비배우자간 인공수정이 권유된 남성불임환자의 의식조사

An attitude survey of male infertile patients with artificial insemination by donor

  • 박현준 (부산대학교 의과대학 비뇨기과학교실) ;
  • 박남철 (부산대학교 의과대학 비뇨기과학교실)
  • Park, Hyun-Jun (Department of Urology, College of Medicine, Pusan National University) ;
  • Park, Nam-Cheol (Department of Urology, College of Medicine, Pusan National University)
  • 발행 : 2003.12.30

초록

Objectives: In determining to perform non-spousal artificial insemination by donor (AID) to an infertile married couple, infertile couple requires not only the thorough understanding of the medical procedure but also scrutinizing the effect, which it will have on the relationship of the family including the baby to be born itself. Materials and methods: 148 cases with non-curable male infertility were enrolled in this inquiry survey. The donor insemination questionnaire consists of 18-items which are assessing subjects' clinical properties, the background for AID practice, psychological traits, and long term influence. Results: Of the survey, 49 cases were returned (33.1%) and 10 cases (20.4%) of these gave birth after AID practice. The mean age of husbands and wives of the 49 cases were $34.6{\pm}4.2$ and $32.1{\pm}3.0$ yers old, respectively and the duration of marriage was 5 years and 4 months. In about half of the cases, AID was first suggested by husband and the decision was made by only the couple. The major reason for the operation was to form a complete family. In the item of the psychological effects, two-third of the couples felt anxiety related to the procedure which are mostly about the possible congenital or acquired deformity of baby. The AID was positively suggested in overall by all of recipients. After giving birth to a child, most couples felt positive about their decision. As a child grows up, about half of the couples felt the child as their own and expected not to tell of the AID. In overall, about 50% of couples presented satisfaction with the procedure. Conclusions: As the above results, various psychological impacts including anxiety about a child-to-be-born were accompanied to those who were recommended of AID. To overcome these problems, sufficient medical information and consultation about the course of selecting the donor and the whole procedures of AID should be provided beforehand.

