I see it it’s more about his role of education in the medical field than about the expert’s circumscribing of human rights… other complex social issues about adequate child support or difficult career and financial environment or changing lifestyle patterns notwithstanding…

The childless infertility issue is also a global social and environmental issue so the tenets of the controversial news article shouldn’t have come as a  surprise to any,  and it is possible that Japan may have more exacerbated or serious fertility issues due to diet and environmental and/or other societal factors (which the article did not explore)… since studies have shown that in places like Osaka where family-friendly policies such as child support, afterschool childcare, failed to reverse the birthrate decline (see 2007 BBC article).  Perhaps, the article might not have generated so much heat, had the article mentioned that the fertility-age problem was equally a male problem? And suggested that other countries shared the same plight?  Research on male sperm count and quality shows that Japanese males along with Danish ones have the lowest fertility rates:

“In many modern studies the percentage normality is quite low. Twenty per cent seems to be average in Singapore only 8% in Switzerland. Denmark and Japan have the lowest rates of normality and this factor is strongly influenced by environment”.–Male role in infertility and miscarriage

Another article “Older men five times more likely to father children with birth defects” citing a Danish study involving 70,000 births suggested that:

“It is not just women who need to keep an eye on the biological clock when it comes to having children.
Older men are up to five times more likely to father children with birth defects, according to some studies.
Experts claim that after 35, the risk of chromosomal abnormalities such as Down’s Syndrome increases in proportion with the father’s age.”

Hence, in situations where sperm or egg quality is already low, what the Japanese infertility expert said in the controversial article should have sounded logical … one should try to do it as early as possible when one was in one’s prime if one wants to have kids? Merely stating that one should be aware of the best windows of “fertility” opportunity surely doesn’t preclude the personal choice of others to have a child later nor the need for other policy initiatives.

Top-down, the Japanese government has been trying to address the issue from all fronts (albeit perhaps too little too late), a working paper since the Koizumi administration had also tried to improve the gender-equality and working environment for women because the cause of the fertility problem was identified as follows:

“it has been proven that the decrease in fertility is due to changes in marriage-related behavior, such as the postponement of marriage or choosing to remain single throughout one’s lifetime, policymakers are thoroughly studying the socioeconomic factors influencing these behaviors. It has been suggested that the trend to remain single was mainly caused by a change in female attitudes. Segregated gender roles and the gendered division of labor that in the past have made it almost impossible for family women to keep regular employment status are now seen as the main factors that prevent young women from getting married and bearing children.”–Working Paper, Tokyo 2006

Other literature suggest diet and environmental factors are to blame for infertility in Japanese men.

Soy diet is also now thought to have something to do with the low fertility of Japanese men (but this does not explain why Japanese men who ate a lot of soy-products in pre-modern to earlier modern eras had no fertility problems) – see Eating soy could slash men’s sperm count:

“Soya foods contain high amounts of isoflavones, compounds that mimic the effects of oestrogen in the body. For this reason, women sometimes increase their intake of soya foods to treat hot flushes caused by declining oestrogen levels in menopause.

Oestrogen-like compounds can also have a dramatic impact on the male body. And previous rodent studies have suggested that high intake of soya products can reduce male fertility. This has led scientists to wonder how isoflavones might influence men’s reproductive function, which is highly sensitive to hormones.”

Based on rodent-research, the connection between fertility and soy appears clearer:

“Women trying to conceive should consider not consuming soya for the few days around ovulation, according to a UK researcher. Her study shows a compound found in soya causes human sperm in a dish to “pop their caps” prematurely, rendering them useless. But it remains unclear whether eating soya has any actual effect on fertility.

Lynn Fraser of King’s College London studied the effect of very low levels of genistein – a compound found in leguminous plants such as soya – on human sperm in a liquid medium similar to that found in the female reproductive tract. “It was very striking,” she says. “Within an hour a third of the sperm had gone all the way.”

This means that the genistein had prematurely triggered the sperm to undergo what is known as the acrosome reaction. The acrosome is the cap on the tip of sperm that contains the enzymes needed to penetrate the thick outer layer of the female’s egg once the sperm has reached it. If it is lost early, sperm have no chance of fertilising an egg.

Fraser says other studies have shown that genistein gets into the blood of people who eat soya products. She believes that in women, it could end up in the reproductive tract and damage their chances of conceiving. “From what we have seen, women should restrict their diet for a short time over the period of ovulation.”

Effects on males

But other experts are not convinced such advice is necessary. James Kumi-Diaka of Florida Atlantic University, US, says his team has also found that genistein has a dramatic effect on sperm – so much so that he has toyed with the idea of incorporating genistein into condoms as a contraceptive.

His team has also found that when genistein is injected into male rats three times a week, it reduces the size of the litters they father, from about 11 pups at most to five. Even low doses had an effect, he says. That would seem to hint that men, too, should worry about eating soya when trying to father children.”

According to the American Scientific article “Could eating too much soy be bad for you?“:

“Infants fed soy formula ingest six to 11 times more genistein on a bodyweight basis than the level known to cause hormonal effects in adults.

“Giving an infant or child estrogen is never a good thing,” said Newbold.

Though studies on the harmful effects of soy isoflavones in people have been limited and inconclusive, there’s strong evidence from animal studies that genistein alters reproduction and embryonic development, according to Newbold, a co-author of two of the new rodent studies”

More ominous-sounding, it was reported that a  study involving GM soy-fed hamsters showed by the third generation, most of the hamsters showed the inability to have babies, suffered slower growth, and there was a higher mortality rate among the pups. The study however thought the causal link between GM soy was inclusive:

“In addition to the GMOs, it could be contaminants, he said, or higher herbicide residues, such as Roundup. There is in fact much higher levels of Roundup on these beans; they’re called “Roundup Ready.” Bacterial genes are forced into their DNA so that the plants can tolerate Monsanto’s Roundup herbicide. Therefore, GM soy always carries the double threat of higher herbicide content, couple with any side effects of genetic engineering.”

“Organochlorines such as PCBs, dioxins, PBDEs and many other persistent organic pollutants are known to mimic estrogen and other hormones. They are sometimes referred to as endocrine distuptors. Japanese who eat large quantities of fish, and especially those who eat whales and dolphins, may be exposed to very high levels of these endocrine disruptors. Men may become more feminized and women accumulate higher than natural levels of estrogen and estrogen imitators.

A group of Japanese scientists reported in September 2007 that the breast milk of Japanese women tested was contaminated by PCBs. The scientists reported the likely route of ingestion into human bodies was through consumption of fish. “One of the causes of the human contamination is believed to be intake of fish,” said Sochi Ota, associate professor at Setsunan University. It should be emphasized that dolphins, at the apex of the food chain, have far higher concentration of contaminants than most fish.

Sperm counts in Japanese men, already low, are decreasing and chemicals that disrupt human hormones may be to blame, according to a report by Yasunori Yoshimura, a professor of obstetrics and gynecology at Keio University.

An analysis of semen samples from 6,000 Japanese men found a 12 percent decrease in the number of sperm over the past three decades. Samples taken from medical students in the 1970s contained an average of about 65 million sperm per millilitre of semen. The figures decreased to about 63 million in the 1980s and further dropped to about 57 million in the 1990s. Environmental chemicals that mimic human hormones could have a role in the decline in sperm counts, Yoshimura said.” — Bluevoice.org

Whatever the stats are,  journalists ought to learn they can’t ever tell women they’re the problem, or when not to have babies,  unless they are ready to treat the contributory issue with an even gender-hand!

Article in focus:

If you want a child, do it before you’re 30, says leading obstetrician
KUCHIKOMI APR. 16, 2012 –

TOKYO —
When entertainers speak, the world listens, and one message they’re delivering lately is profoundly disturbing to at least one leading obstetrician – namely, that giving birth relatively late in life is okay. It’s not, Kyoto Medical University professor and infertility expert Nobuhiko Suganuma writes in Shukan Bunshun (April 12). Suganuma has a message of his own: “If you want children, have your first before you turn 30.”

The influence of celebrities on matters remote from their talents is a remarkable fact of life. When Mariko Shinoda of the girl band AKB48 mused in January about getting married around 40 or 50, Suganuma took notice – he could easily imagine young women listening starry-eyed and thinking, “Me too.”

Suganuma has been treating women for infertility since the dawn of the artificial insemination era more than 30 years ago. His own patients over the years number some 5,000. He has seen the numbers soar nationwide during those decades – and no wonder, he says. Ovaries, wombs and hormones, in his view, are in prime condition before 30. A first childbirth then can prolong the reproductive peak, but starting after 30 “entails risks” – of Down’s Syndrome or other diseases in the child at worst, of miscarriage, or simply of infertility. “There are no firm statistics,” he writes, “but the rising number of women marrying late and then being unable to conceive is an undeniable fact.” Moreover, “the success rate of infertility treatment starts dropping at age 30 and plunges past 35.”

Entertainers whose own highly public lives have popularized late marriage and childbirth include the model Rika, who had her first child at 38; Shoko Aida, formerly of the pop duo Wink (41); actress Koyuki (35); and comedian-actress Naomi Matsushima (40).

For a woman of a certain age who is aware of the risks and decides to proceed with pregnancy anyway, “that’s a matter of individual freedom,” writes Suganuma. The problem, he claims, is that many are not aware of the risks.

Liberal-Democratic Party Lower House lawmaker Seiko Noda was 50 when she gave birth a year ago through artificial insemination. Her son Masaki has been hospitalized ever since with serious medical problems. Suganuma in his Shukan Bunshun article quotes Noda as saying, “No one ever told me that having a child after 40 could be difficult.”

Every year, says Suganuma, the number of women giving birth past age 35 is rising. In 1985, late births (not necessarily first-time births) comprised approximately 7% of the total. By 2010 they accounted for 23.8%.

“Japanese sex education,” he writes, “is all about birth control. Of course, it’s important for teenagers to know how to prevent unwanted pregnancies. But it seems to me it also needs to be taught that under 30 is the most suitable time of life for women to begin giving birth.”

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