키워드

참고문헌

  1. Nachtigall, RD. Tschann JM, Quiroga SS. Pitcher L, Becker G. Related Stigma, disclosure, and family functioning among parents of children conceived through donor insemination Fertil Steril 1997; 68: 83-9
  2. 대한산부인과학회 보조생식술 윤리지침 제 5 판. 대한산부인과학회 인공수태 시술의료기관 심사소위원회. 1999
  3. 한국 보조생식술의 현황: 1996년. 대한산부인 과회지 2002; 45:1700-17
  4. Curie-Cohen M, Luttrell L, Shapiro S. Current practice of artificial insemination by donor in the United States. N Engl J Med 1979; 300: 585-90 https://doi.org/10.1056/NEJM197903153001103
  5. U.S. Congress. Office of Technology Assessment. Artificial insemination practice in the United States: Summary of a 1987 OTA 38-BA-48 Washington, D.C.: U.S. Government Printing Office 1988
  6. Critser, JK. Current status of semen banking in the U.S.A. Hum Reprod 1998;13(Suppl.2): 55- 67, discussion 68-9
  7. Human Fertilisation and Embryology Authority 3rd Annual Reports. Human Fertilisation and Embryology Authority; 1994
  8. Hennebicq S, Thepot F. Bilan 199 des CECOS. Report Hum Horm 2000; 13: 465-9
  9. Klock SC, Maier D. Psychological factors related to donor insemination. Fertil Steril 1991; 56: 489-95 https://doi.org/10.1016/S0015-0282(16)54546-4
  10. Armand M. Karow. Family Secret: Who is to know about AID? N Engl J Med 1982; 306: 372-7
  11. Mochimaru F. Artificial insemination with frozen donor semen: its current status and follow-up studies. Keio J Med 1979; 28: 33-48 https://doi.org/10.2302/kjm.28.33
  12. Weller J. Schwangerschafts und geburtsverlauf nach 104 erfolgreichen artifiziellen donogene: Insemination (ADI) mit Nativ-un Kryosperma. Geburtsh u Frauenheilk 1980; 40: 269-75 https://doi.org/10.1055/s-2008-1037009
  13. Katzorke T, Propping D, Tauber-peter F. Results of donor artificial insemination (AID) in 415 couples. Int J Fertil 1981; 26: 260-6
  14. Aiman J. Factors affecting the success of donor insemination. Fertil Steril 1982; 37: 94-9 https://doi.org/10.1016/S0015-0282(16)45984-4
  15. Chong AP, Taymor ML. Sixteen year's experience with therapeutic donor insemination. Fertil Steril 1975; 26: 791-5 https://doi.org/10.1016/S0015-0282(16)41294-X
  16. Newill R. AID-A review of 200 cases. BJU 1976; 48: 139-44 https://doi.org/10.1111/j.1464-410X.1976.tb02999.x
  17. Harlap S. Gender of infants conceived on different days of the menstrual cycle. N Engl J Med 1979; 300: 1445-8 https://doi.org/10.1056/NEJM197906283002601
  18. Virro MR, Shewchuk AB. Pregnancy outcome in 242 conceptions after artificial insemination with donor sperm and effects of maternal age on the prognosis for successful pregnancy. Am J Obstet Gynecol 1984; 148: 518-24 https://doi.org/10.1016/0002-9378(84)90739-7
  19. Adashi EY, Rock JA, Sapp KC. Gestational outcome of clomiphene related conception. Fertil Steril 1979; 31: 620-6 https://doi.org/10.1016/S0015-0282(16)44051-3
  20. James WJ Artificial insemination by donor: a review of 12 year's experience: a comment. J Biosoc Sci 1984; 16: 153-4
  21. Klock SC, Jacob MC, Maier D. A prospective study of donor insemination recipients: secrecy, privacy, and disclosure. Fertil Steril 1994; 62: 477-84 https://doi.org/10.1016/S0015-0282(16)56934-9
  22. Manuel C, Chevert M, Czyba J. Handling of secrecy by AID couples. In Human Artificial Insemination and Semen Preservation, Edited by G David, W Price. New York, Plenum Press 1980: 419-21
  23. Wright J, Duchesne C, Sabourin S, Bissonnette F, Benoit J, Girard Y. Psychologic distress and infertility: men and women respond differently. Fertil Steril 1997; 55: 100-8
  24. Bolton V, Golombok S, Cook R, Bish A, Rust J. A comparative study of attitudes towards donor insemination and egg donation in recipients, potential donors and the public. J Psychosom Obstet Gynecol 1991; 12: 217-28 https://doi.org/10.3109/01674829109078003
  25. Verp MS, Cohen MR, Simpson JL. Necessity of formal genetic screening in artificial insemination by donor. Obstet Gynecol 1983; 62: 474-9
  26. Virro MR, Shewchuk AB. Pregnancy outcome in 242 conceptions after artificial insemination with donor sperm and effects of maternal age on the prognosis for successful pregnancy. Am J Obstet Gynecol 1984; 148: 518-24 https://doi.org/10.1016/0002-9378(84)90739-7
  27. Claytom CE, Kouacs GT. AID: a pretreatment social assessment. Aust N Z J Obstet Gynaecol 1980; 20: 208-10 https://doi.org/10.1111/j.1479-828X.1980.tb00766.x
  28. Adamson D. Clinical management of psychological issues in therapeutic donor insemination. Presented at the 22nd annual Postgraduate Course of The American Fertility Society. San Francisco, California, 1989; 53
  29. Stewart C, Daniels K, Boulnois J. The development of a psaychosocial approach to artificial insemination of donor sperm. N Z Med J 1982; 95: 853-6
  30. Bendvold E, Moe N, Skjaeraasen J. Social conditions of children born after artificial insemination by donor. Scand J Soc Med 1990; 18: 203-6 https://doi.org/10.1177/140349489001800308
  31. Amuzu B, Laxova R, Shapiro SS. Pregancy outcome, health of children, and family adjustment after donor insemination. Obstet Gynecol 1990; 75: 899-905
  32. Lansac J, Royere D. Follow-up studies of children born after frozen sperm donation. Hum Reprod Update 2001; 7: 33-7 https://doi.org/10.1093/humupd/7.1.33
  33. Schover LR, Collins RL, Richards S. Psychological aspects of donor insemination: evaluation and follow-up of recipient couples. Fertil Steril 1992; 57: 583-90 https://doi.org/10.1016/S0015-0282(16)54904-8
  34. Farris EJ, Garrison M Jr. Emotional impact of successful donor insemination: a report on 38 couples. Obstet Gynecol 1954; 3: 19-20
  35. David A, Avidan D. Artificial insemination donor: clinical and psychologic aspects. Fertil Steril 1976; 27: 528-32 https://doi.org/10.1016/S0015-0282(16)41834-0